Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide

Elisabet Beseran, Juan M. Pericàs, Lucinda Cash-Gibson, Meritxell Ventura-Cots, Keshia M. Pollack Porter and Joan Benach ()
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Elisabet Beseran: Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
Juan M. Pericàs: Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
Lucinda Cash-Gibson: Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain
Meritxell Ventura-Cots: Liver Unit, Internal Medicine Department, Vall d’Hebron University Hospital, Vall d’Hebron Institute for Research, CIBERehd, 08036 Barcelona, Spain
Keshia M. Pollack Porter: Johns Hopkins University—Pompeu Fabra University Public Policy Center (UPF-BSM), 08002 Barcelona, Spain
Joan Benach: Research Group on Health Inequalities, Environment, and Employment Conditions, Pompeu Fabra University, 08002 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 19, 1-18

Abstract: Background: There is a lack of consensus on the social determinants of Deaths of Despair (DoD), i.e., an increase in mortality attributed to drug overdose, alcohol-related liver disease, and suicide in the United States (USA) during recent years. The objective of this study was to review the scientific literature on DoD with the purpose of identifying relevant social determinants and inequalities related to these mortality trends. Methods: Scoping review focusing on the period 2015–2022 based on PubMed search. Articles were selected according to the following inclusion criteria: published between 1 January 2000 and 31 October 2021; including empirical data; analyzed DoD including the three causes defined by Case and Deaton; analyzed at least one social determinant; written in English; and studied DoD in the USA context only. Studies were excluded if they only analyzed adolescent populations. We synthesized our findings in a narrative report specifically addressing DoD by economic conditions, occupational hazards, educational level, geographical setting, and race/ethnicity. Results: Seventeen studies were included. Overall, findings identify a progressive increase in deaths attributable to suicide, drug overdose, and alcohol-related liver disease in the USA in the last two decades. The literature concerning DoD and social determinants is relatively scarce and some determinants have been barely studied. However different, however, large inequalities have been identified in the manner in which the causes of death embedded in the concept of DoD affect different subpopulations, particularly African American, and Hispanic populations, but blue collar-whites are also significantly impacted. Low socioeconomic position and education levels and working in jobs with high insecurity, unemployment, and living in rural areas were identified as the most relevant social determinants of DoD. Conclusions: There is a need for further research on the structural and intermediate social determinants of DoD and social mechanisms. Intersectional and systemic approaches are needed to better understand and tackle DoD and related inequalities.

Keywords: death of despair; public health; social determinants of health; health inequalities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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