Mejia, M.C et al. (2024).
Advances in Preventive Medicine
and Health Care, 7(2).
Abstract
Objective: The International Classification of Disease (ICD) assumes that each disease entity is distinct. The hypothesis that each disease entity may have similar underlying and contributory factors have led to the emerging concept of “deaths of despair.” Our objective was to explore temporal trends in the occurrence of United States (US) deaths of despair from 1999 to 2021.
Methods: We utilized the previously defined definition as a constellation of 19 underlying causes: chronic hepatitis; liver fibrosis/cirrhosis; suicide/sequelae of suicide; poisoning (accidental or undetermined intent) or exposure to nonopioid analgesics, antipyretics, rheumatic, antiepileptic’s, sedative hypnotics, antiparkinson and psychotropic drugs; narcotics, psychodysleptics, drugs acting on the central nervous system, and alcohol. We used mortality data for those 25 to 74 years of age from 1999 to 2021
to calculate annual percent changes (APC) as measures of effect size and joinpoint regression to test for statistical significance. We used the US Centers for Disease Control and Prevention (CDC) Wide-Ranging Data for Epidemiologic Research (WONDER)
and the Multiple Cause of Death files.
Results: Using this definition, deaths of despair were the fifth leading cause of US mortality in 2021. From1999 to 2021, the APCfor deaths of despair increased 2.5-fold among people aged 25- to 74-years.
Conclusions: Using this definition, deaths of despair would have been the 5th leading cause of death in the US in 2021. Healthcare providers should have an increased awareness of deaths of despair. Public health practitioners may consider new initiatives to prevent deaths of despair locally, regionally, and nationally.
Here are some thoughts:
This research article examines the increasing trend of "deaths of despair" in the United States from 1999 to 2021, defining these deaths as those resulting from chronic hepatitis, liver cirrhosis, suicide, and poisonings related to substances like alcohol and drugs. Analyzing mortality data from the CDC, the study reveals a 2.5-fold increase in these deaths among individuals aged 25-74. In 2021, deaths of despair would have been the fifth leading cause of death in the U.S., surpassing cerebrovascular diseases, if categorized as such. The authors advocate for integrated strategies addressing both clinical and socioeconomic factors, including enhanced mental health services, and suggest considering a specific classification for deaths of despair in future ICD revisions.
This study underscores the urgent need for psychologists to broaden their approach to mental health care by directly addressing the socioeconomic factors contributing to despair, such as economic instability and lack of access to healthcare. By understanding the influence of these external factors, psychologists can better tailor interventions to build resilience in vulnerable populations.
