I confess that, when I ran for the Virginia state Senate four years ago, I didn’t talk about the opioid crisis. Not that I was indifferent to the human suffering; I just wasn’t fully aware of this fast-emerging problem in our area, and in America.

But it is so big now; one can’t help but see it. More Americans now die from such drug overdoses each year than died in the entire Vietnam war over more than a decade!

Such a huge human toll makes this opioid crisis – even considered by itself – one that must be dealt with in whatever ways will help. But now that I’m aware of this opioid problem, I can see that it is but one cause of a larger, deeper American problem – revealed by this alarming fact: for the last several years, the life-expectancy of Americans has been declining.

American lives being cut shorter in this way for so long a stretch of time has not occurred for a century – not since the end of World War I, and the terrible flu pandemic that swept the world, including the United States.

So why are Americans dying earlier now?

In addition to the deaths caused by opioid overdoses, two other causes have been identified: alcoholism (which kills by destroying the liver) and suicide (the rate of which in the U.S. has increased by some 40 percent over the past two decades).

These three factors together have been called “deaths of despair,” for those who study these problems have perceived in these three causes of death a growing problem of hopelessness among Americans – particularly in rural areas and in some parts of the nation (such as Appalachia).

With something that goes so deep into a society as widespread despair, it is not easy to know what to do about it. But we must make the effort to understand the underlying problems, and to deal with them effectively.

After all, can any patriotic American be content with a situation in which the United States ranks 64th in life-expectancy among the nations of the world? That should tell us that better is possible!

To what extent is the cause of the despair the declining economic fortunes of a large part of our population?

We know that prosperity has lately centered around cities – is that why rural areas have been hard hit by these “deaths of despair?”

We know that globalization has helped American capital but has hurt many American workers.

And to the extent that economic disappointment feeds the despair, what should we Americans call upon our state and national governments to do to help?

To what extent is the cause of despair the breakdown of the social networks that used to support people in their lives?

We know that family structures have been breaking down – that some of the groups where “deaths of despair” are occurring have lower rates of marriage, with families that do form breaking up more often.

And lately, it has been reported that nearly half of Americans say they suffer from chronic loneliness. Studies have also shown that since 1985 the social network of the average American has been reduced by one-third.

And if the despair that is killing so many Americans comes from the severing of supportive social bonds, what are we to do about it – through our communities, our churches, our governments?

Not an easy question to answer. But if we care about people, we cannot ignore the human suffering these numbers are screaming to us.

We have to know that those who are dying from despair are but the tip of the iceberg: for each one who actually goes to an early death out of such despair, how many others live on, weighed down by the absence of hope and joy?

Some people, it may be supposed, will say that these are problems that must be dealt with by individuals, who must take responsibility for their own lives.

Surely the idea of “individual responsibility” is an important and valid one. But it is not sufficient.

For one thing, whenever the numbers show that a problem has grown to epidemic proportions, it is a clear sign that something is going on that is larger than the individual. Whatever has gone this wrong at the societal level calls for action at that level.

Besides, most of us believe that we have been called upon to love our neighbors. When we love others, we do not turn away from them in their suffering, whatever their own role in that suffering may be.

Something important has gone wrong in America. We should confront and remedy it – treating not only the visible symptoms but the underlying causes as well.

April Moore is a Shenandoah County resident.