Drug-Related Deaths Among Whites Soar But Alcohol and Suicide Mortality Stable

MedicalResearch.com Interview with:
Andrea M. Tilstra
Doctoral Student, Department of Sociology
Population Program, Institute of Behavioral Science
University of Colorado Boulder and
Ryan K. Masters
Assistant Professor, Department of Sociology
Faculty Associate, Population Program and Health & Society Program
Institute of Behavioral Science
University of Colorado Boulder

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  “Despair” deaths – deaths from suicides, alcohol poisonings, and drug overdoses – have been a topic of interest in recent mortality research. For instance, existing findings suggest that mortality among white Americans has increased as a result of middle-aged whites experiencing elevated levels of despair and distress. These factors supposedly are driving white Americans to cope in unhealthy ways – excessive drinking, drug use, and suicides.

However, there were two major problems with the existing research that supported this narrative. First, men and women were analyzed together, despite the knowledge that overall mortality levels and trends differ significantly by gender. Second, all three of the aforementioned causes of death were pooled together and analyzed as one group. This is highly problematic if deaths from suicides, alcohol use, and drug use are not, in fact, moving in conjunction with one another. We addressed these issues and expanded previous analyses by analyzing cause-specific death rates for men and women separately, for years 1980-2014, and decomposing the trends into period- and cohort- based analyses.

We find that there are huge gender differences in U.S. white mortality rates and that trends in mortality from the three causes of death are quite distinct from one another. Recent increases in U.S. white mortality are largely driven by period-based increases in drug poisoning deaths and cohort-based increases in metabolic disease deaths.

MedicalResearch.com: What should readers take away from your report?

Response:  The differing patterns in cause-specific deaths rates do not support the distress and despair narrative suggested by findings in previous research. In fact, our findings do not support the idea of “despair deaths” at all. Trends in drug-related mortality have sky-rocketed, but trends in alcohol-related mortality and suicide mortality have remained more or less stable for the past 30 years. Further, the increases in drug-related deaths track strongly with the increased prescription and use of opioid-based painkillers, and these increases are affecting white men and women of all ages. The increases in cohort-based metabolic disease deaths are concerning too, as they likely represent the onset of health consequences related to the U.S. obesity epidemic.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response:  Future mortality research ought to continue examining cause-specific death rates, especially those causes related to the U.S. opiate epidemic and the U.S. obesity epidemic. It is likely that these two public health challenges will continue to have serious mortality consequences for all Americans, not just the white population. We hope that future research will continue to examine the causes and consequences of these epidemics.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

Response: Thanks much for your interest in this topic. There are no conflicts of interest. We would like thank the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)-funded University of Colorado Population Center (Award Number P2C HD066613) for development, administrative, and computing support. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NICHD or the National Institutes.


Ryan K. Masters, Andrea M. Tilstra, Daniel H. Simon; Explaining recent mortality trends among younger and middle-aged White Americans. Int J Epidemiol 2017 dyx127. doi: 10.1093/ije/dyx127

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Last Updated on July 28, 2017 by Marie Benz MD FAAD