Science
Are 'deaths of despair' really more common for white Americans? A UCLA report says no
Nakeya Fields has seen how the stresses that come with being Black — racial injustice, financial strain, social isolation — can leave people feeling hopeless and push some into substance abuse.
It’s one of the reasons the Pasadena social worker started offering “therapeutic play” gatherings for Black mothers like herself and children.
“I’m trying to host more safe spaces for us to come and share that we’re suffering,” the 32-year-old said. “And honestly, the adults need play more than kids.”
Yet while Black and brown mental health practitioners such as Fields have labored to address these issues within their communities, a very different conversation has been occurring in the nation at large.
For years, discussions about America’s substance-abuse crisis have focused almost exclusively on the narrative that it is white, middle-age adults who face the greatest risk of dying from drug overdoses, alcoholic liver disease and suicide.
The theory, which was presented by two Princeton economists in 2015 and based on data from 1999 to 2013, argued that despair was behind rising premature mortality rates among white Americans, especially those who were less educated.
Virtually overnight, the “deaths of despair” concept began to drive the national discourse over populist far-right politics; the rise of Donald Trump; and deepening political polarization over such topics as addiction treatment, law enforcement and immigration.
But after roughly a decade, researchers at UCLA and elsewhere have begun to dismantle this idea.
In a study published recently in the journal JAMA Psychiatry, authors found that deaths of despair rates for middle-age Black and Native Americans have surged past those of white Americans as the overdose crisis moves from being driven by prescription opioids to illegal drugs such as fentanyl and heroin.
While the opioid crisis did raise drug overdose deaths among white Americans for a time, it was an anomaly, said Joseph Friedman, a social medicine expert at UCLA’s David Geffen School of Medicine who was the lead author of the journal analysis. In fact, by 2022 the rate for white Americans had started to dip.
“What’s really important is that now, with these three causes of death, the gap has closed, and it’s moving in the other direction,” Friedman said.
Sandra Mims, a community health worker with Community Health Project L.A., puts out boxes of Narcan — a naloxone nasal spray that reverses the effects of opioid overdose — at an event at MacArthur Park in Los Angeles on International Overdose Awareness Day.
(Mel Melcon / Los Angeles Times)
The analysis found that deaths of despair for Black Americans hit a rate of 103.81 per 100,000 people in 2022, compared with 102.63 for white Americans. The rate for Native American and Alaska Native populations was even higher at 241.7 per 100,000 people in 2022.
The UCLA analysis doesn’t specify the midlife personal issues that might have led to addiction or suicide.
But the authors say that flaws in the methodology of the 2015 deaths of despair report skewed its conclusions about who was most at risk. Specifically, Friedman said that it failed to give enough consideration to long-standing racial inequities that Black Americans experience in income, educational attainment, incarceration and access to quality medical care, all of which can contribute to drug use and poor mental health outcomes. And statistics for Native Americans weren’t factored in at all.
“It was burned into the American psyche that it was white people in the rural U.S.,” Friedman said. “It was just a very small piece of the truth that was very interesting but was widely sold as something it wasn’t.”
Another recent worrying sign, Friedman says: Deaths of despair among Latinos are starting to catch up to those among Black and Native Americans.
Princeton professors Anne Case and her husband Angus Deaton, winner of the 2015 Nobel Prize in economic sciences, were thrust into the media spotlight when their deaths of despair findings were first published. Deaton told NPR that during a visit to the White House, even President Obama asked him about the phenomenon.
Their 2020 book, “Deaths of Despair and the Future of Capitalism,” was described by publisher Princeton University Press as “a troubling portrait of the American dream in decline.”
“For the white working class, today’s America has become a land of broken families and few prospects. As the college educated become healthier and wealthier, adults without a degree are literally dying from pain and despair,” the publisher said.
Fields, who employs yoga and pottery in her therapy, said this framing was misleading and racially biased.
“I’m actually flabbergasted that somebody has a term called ‘deaths of despair,’” Fields said. “It’s ‘despair’ when white people experience this suffering. But when we experience it, it’s just what we have to deal with.”
Nakeya Fields says it’s important to address mental wellness issues early, before people reach a crisis point and become another statistic.
(Jason Armond / Los Angeles Times)
Both Friedman and Fields say their critiques are not intended to minimize deaths among white Americans.
Still, Friedman wonders: “How do we empower Black and Native American communities in a way that enables them to treat these problems?”
Racism must be considered when trying to make sense of the crisis in premature deaths, says Dr. Helena Hansen, head of UCLA’s Department of Psychiatry and a senior author on Friedman’s analysis. Hansen, who is Black and specializes in addiction psychiatry, also co-authored the book “Whiteout: How Racial Capitalism Changed the Color of Opioids in America.”
