2022 Spike in “Deaths of Despair” Among Black Population Surpasses White People

Joseph Friedman, PhD, MPH

Credit: UCLA, MII

In roughly 10 years, the prevalence of “deaths of despair” among Black individuals transitioned from trailing far behind to exceeding that of the White population, a new study found.

The “deaths of despair” theory helps society understand the declining health status among people in the US. The term describes midlife deaths from suicide, drug overdose, and alcoholic liver disease.

“The increases have, in part, been associated with differential access to safety resources in the context of an increasingly toxic illicit drug supply, increased rates of polysubstance use, worsening economic precarity, and stark disparities in access to mental health and substance use treatment programs,” wrote the team, co-authored by Joseph Friedman, PhD, MPH, of the David Geffen School of Medicine at UCLA and Helena Hansen, MD, PhD, from the department of psychiatry and biobehavioral sciences at UCLA.

Friedman said in a press release the sharp increase in premature mortality is connected to mental health issues and substance use disorders among minority groups.

Previous research found these types of deaths were linked to declining social and economic conditions, as well as a perceived loss of status. White US individuals without a college degree were the ones thought to have deaths of despair the most.

Investigators conducted a cross-sectional study, aiming to assess trends by race and ethnicity in deaths of despair in the years after the seminal analysis on deaths of despair. The seminal analysis ended in 2013. Leveraging data from the Centers for Disease Control (CDC) and Prevention WONDER database, they calculated midlife (ages: 45 – 54 years) mortality from deaths of despair in the US from January 1999 to December 2022.

From 2013 to 2022, the deaths of despair of Black individuals surpassed White individuals.

In 2013, the total midlife mortality rate from these causes among White individuals was 72.15 per 100,000 population, which was 1.99 times greater than the mortality rate of 36.24 per 100,000 Black individuals. Black individuals had a sharp increase in deaths of despair after 2015. By 2022, the deaths of despair of Black individuals (103.81 per 100,000) surpassed White individuals (102.63 per 100,000).

The team also found the midlife mortality rate from deaths of despair among American Indian or Alaska Native individuals was significantly greater than that among White individuals from 1999 to 2022. In 2022, the rate among American Indian or Alaska Native individuals (241.70 per 100,000) was 2.36 times greater than the rate among White individuals.

The findings reveal people among racial and ethnic minority groups, such as American Indian or Alaska Native (104.95 per 100,000) and Black (84.80) have greater rates of drug overdose mortality than White individuals (59.26 per 100,000) in 2022.

In 2022, American Indian or Alaska Native individuals had a 6.06 times greater rate of midlife deaths of alcoholic liver disease compared to White individuals. Rates of midlife suicide deaths stayed high among American Indian or Alaska Native individuals (27.92 per 100,000) and White individuals (24.45 per 100,000) in 2022 but were only 9.21 per 100,000 for Black individuals.

Investigators noted 2 limitations: the possible misclassification of race and ethnicity which could impact the study’s results and the ecological design which makes it difficult to measure the causality of underlying factors.

“The findings reinforce the notion that we need to invest in services that can address these issues and, ultimately, we need much more comprehensive access to low-barrier mental health care and substance use treatment in the US,” Friedman said. “…We need to specifically make sure those treatments, services, and programs are implemented in a way that is accessible for communities of color and will actively work to address inequality.”

^References

1. ^{Friedman J, Hansen H. Trends in Deaths of Despair by Race and Ethnicity From 1999 to 2022. JAMA Psychiatry. Published online April 10, 2024. doi:10.1001/jamapsychiatry.2024.0303}
2. ^{‘Deaths Of Despair’ Among Black Americans Surpassed Those of White Americans In 2022. EurekAlert! April 10, 2024. https://www.eurekalert.org/news-releases/1040516. Accessed April 17, 2024.}