'Despair deaths' are not to blame for rising mortality rates among white Americans

Suicide and alcohol-related deaths – so-called 'despair deaths' – are not to blame for the increasing mortality rates among middle-aged white Americans, a new study has revealed. Instead, the US opioid epidemic and obesity are identified as important factors to explain these deaths.

Recent research has focused a lot on the phenomenon of 'despair deaths', arguing that the surge in mortality among middle-aged white Americans, men in particular, was fuelled by suicides and poisoning from alcohol and drug use.

These studies suggested that chronic pain and lack of economic opportunities explained why these middle-aged individuals turned to substances of abuse or decided to kill themselves.

Drug use on the rise

Using official mortality data from US registers – from the National Center for Health Statistics, the Centers for Disease Control and Prevention, and US Census Bureau - the authors of the new study now published in the International Journal of Epidemiology investigated the cause of death of non-Hispanic white men and women age 25 to 34 and 35 to 54, from 1980 to 2014.

In previous work, scientists had lumped together men and women, as well as drug, alcohol and suicide deaths together but in this study, the researchers disentangled the datasets, looking independently at genders, individual year ages and distinct causes of death.

Part of their analysis was to estimate trends in cause-specific mortality from suicides, alcohol-related deaths, drug-related deaths, and 'metabolic diseases' linked to obesity in each age group and for both genders.

One trend was very clear, in every group of individuals they studied - among men and women of all age cohorts studied, drug-related deaths appear to have skyrocketed by the turn of the century.

"It took off around the time when prescription opioids became readily available, and it has kept rising steadily ever since," lead author Ryan Masters, from the University of Colorado's Institute of Behavioral Science, said in a statement.

On the other hand, there was "no substantive increases in white men's alcohol-related mortality at any time." Furthermore, when the scientists looked at suicide trends, they did see a slight increase over the years linked to the economic crisis, but it was present in all age groups. These findings suggest that economic insecurity is not isolated to a single 'lost generation' and that it does not lead to despair and to suicide in massive proportions.

"We do not doubt that times of economic insecurity can have severe consequences for a population's health, nor do we doubt that pain and distress can pose serious health problems," the authors conclude. "However, taken together, our findings suggest that it is unlikely that recent trends in US white men's and women's mortality rates have been driven by an epidemic of pain and rising distress."

Rather, the scientists think that the mortality among white middle-aged Americans is more closely associated with the opioid epidemic, with the rise of prescription drugs for chronic pain, and to obesity, which causes many individuals to develop deadly diseases.