For years, pharmaceutical companies steered expensive prescription pain medications, such as the opioid Oxycontin, as well as the most effective medications for opioid-use disorder, to white Americans with good access to healthcare, she said.
But at the same time, Black and brown Americans were unfairly subjected to law enforcement policies that prioritized incarceration for illegal drug use over increasing access to more humane medical strategies to help them, further harming already vulnerable communities, Hansen said.
“In our society, people with access to the new technologies and pharmaceuticals are more likely to be white,” Hansen says. “None of this is by accident. All of this is the direct result of careful racially and class-segmented marketing strategies by pharmaceutical companies.”
This two-tiered system arose because drug manufacturers, doctors and policymakers have for too long failed to see people from historically marginalized communities who live with addiction and mental health crises as worthy of the same sympathy and treatments that many white Americans receive, Hansen says.
Joseph Gone, a professor of anthropology at Harvard who has spent 25 years studying the intersection of colonialism, culture and mental health in Indigenous communities, agreed.
“Deaths of despair have been a reality for Indigenous communities since conquest and dispossession,” he said.
“It’s amazing how much grief our people contend with from early deaths — there are not that many communities in America that bear it quite the way we do,” said Gone, who is a member of the Aaniiih-Gros Ventre tribal nation of north-central Montana. “Until we acknowledge and take responsibility for the casualties of colonization, which endure to this day through deaths of despair, it’s going to be very hard to turn this around.”
Gone, who has collaborated with Friedman on previous research, says the mental health crisis in tribal nations is aggravated by widespread joblessness and generational poverty, and a lack of healthcare resources to treat people in need of immediate or long-term treatment.
Just one traveling psychiatrist serves reservations spread across both Montana and Wyoming — a region covering more than 243,300 square miles — mostly to manage patients’ prescriptions, he says.
And “for all of Indian country, we’re talking about a very small number of in-patient psychiatric facilities,” Gone says.
General practitioners can serve as a first line of defense, but they are not necessarily equipped to address the ongoing life crises that can lead to excessive drug and alcohol use, Gone says.
Fields says it’s important to address mental wellness issues early, before people reach a crisis point and become another statistic.
While her focus remains on Black women, she’s developed additional programming for adults, families and children, such as developmental screenings that measure for high stress levels. In June, Fields will co-present “Rap 4 Peace,” a conference and gala featuring hip-hop artists talking about mental health and reducing gun violence.
“This ‘tragedy of despair’ lives in us,” Fields says. “We breathe it. We go outside hoping that nobody will harm us or our children because they feel threatened by us. This is truly harmful to our bodies.”
Science
Water from Boyle Heights warehouse fire carries foam into L.A. River, sparks testing
LOS ANGELES — All the water unleashed onto the warehouse fire in Boyle Heights — some of it 480 gallons at a time by helicopter — had to end up somewhere.
That somewhere is the Los Angeles River.
Los Angeles Fire Department crews ripped through 50-foot walls filled with foam insulation to get to the building’s steel skeleton and its storage racks.
Charred chunks of foam have been floating from the burn site, partially blocking storm drains. Now organizers from East Yard Communities for Environmental Justice are teaming up with scientists from UCLA and Columbia University to find out more about what’s in the runoff.
“The community here is really interested in knowing, ‘Are there any contaminants that are potentially making their way down to the L.A. River?’” said Yoshira “Yoshi” Ornelas Van Horne, UCLA assistant professor in environmental health sciences. “We really can’t answer that unless we actually have measures and samples analyzed.”
Water samples collected directly from the warehouse fire runoff have been shipped to Columbia‘s Multi-Element Trace Analysis Laboratory in New York, which has a spectrometer that can identify trace levels of elements. The lab also has relationships with researchers in Southern California.
1. Emmanuel Carrera Ruedas, left, and Casey Cooper prep containers to take water samples from the L.A. River. 2. Casey Cooper holds a water sample. (Christina House / Los Angeles Times)
The data will then come back to UCLA for analysis. For now, the scientists and community advocates only have the money to test for copper, lead and arsenic, Ornelas Van Horne said. Residents have expressed interest in testing for more contaminants.
As the water from the firefighting efforts trickles through the warehouse in rivulets, it forms a stream at the corner of S. Indiana and Noakes streets, that gushed into the storm drain. On a recent visit, the water traversed a smoky 10-foot canyon of charred foam and twisted wall panels on its way to the drain.
From there, the water flows to the L.A. River. Despite the fact that its concrete design is intended to whisk water out of the city as fast as possible, life stubbornly persists in the river and nearby. Recreational swimming is not permitted, yet anglers fishing for tilapia, largemouth bass and carp are a common sight along the rocky sides of the soft-bottom areas.
The L.A. River, and all it carries with it, meets the ocean in Long Beach.
