The stories have become all too familiar in Japan, though people often do their best to ignore them. An elderly or middle-aged person, usually a man, is found dead, at home in his apartment, frequently right in his bed. It has been days, weeks, or even months since he has had contact with another human being. Often the discovery is made by a landlord frustrated at not receiving a rent payment or a neighbor who notices an unpleasant smell. The deceased has almost no connections with the world around him: no job, no relationships with neighbors, no spouse or children who care to be in contact. He has little desire to take care of his home, his relationships, his health. “The majority of lonely deaths are people who are kind of messy,” Taichi Yoshida, who runs a moving company that often cleans out apartments where people are discovered long after they die, told Time magazine. “It’s the person who, when they take something out, they don’t put it back; when something breaks, they don’t fix it; when a relationship falls apart, they don’t repair it.” [...]
In many ways, kodokushi seems to be specifically Japanese. It’s afflicting a society simultaneously coping with significant change in family structure and a generation-long economic slump. Japanese people in sad isolation may feel limited by gaman, the ideal of suffering through tough times without complaint, keeping a stiff upper lip. Similarly, the society has traditionally rejected the American trend toward medicalizing mental illness and mood disorders, spurning talk therapy and antidepressants long after they became commonplace in the West. Many lonely seniors never reach out for help or connection.
But the increase in deaths of despair may not be unique to Japan. In November of last year, Nobel Prize–winning economist Angus Deaton and Anne Case reported a reversal in one of the most reliable and reassuring trends in modern public health: A big slice of the American populace was dying faster than expected. Deaton and Case, a pair of Princeton economists who happen to be married to each other, specifically found that the mortality rate for white people aged 45–54 without a college education had increased dramatically between 1999 and 2013. The increase ran counter to all recent historical precedent, and it contrasted with concurrent decreases among black and Hispanic people in the U.S. and nationwide decreases in all other rich countries. “Half a million people are dead who should not be dead,” Deaton told the Washington Post. “About 40 times the Ebola stats. You’re getting up there with [deaths from] HIV-AIDS.” Deaton said the increase is so contrary to longstanding trends that demographers’ first reaction would be to say, “‘You’ve got to have made a mistake. That cannot possibly be true.’”
