Evidence map›Paper›PMID 40394421›Full record

ArticleSocial psychiatry and psychiatric epidemiology2025

Income inequality and deaths of despair: a population-based study of 19 million Canadian adults.

Jason Mulimba Were, Gregory Farmer, Claire Benny, Brendan T Smith, Shelby Yamamoto, Katerina Maximova, Candace I J Nykiforuk, Frank Trovato, Ambikaipakan Senthilselvan, Arjumand Siddiqi and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jason Mulimba Were *University of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Gregory Farmer *University of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Claire BennyUniversity of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Brendan T SmithPublic Health Ontario, Toronto, Ontario, M5G 1M1, Canada.
Shelby YamamotoUniversity of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Katerina MaximovaDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada.
Candace I J NykiforukUniversity of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Frank TrovatoDepartment of Sociology, University of Alberta, Edmonton, Alberta, T6G 2H4, Canada.
Ambikaipakan SenthilselvanUniversity of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada.
Arjumand SiddiqiDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada.
Roman PabayoUniversity of Alberta School of Public Health, Edmonton, Alberta, T6G 1C9, Canada. pabayo@ualberta.ca.

Funding

CIHR 438740
6 · The paper itself

Abstract

purposeTo estimate the association between regional level income inequality (a relative measure of socioeconomic disparity) and deaths of despair and assess whether this association is moderated by age, gender, racialized minority status, and income.

methodsData from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) study were used. A cohort of Canadian adults (n = 19,436,790) within 288 CDs were followed from May 2006 to December 2019. Multilevel Cox-proportional hazard regression was used to estimate the association between income inequality and time to deaths attributed to suicide, drug overdose, and alcohol.

resultsIn models adjusted for confounders, income inequality was associated with time to death due to alcohol (HR = 1.14; 95% CI: 1.05, 1.25), drug overdose (HR = 1.19; 95% CI: 1.06, 1.33), and deaths of despair (HR = 1.05; 95% CI: 1.00, 1.11). Significant interactions were primarily observed in cases of deaths attributed to drug overdose. The association between income inequality and the hazards for drug overdose deaths was stronger for individuals aged 40-49 (HR = 1.71; 95% CI: 1.24, 2.37), males (HR = 1.69; 95% CI: 1.22, 2.35), from low-income households (HR = 1.69; 95% CI: 1.22, 2.35), self identified as White (HR = 1.69; 95% CI: 1.22, 2.35) and those living in low-income areas (HR = 1.69; 95% CI: 1.22, 2.35).

conclusionIncome inequality is associated with high risk of deaths of despair. Additionally, this association is significantly moderated by age, gender, racialized minority status and income at the household and area levels. As such, our findings suggest the need to address income inequality in interventions for reducing deaths of despair among Canadian adults.

Indexed as

Drug OverdoseIncomeSuicideAdultAgedCanadaCause of DeathCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsSocioeconomic FactorsYoung AdultCohort studyDeaths of despairIncome inequalityPopulation-based studySurvival analysis

Identifiers

PMID40394421

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.