Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?
<p><strong>Objectives</strong> In 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 Ca...
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
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BMJ Publishing Group
2023
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| _version_ | 1797112245494218752 |
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| author | Dowd, JB Angus, C Zajacova, A Tilstra, AM |
| author_facet | Dowd, JB Angus, C Zajacova, A Tilstra, AM |
| author_sort | Dowd, JB |
| collection | OXFORD |
| description | <p><strong>Objectives</strong> In 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.</p>
<p><strong>Design</strong> Descriptive analysis of population mortality rates.</p>
<p><strong>Setting</strong> The USA, UK (and constituent nations England and Wales, Northern Ireland and Scotland) and Canada, 2001–2019.</p>
<p><strong>Participants</strong> Full population aged 35–64 years.</p>
<p><strong>Outcome measures</strong> We 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.</p>
<p><strong>Results</strong> The 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.</p>
<p><strong>Conclusions</strong> In 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.</p> |
| first_indexed | 2024-03-07T08:23:00Z |
| format | Journal article |
| id | oxford-uuid:4907b29d-a290-4130-8cb5-3fb89c2282e0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:23:00Z |
| publishDate | 2023 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:4907b29d-a290-4130-8cb5-3fb89c2282e02024-02-05T13:32:22ZComparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4907b29d-a290-4130-8cb5-3fb89c2282e0EnglishSymplectic ElementsBMJ Publishing Group2023Dowd, JBAngus, CZajacova, ATilstra, AM<p><strong>Objectives</strong> In 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.</p> <p><strong>Design</strong> Descriptive analysis of population mortality rates.</p> <p><strong>Setting</strong> The USA, UK (and constituent nations England and Wales, Northern Ireland and Scotland) and Canada, 2001–2019.</p> <p><strong>Participants</strong> Full population aged 35–64 years.</p> <p><strong>Outcome measures</strong> We 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.</p> <p><strong>Results</strong> The 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.</p> <p><strong>Conclusions</strong> In 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.</p> |
| spellingShingle | Dowd, JB Angus, C Zajacova, A Tilstra, AM Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title | Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title_full | Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title_fullStr | Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title_full_unstemmed | Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title_short | Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? |
| title_sort | comparing trends in mid life deaths of despair in the usa canada and uk 2001 2019 is the usa an anomaly |
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