Deaths of despair: cause-specific mortality and socioeconomic inequalities in cause-specific mortality among young men in Scotland.
Level 3 - non-randomized controlled study
Population-based longitudinal registry and trend analysis (by design analogy)
PubMed 33276793 · doi:10.1186/s12939-020-01329-7
What was done
The authors analyzed population-wide Scottish vital statistics data to compute directly age-standardized mortality rates for men aged 15–44 years between 1980 and 2018 across 15 leading causes of death. Absolute and relative socioeconomic inequalities in cause-specific mortality were calculated across small-area deprivation indices using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII_L) for 2001–2018.
What was found
Between 1980 and 2018, overall mortality among Scottish men aged 15–44 saw only minor reductions, while drug-related deaths rose from 1.2 (95% CI 0.7–1.4) to 44.9 (95% CI 42.5–47.4) deaths per 100,000, becoming the leading cause of mortality. Between 2001 and 2018, absolute inequalities in drug-related mortality doubled from an SII of 66.6 (95% CI 61.5–70.9) in 2001–2003 to 120.0 (95% CI 113.3–126.8) in 2016–2018. Together, drug harm, alcohol harm, and suicide accounted for 65% of absolute inequalities in mortality.
Why it matters
This study shows that preventable deaths of despair are concentrated in socioeconomically deprived areas and drive the vast majority of widening mortality inequalities among young Scottish men, offsetting general population mortality improvements.
Limits
The abstract restricts analysis to men aged 15–44 in Scotland, omitting women and older cohorts. Deprivation was assessed using small-area measures rather than individual socioeconomic status, and total participant count (n) is not explicitly quantified in the abstract.
Cited by
- supports Deaths of despair are one of the primary causes of death in people under the age of 30.