Meaning-making in Contexts of Despair

Abstract

This dissertation examines the empirical problem at the center of the “deaths of despair” epidemic: how are the declining social positions of working-class rural Americans connected to their psychological distress and ultimately, their higher rates of preventable midlife mortality? While prior research shows that declining social position is connected to negative mental health outcomes in this population, it does not explore the meanings that precede and comprise affected individuals’ experience. I extend this scholarship by examining the ways that middle- and working-class people living in areas said to be affected by this epidemic of low mental health—one that is almost entirely confined to low-skilled, low-educated midlife adults—make sense of their social worlds, and how class-based meaning-making processes relate to differential mental health outcomes. Using data from in-depth interviews with 79 people living in rural central-southwestern Pennsylvania over a five-month period, this research compares how people of different socio-economic standing understand their stressful past experiences, their methods of coping with stress, and their close relationships. I consider how social position “gets under people’s skin” and shapes the way that respondents draw meaning from their experience, and propose an explanation of the meaning-making process that connects people’s social position and their mental health.