Increases in ‘deaths of despair’ during the COVID-19 pandemic in the USA and UK
The COVID-19 pandemic significantly impacted mental health, health-related behaviours such as alcohol and other drug use, and the accessibility of health and social care services. How these pandemic shocks affected “despair”-related mortality in different countries is less clear.
This study uses public data to compare deaths from alcohol, other drugs, and suicide in the USA and UK to identify similarities or differences in the impact of the pandemic on important non-COVID causes of death across countries and to consider the public health implications of these trends.
Study design and methods
Data was taken from publicly available mortality figures for England & Wales, Northern Ireland, Scotland and the United States of America 2001-2021 and analysed descriptively through age-standardised and age-specific mortality rates from suicide, alcohol and other drug use.
Alcohol-specific deaths increased in all countries between 2019 and 2021, most notably in the USA and, to a lesser extent, England and Wales.
Suicide rates did not increase markedly during the pandemic in any of the included nations.
Illicit drug-related mortality rates rose dramatically over the same period in the USA but not in other nations.
Mortality from ‘deaths of despair’ during the pandemic has displayed divergent trends between causes and countries. Concerns about increases in deaths by suicide appear to have been unfounded.
Deaths due to alcohol have risen across the UK and in the USA and across almost all age groups.
Scotland and the USA had similarly high levels of illicit drug-related deaths pre-pandemic, but the differing trends during the pandemic highlight the different underlying causes of these illicit drug death epidemics and the importance of tailoring policy responses to these specific contexts.
- Alcohol-specific deaths rose everywhere, but to different extents in different countries.
- US numbers have risen starkly.
- England and Wales have seen the biggest relative rise of alcohol-specific deaths in the UK, but remain lower than Scotland and Northern Ireland.
- In England and Wales the rise in alcohol-specific deaths stands out across all age groups and for both men and women.
- In the US data is showing consistent increases in alcohol-specific deaths across all age groups
- Why did deaths by suicide fall and alcohol deaths rise everywhere, while illicit drug deaths have seen such different patterns?
- The complex situation is due to the interactions between pandemic responses, pre-pandemic trends, and the pre-existing infrastructure to support people in crisis, be that mental health, or alcohol and other drug treatment.
- This emphasises the need for tailored public health policy approaches that reflect the specific harms and underlying causes in each country.
- The United States needs to do something urgently about alcohol deaths.