ArticleBMJ open2023
Comparing trends in mid-life 'deaths of despair' in the USA, Canada and UK, 2001-2019: is the USA an anomaly?
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed.
- Long-term negative divergence in mortality at ages 25-49 years between the United Kingdom and 21 peer countries between 1990 and 2019.European journal of epidemiology · 2026Article
- Causes of Excess Deaths in the US Compared With Other High-Income Countries.JAMA network open · 2026Article
- Slowdown in mortality improvements and trends in lifespan inequality across high-income countries: the role of changing causes of death, 2010-2021.European journal of public health · 2026Article
- The decline of 'Deaths of Despair' in Italy: unveiling this phenomenon in a new context.Population health metrics · 2026Article
- Deaths of despair before and during the COVID-19 pandemic: a comparative analysis of 27 European countries and the United States.Frontiers in public health · 2026Article
- Deaths of despair in England, 2014-2022: trends by sex and socioeconomic deprivation before and after COVID-19.International journal of public health · 2026Article
- Moralisation, stigmatisation, and downstream interventions: How symbolic violence sustains geographic inequalities in deaths of despair in England.Social science & medicine (1982) · 2025Article
- Employment quality and suicide, drug poisoning, and alcohol-attributable mortality.American journal of epidemiology · 2025Article
- Article
- Trends in educational inequalities in all-course mortality and deaths of despair in Swedish youths 1990-2018.SSM - population health · 2025Article
- "They pulled that funding away and we're not recovering. it's getting worse": deaths of despair in post-austerity north east England.International journal for equity in health · 2024Article
- "They're not mentally ill, their lives are just shit": Stakeholders' understanding of deaths of despair in a deindustrialised community in North East England.Health & place · 2024Article
- Faltering mortality improvements at young-middle ages in high-income English-speaking countries.International journal of epidemiology · 2024Article
- US exceptionalism? International trends in midlife mortality.International journal of epidemiology · 2024Article
- Article
- Lifestyle and psychosocial associations with cognition at the cusp of midlife using twins and siblings.Alzheimer's & dementia (Amsterdam, Netherlands)Article
- "They're Lacking Purpose. It's a Recipe for Suicide.": Masculinity and Gender-Based Inequalities in Deaths of Despair in England.American journal of men's healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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 MEASURES: 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.
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.