Deaths of despair
Since the late 1990s, there has been a marked increase in the overall mortality of middle-aged white non-Hispanic males and females in the United States (Case and Deaton 2015, 2017, 2020). This increase in mortality was largely attributed to increases in deaths by suicide, drug and alcohol poisonings (both accidental and undetermined intent) and deaths due to chronic liver diseases and cirrhosis – together termed ‘deaths of despair’ by Case and Deaton (2015, 2017, 2020). They linked this trend to a decline in economic security, a lack of universal health care and the widespread availability of opioids (Case and Deaton 2015, 2017, 2020). In 2017, Case and Deaton suggested that a similar increase in mortality from deaths of despair may be emerging in other countries (Case and Deaton 2017).
Selected causes of death, by sex, Australia, 1997 to 2022.
The line graph shows age-standardised rates of death by suicide, alcoholic liver disease and cirrhosis, accidental poisoning, and all of these causes combined from 1997 to 2022. Users can also choose to view age-standardised death rates and numbers of deaths for this period by sex and cause of death.
An analysis of Australian mortality data using methods similar to those used by Case and Deaton shows that Australians are not increasingly dying due to these ‘deaths of despair’ over time. The rates of combined deaths by suicide, alcoholic liver disease and cirrhosis, and accidental poisoning (deaths of despair) over the period 1997 to 2022 show no clear trend. Since 2014 the rate has remained around 23 to 25 deaths per 100,000 population (from 2014 to 2022), similar to rates at the start of the period 1997 to 1999; between these dates rates remained lower (around 20.1 deaths per 100,000 population).
Males are more likely than females to die by these selected causes of death (suicide, alcoholic liver disease and cirrhosis, and accidental poisoning). At the start of the period, between 1997 and 1999, male rates of combined deaths by suicide, alcoholic liver disease and cirrhosis, and accidental poisoning ranged between 35.7 and 38.1 deaths per 100,000 population. Female rates, for the same period, ranged from 10.8 to 11.2 – 3.2 to 3.5 times lower than males. Since 2014, death rates for both males and females have shown little variation. Male rates ranged between 33.9 and 36.8 deaths per 100,000 population and female rates ranged from 12.3 to 13.8. Since 2014 these causes of death were, on average, 2.7 times more common in males than females.
Case A & Deaton A 2020. Deaths of Despair and the Future of Capitalism. Princeton: Princeton University Press.
Case A & Deaton A 2017. Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity 397.
Case A & Deaton A 2015. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. PNAS. 112(49):15078-15083.