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Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide

Author

Listed:
  • Elisabet Beseran

    (Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain)

  • Juan M. Pericàs

    (Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
    Liver Unit, Internal Medicine Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute for Research, CIBERehd, 08036 Barcelona, Spain
    Johns Hopkins University—Pompeu Fabra University Public Policy Center (UPF-BSM), 08002 Barcelona, Spain)

  • Lucinda Cash-Gibson

    (Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
    Johns Hopkins University—Pompeu Fabra University Public Policy Center (UPF-BSM), 08002 Barcelona, Spain
    UPF Barcelona School of Management, Pompeu Fabra University, 08008 Barcelona, Spain)

  • Meritxell Ventura-Cots

    (Liver Unit, Internal Medicine Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute for Research, CIBERehd, 08036 Barcelona, Spain)

  • Keshia M. Pollack Porter

    (Johns Hopkins University—Pompeu Fabra University Public Policy Center (UPF-BSM), 08002 Barcelona, Spain
    Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
    Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Joan Benach

    (Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
    Johns Hopkins University—Pompeu Fabra University Public Policy Center (UPF-BSM), 08002 Barcelona, Spain
    Ecological Humanities Research Group (GHECO), Universidad Autónoma de Madrid, 28049 Madrid, Spain)

Abstract

Background: There is a lack of consensus on the social determinants of Deaths of Despair (DoD), i.e., an increase in mortality attributed to drug overdose, alcohol-related liver disease, and suicide in the United States (USA) during recent years. The objective of this study was to review the scientific literature on DoD with the purpose of identifying relevant social determinants and inequalities related to these mortality trends. Methods: Scoping review focusing on the period 2015–2022 based on PubMed search. Articles were selected according to the following inclusion criteria: published between 1 January 2000 and 31 October 2021; including empirical data; analyzed DoD including the three causes defined by Case and Deaton; analyzed at least one social determinant; written in English; and studied DoD in the USA context only. Studies were excluded if they only analyzed adolescent populations. We synthesized our findings in a narrative report specifically addressing DoD by economic conditions, occupational hazards, educational level, geographical setting, and race/ethnicity. Results: Seventeen studies were included. Overall, findings identify a progressive increase in deaths attributable to suicide, drug overdose, and alcohol-related liver disease in the USA in the last two decades. The literature concerning DoD and social determinants is relatively scarce and some determinants have been barely studied. However different, however, large inequalities have been identified in the manner in which the causes of death embedded in the concept of DoD affect different subpopulations, particularly African American, and Hispanic populations, but blue collar-whites are also significantly impacted. Low socioeconomic position and education levels and working in jobs with high insecurity, unemployment, and living in rural areas were identified as the most relevant social determinants of DoD. Conclusions: There is a need for further research on the structural and intermediate social determinants of DoD and social mechanisms. Intersectional and systemic approaches are needed to better understand and tackle DoD and related inequalities.

Suggested Citation

  • Elisabet Beseran & Juan M. Pericàs & Lucinda Cash-Gibson & Meritxell Ventura-Cots & Keshia M. Pollack Porter & Joan Benach, 2022. "Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12395-:d:928795
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    References listed on IDEAS

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    1. Stein, E.M. & Gennuso, K.P. & Ugboaja, D.C. & Remington, P.L., 2017. "The epidemic of despair among white americans: Trends in the leading causes of premature death, 1999-2015," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1541-1547.
    2. Diez Roux, A.V., 2017. "Despair as a cause of death: More complex than it first appears," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1566-1567.
    3. Anne Case & Angus Deaton, 2017. "Mortality and Morbidity in the 21st Century," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(1 (Spring), pages 397-476.
    4. Scutchfield, F.D. & Keck, C.W., 2017. "Deaths of despair: Why? what to do?," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1564-1565.
    5. repec:aph:ajpbhl:10.2105/ajph.2017.304041_8 is not listed on IDEAS
    6. Justin R. Pierce & Peter K. Schott, 2020. "Trade Liberalization and Mortality: Evidence from US Counties," American Economic Review: Insights, American Economic Association, vol. 2(1), pages 47-64, March.
    7. Rohde, Nicholas & Tang, K.K. & Osberg, Lars & Rao, Prasada, 2016. "The effect of economic insecurity on mental health: Recent evidence from Australian panel data," Social Science & Medicine, Elsevier, vol. 151(C), pages 250-258.
    8. repec:aph:ajpbhl:10.2105/ajph.2017.303992_3 is not listed on IDEAS
    9. Richard G. Rogers & Robert A. Hummer & Justin M. Vinneau & Elizabeth M. Lawrence, 2020. "Greater mortality variability in the United States in comparison with peer countries," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 42(36), pages 1039-1056.
    10. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    11. repec:aph:ajpbhl:10.2105/ajph.2017.303941_0 is not listed on IDEAS
    12. Vandoros, Sotiris & Avendano, Mauricio & Kawachi, Ichiro, 2019. "The association between economic uncertainty and suicide in the short-run," Social Science & Medicine, Elsevier, vol. 220(C), pages 403-410.
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    1. Lowenstein, Christopher, 2024. "“Deaths of despair” over the business cycle: New estimates from a shift-share instrumental variables approach," Economics & Human Biology, Elsevier, vol. 53(C).
    2. Camacho, Christine & Webb, Roger T. & Bower, Peter & Munford, Luke, 2024. "Risk factors for deaths of despair in England: An ecological study of local authority mortality data," Social Science & Medicine, Elsevier, vol. 342(C).

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