ArticleInternational journal of public health2026
Deaths of despair in England, 2014-2022: trends by sex and socioeconomic deprivation before and after COVID-19.
Article in International journal of public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Deaths of despair-alcohol, substance use, suicide and non-organic mental health related-have attracted international attention, but English evidence remains limited. We examined trends in deaths of despair in England (2014-2022), including COVID-19 impacts and inequalities by sex and deprivation. Methods: We analysed all registered deaths in England (2014-2022), identifying deaths of despair by ICD-10 code. Age-standardised mortality rates, years of life lost, and inequalities by sex and deprivation were calculated. Log-linear regression estimated pre-pandemic trends and deviations during COVID-19. Results: There were 133,600 deaths of despair (2.9% of all deaths). Age-standardised mortality rates rose 33%, from 22.6 to 30.1 per 100,000. Mortality was consistently higher in men and deprived areas, with widening inequalities. During COVID-19, mortality temporarily exceeded the pre-pandemic trend, particularly among women and deprived groups, before returning to trend. Deaths of despair accounted for a rising share of years of potential life lost (13.9%-16.6%). Conclusion: Deaths of despair increased substantially in England, contributing a growing burden of premature mortality. Persistent, widening inequalities highlight a public health challenge requiring surveillance and interventions addressing immediate causes and social determinants.
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