The L.A. County Public Works Department said it has deployed three containment booms — floating barriers — on the L.A. River, and is continuing to monitor the water as it makes its way to the ocean.
Emmanuel Carrera Ruedas takes a water sample.
(Christina House / Los Angeles Times)
Before it gets there, the river passes through the Dominguez wetlands, where Public Works is removing some number of dead fish. The wetland has absorbed toxic runoff from a warehouse fire before, resulting in a fish die-off.
“For so long, the L.A. River has been used as a dumping ground for all kinds of chemicals,” said Emmanuel Carrera Ruedas, a community scientist and member of East Yard Communities for Environmental Justice.
Pollution has plagued the L.A. River, but it does have allies. In the 1980s, the Friends of the LA River pushed to address street runoff and trash that had made the water body infamous. Significant progress from advocacy and government initiatives improved water conditions, but these efforts have not been equally distributed.
Carrera said the samples represent “proof of what’s actually going on, and accountability, too, for the city, of not just what’s happening in our air, but what’s actually happening in our waterways.”
The first samples for the project were taken last Friday, the second day of the fire.
They were the first of 20 samples the research groups have agreed to test at no cost to see if any exceed regulatory standards and could pose a risk to people nearby.
The warehouse fire represents the latest environmental disaster for people in Boyle Heights and East L.A. Just four weeks ago, a telecommunications crew accidentally struck one of the many oil pipelines beneath the L.A. area, spilling 25,000 gallons of crude oil near Eastern and Cesar Chavez avenues — including into storm drains feeding to the L.A. River.
“I think it really is difficult to see disaster after disaster hit the communities here, with not a lot of talk about how we can move through these disasters together,” said Casey Cooper, a volunteer community scientist involved in the sampling. They were inspired, they said, by the response of neighbors, and how people were supporting one another.
Results from the laboratory analysis could be back to Ornelas Van Horne within a month.
Science
EPA touts crackdown on smuggled pesticides in L.A. visit
The U.S. Environmental Protection Agency is ramping up its enforcement of illegal pesticides smuggled through the ports of Long Beach and Los Angeles, officials said during a visit to L.A. on Thursday.
Since President Trump began his second term in January 2025, EPA has blocked more than 2.4 million pounds of illegal pesticides from entering the country, said Lee Zeldin, the agency’s administrator. Much of it comes from China, but some comes from Mexico and, on the East Coast, from Africa.
“We’re very alarmed by any chemical that anyone would seek to bring into this country that our own government hasn’t had the opportunity to vet, to research to fully understand,” Zeldin said. “That’s why it’s so important that these products get stopped at the border.”
The announcement came just hours after the Supreme Court handed a major victory to the makers of the weedkiller Roundup, shielding it from thousands of lawsuits from states alleging the company failed to warn people the product could cause cancer.
Speaking from a U.S. Customs and Border Protection warehouse in Carson, Zeldin pointed to a white bottle with a yellow label reading “SNIPER” — an illegal pesticide product commonly imported from abroad and sold online — that was recently intercepted at the Port of L.A. complex. Sniper contains dichlorvos, or DDVP, a highly toxic insecticide that is not registered or approved for use in the U.S. It is known to cause neurological problems, convulsions and comas, with children particularly at risk.
Illegal pesticides are cause for concern in California, where they are often associated with illegal cannabis operations. Last year, Siskiyou County declared a local emergency in response to the “escalating threat” posed by illegal pesticides, often fumigants, in illicit cannabis operations.
“These chemicals, when burned, create thick, poisonous smoke that presents serious risks to public health, the environment, waterways, and first responder safety,” the county said.
A 2024 Los Angeles Times investigation found that contraband Chinese pesticides used on cannabis farms is a growing problem in the state.
Customs and Border Protection seized containers of an illegal pesticide from China that were packed with legitimate items.
(Myung J. Chun/Los Angeles Times)
Much of the illegal product comes through the ports of L.A. and Long Beach, which together handle more than 30% of the nation’s container traffic, officials said. EPA works closely with Border Patrol officials, who flag suspicious cargo containers at the port for further inspection.
CBP spokesman Jaime Ruiz said the agency is using artificial intelligence tools to help scan incoming cargo manifests for potentially illegal items. Thousands of containers are flagged for inspection each year, although that number also includes drugs, counterfeit goods and other contraband in addition to pesticides, he said. He could not immediately say what percentage were illegal pesticides.
Illegal pesticides have at times been found in California agriculture and the California Department of Pesticide Regulation has taken enforcement action against violators. The DPR operates one of the nation’s largest pesticide residue testing programs, analyzing some 3,500 produce samples each year from wholesale and retail stores and other outlets. The state produces about half of the nation’s fruits and vegetables.
Jeff Hall, assistant administrator of EPA’s Office of Enforcement and Compliance, said the issue should be bipartisan.
