Four themes for diseases of despair (IMAGE) Penn State Caption Financial instability, lack of infrastructure, a deteriorating sense of community and family fragmentation are key contributors to diseases of despair in Pennsylvania communities, according to Penn State College of Medicine and Highmark Health researchers. Credit Penn State Usage Restrictions None License Licensed content Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.