Invited Commentary: Stop Analyzing Suicides, Drug-Related Deaths, and Alcohol-Related Deaths Together

Tilstra, Andrea M

doi:10.1093/aje/kwad002

Cited by 6 publications

(2 citation statements)

References 10 publications

(7 reference statements)

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“…This is consistent with other work finding different spatiotemporal patterns of these causes within the USA 51. Future research should consider the determinants of these specific causes across place and time without assuming they represent an underlying phenomenon with the same underlying drivers 52…”

Section: Discussionsupporting

confidence: 90%

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Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?

Dowd,

Angus,

Zajacova

et al. 2023

BMJ Open

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ObjectivesIn recent years, ‘deaths of despair’ due to drugs, alcohol and suicide have contributed to rising mid-life mortality in the USA. We examine whether despair-related deaths and mid-life mortality trends are also changing in peer countries, the UK and Canada.DesignDescriptive analysis of population mortality rates.SettingThe USA, UK (and constituent nations England and Wales, Northern Ireland and Scotland) and Canada, 2001–2019.ParticipantsFull population aged 35–64 years.Outcome measuresWe compared all-cause and ‘despair’-related mortality trends at mid-life across countries using publicly available mortality data, stratified by three age groups (35–44, 45–54 and 55–64 years) and by sex. We examined trends in all-cause mortality and mortality by causes categorised as (1) suicides, (2) alcohol-specific deaths and (3) drug-related deaths. We employ several descriptive approaches to visually inspect age, period and cohort trends in these causes of death.ResultsThe USA and Scotland both saw large relative increases and high absolute levels of drug-related deaths. The rest of the UK and Canada saw relative increases but much lower absolute levels in comparison. Alcohol-specific deaths showed less consistent trends that did not track other ‘despair’ causes, with older groups in Scotland seeing steep declines over time. Suicide deaths trended slowly upward in most countries.ConclusionsIn the UK, Scotland has suffered increases in drug-related mortality comparable with the USA, while Canada and other UK constituent nations did not see dramatic increases. Alcohol-specific and suicide mortalities generally follow different patterns to drug-related deaths across countries and over time, questioning the utility of a cohesive ‘deaths of despair’ narrative.

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Section: Discussionsupporting

confidence: 90%

“…51 Future research should consider the determinants of these specific causes across place and time without assuming they represent an underlying phenomenon with the same underlying drivers. 52 Twitter Jennifer Beam Dowd @drjenndowd and Colin Angus @VictimOfMaths…”

Section: Discussionmentioning

confidence: 99%

Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?

Dowd,

Angus,

Zajacova

et al. 2023

BMJ Open

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Age, period, and cohort trends of substance poisoning, alcohol-related disease, and suicide deaths in Australia, 1980–2019

Bharat,

Hopkins,

Chambers

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose Deaths due to substance poisoning, alcohol-related disease, and suicide pose a critical public health issue, and have been categorized as “deaths of despair” in the US. Whether these deaths represent a distinct phenomenon requires exploration, particularly in other countries. Methods This retrospective observational study examines age-period-cohort trends of (combined and cause-specific) substance poisoning, alcohol-related disease, and suicide deaths among Australians aged ≥15-years that occurred between 1980 and 2019 and compares trends between males and females. Results Combined mortality rates were initially (1980–1999) relatively stable, reflecting a reduction in alcohol-related disease deaths offset by an increase in substance poisoning deaths. A decline (2000–2006) and subsequent increase (2007–2019) in combined rates were primarily attributable to corresponding changes in both substance poisoning and suicide deaths among males. Distinct age-period-cohort trends were observed between cause of death sub-types, with net drifts: increasing for male (net drift [95% CI]: 3.33 [2.84, 3.83]) and female (2.58 [2.18, 2.98]) substance poisoning deaths; decreasing among male alcohol-related disease (− 1.46 [− 1.75, − 1.16]) and suicide deaths (− 0.52[− 0.69, − 0.36]); and remaining relatively stable for female alcohol-related disease (− 0.28 [− 0.66, 0.09]) and suicide deaths (− 0.25 [− 0.52, 0.01]). Conclusions Although combined age-specific trends were relatively stable over the study period, different and distinct patterns were observed within cause-specific deaths, challenging the notion that these causes of death represent a distinct epidemiological phenomenon. These data indicate a critical need to review the appropriateness of guidance for clinical practice, prevention strategies, and policy initiatives aimed at preventing future deaths.

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Defining despair: Assessing the multidimensionality of despair and its association with suicidality and substance use in early to middle adulthood

Gutin

Copeland

Godwin

et al. 2023

Social Science & Medicine

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Invited Commentary: Stop Analyzing Suicides, Drug-Related Deaths, and Alcohol-Related Deaths Together

Cited by 6 publications

References 10 publications

Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?

Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?

Age, period, and cohort trends of substance poisoning, alcohol-related disease, and suicide deaths in Australia, 1980–2019

Defining despair: Assessing the multidimensionality of despair and its association with suicidality and substance use in early to middle adulthood

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