“We cannot allow foreign actors to profit by sending toxic and poisonous products into the United States and poisoning American communities,” he said. “This is a message that we should all be able to agree on, especially for pesticides.”
However, the agency’s visit to L.A. arrived at a fractured moment for U.S. pesticide regulation and for the Trump-aligned Make America Healthy Again movement.
On Thursday, the Supreme Court ruled 7-2 in favor of Bayer’s Monsanto, the maker of the powerful weedkiller Roundup, shielding it from thousands of state lawsuits that allege the company failed to warn people the product could cause cancer.
Roundup contains glyphosate, which was classified by the World Health Organization as “probably carcinogenic” in 2015. But the Supreme Court found that the company can’t be sued in state courts because federal agencies — including the EPA — have determined that it’s not likely to cause cancer in humans when used as directed. The EPA has repeatedly approved a label for the product without a cancer warning.
“When people are exposed to pesticides, they deserve honest warnings about the risks,” said Bill Jordan, former deputy director of EPA’s Office of Pesticide Programs, in a statement. “The Court’s decision leaves families, workers, and communities with fewer tools to protect themselves and to recover damages when they are injured by a pesticide.”
Science
Drug overdoses in L.A County drop for third straight year. Here’s why
For the third year in a row, accidental drug-related overdose and poisoning deaths have dropped in Los Angeles County, a decline officials attribute to ongoing investments in prevention and harm reduction resources countywide.
There were 2,298 accidental drug overdose and poisoning deaths in 2025, down 6%, a relatively small drop from 2,438 the prior year but an overall substantial reduction from the all-time high of 3,220 deaths countywide in 2022, according to a recent report from the Los Angeles County Department of Public Health.
Drug overdoses continue to be the leading cause of accidental deaths countywide — surpassing the deaths due to vehicle crashes and firearms in 2017 combined — with methamphetamine and fentanyl most often involved in the overdoses.
The problem reached a historic high in 2022 when fentanyl surpassed methamphetamine as the most common drug listed as a cause of overdose deaths. At the time, the number of overdoses in general had increased across the board.
However, these accidental deaths have been on a downward trend, with a nearly 30% overall decrease in drug-related overdoses from 2022 to 2025. Fentanyl-related deaths dropped by 40% and methamphetamine-related deaths declined by 25% in that period.
Officials said in the report that the numbers are more modest compared with 2024, when accidental overdose deaths plunged overall by 22%, which they said “demonstrates sustained progress in the County’s efforts to address the overdose crisis.”
“Three consecutive years of fewer overdose deaths in LA County is proof that sustained investments in prevention, harm reduction, treatment, and recovery services saves lives,” Barbara Ferrer, director of the Los Angeles County Department of Public Health, said in a statement.
Ferrer credited the continued reduction to outreach workers and community partners who “are working every day to connect people to treatment, distribute lifesaving naloxone and meet people where they are without judgment.”
The department continues to invest in a coordinated spectrum of community-based overdose prevention efforts that include the Fentanyl Frontline — a multimedia campaign focused on the widespread distribution of naloxone — and ByLAforLA.org, a community-powered platform that connects residents to lifesaving services with an aim to reduce stigma.
The health department report also found:
- Los Angeles County overdose deaths declined across most age groups in 2025 but deaths among adults 65 and older increased by 14%.
- Although older adults accounted for only 11% of all overdose deaths, this increase contrasts with the broader downward trend observed across other age groups, according to the report.
- Those aged 40 to 64 remained the most affected group, accounting for 53% of overdose deaths last year.
- Communities with 30% of residents living below the federal poverty level had a higher rate of drug overdose deaths than areas with less than 10% of families living below the federal poverty level.
- By race, Black residents continued to experience the highest overdose death rates in 2025.
- By gender, a persistent disparity remains, with men accounting for most overdose deaths, nearly 1,800 compared with more than 500 deaths among women.
Nationwide, opioid overdose deaths have been on the decline since mid-2023, driven largely by decreases in fentanyl-related deaths, but the numbers remain above pre-pandemic levels, according to a recent report by KFF, a national health policy organization.
KFF said multiple policy actions have contributed to the decline, including efforts to expand access to treatment as well as overdose-reversal drugs and public awareness campaigns. At the federal level, there have been some efforts to mitigate the crisis including improving fentanyl detection at ports and borders.
“Despite progress, a range of more recent federal policy actions may affect future trends, including federal budget cuts, federal staffing reductions, and cuts to federal grants that support state and local programs; reduced Medicaid and Marketplace coverage; and a shift toward a more enforcement-focused approach, including the designation of illicit fentanyl as a ‘Weapon of Mass Destruction,’” according to the report.
Los Angeles County residents can access assistance for substance-use services 24 hours a day, seven days a week by calling (800) 854-7771, select Option 2 after the language prompt.
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