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As Gen-Xers Reach Middle Age, Indicators of Despair Grow

April 26, 2019

Indicators of despair are rising among US adults from Generation X who are now entering midlife, warns a study in the American Journal of Public Health.

“Despite a lack of scientific consensus regarding the cause of elevated midlife mortality among Whites, the image of the forgotten low-educated, White, rural American has captured the public’s attention,” wrote lead author Lauren Gaydosh, PhD, an assistant professor at Vanderbilt University in Nashville, Tennessee, and colleagues. “By contrast to this narrative, our findings demonstrated a generalized increase in multiple indicators of despair among all White, Black, and Hispanic adults in their 30s.”

The study used data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of US adolescents that began in 1994 and tracked the physical and mental health of participants through 2017.

Systemic Midlife Inflammation Linked With Steeper Cognitive Decline

Among Americans born between 1974 and 1983, adolescence tended to be rocky, followed by a period of improvement when participants hit their 20s. But researchers found indicators of despair—specifically depression, suicidal ideation, and substance abuse—rising across demographic groups when participants reached their late 30s.

“We found that suicidal ideation, depressive symptoms, marijuana use, and heavy drinking increased as the cohort aged into their late 30s,” researchers wrote. “We found no evidence that increases in despair were limited to low-educated Whites.”

The findings suggest midlife mortality due to so-called “deaths of despair” previously observed among low-educated Baby Boomers may begin to impact the youngest members of Generation X more broadly in the coming years.

“Public health efforts to reduce despair targeted only to low-educated Whites, or in rural areas, would be misdirected,” researchers wrote. “Instead, efforts to reduce depression, suicidality, and substance use should target the general population of US young adults who are experiencing rising despair as they enter midlife.”

—Jolynn Tumolo


Gaydosh L, Hummer RA, Hargrove TW, et al. The depths of despair among US adults entering midlife. American Journal of Public Health. 2019;109(5):774-780.

Entman L. Indicators of despair rising among Gen X-ers entering middle age [press release]. Nashville, Tennessee: Vanderbilt University; April 17, 2019.

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