Observational studyJournal of epidemiology and community health2025
Educational inequalities in deaths of despair in 14 OECD countries: a cross-sectional observational study.
Observational study in Journal of epidemiology and community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The trial behind it
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Who cites it
5 citing papers in PubMed.
- Causes of death contributions to the sex gaps in life expectancy: evidence by education levels from Australia.BMC public health · 2026Article
- Qualitative evidence for the determinants of deaths of despair: a scoping review.BMC 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
- Trends in educational inequalities in all-course mortality and deaths of despair in Swedish youths 1990-2018.SSM - population health · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
backgroundDeaths of despair are a key contributor to stagnating life expectancy in the USA, especially among those without a university-level education, but these findings have not been compared internationally.
methodsMortality and person-year population exposure data were collected in 14 Organisation for Economic Co-operation and Development member countries and stratified by age, sex, educational attainment and cause of death. The sample included 1.4 billion person-year observations from persons aged ≥25 years between 2013 and 2019. Country-specific and sex-specific contributions of deaths of despair to: (a) the life expectancy gap at age 25 and (b) rate differences in age-standardised mortality rates between high and low educational attainment groups were calculated.
resultsEliminating deaths of despair could reduce the life expectancy gap in the USA by 1.1 years for men and 0.6 years for women was second only to Korea, where it would reduce the gap by 3.4 years for men and 2.2 years for women. In Italy, Spain and Türkiye, eliminating deaths of despair would improve life expectancy gains by less than 0.1 years for women and 0.3 years for men, closing the educational gap by <1%. Findings were robust to controls for differences in population structures.
conclusionsDeaths of despair are a major determinant of educational inequalities in longevity in Korea and the USA, while having limited impact in Southern European countries, indicating substantial international variation and scope for improvement in high burden high-income countries.
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