MUIU.S. life expectancy has decreased in recent years, a trend driven in large part by “deaths of despair”—suicides as well as fatalities related to alcohol and other drugs. NIH researchers, including ORWH Special Advisor David A. Thomas, Ph.D., recently published findings on drug poisonings, suicides, and alcohol-induced deaths. The researchers analyzed death certificate statistics from the Centers for Disease Control and Prevention (CDC) on premature deaths (i.e., deaths of individuals ages 20–64) and compared data by geography, age, sex, and race/ethnicity. 

The researchers identified several troubling trends, including:

  • Overall, death rates for all three causes were higher among men than women from 2013 to 2017, but from 2000 to 2017, these death rates increased more rapidly among women. 
  • Geographical analysis identified clusters of premature mortality associated with drug poisoning in the Northeast through Appalachia, with suicide and alcohol in the Western U.S. region, and with suicide in rural areas. 
  • Death rates from drug poisoning were highest among 35-to-49-year-olds. Death rates from suicide and alcohol were highest among 50-to-64-year-olds. Complex patterns associated with race and ethnicity varied over time and among the three causes of death. 
  • Drug poisoning and alcohol-induced deaths increased dramatically in recent years (2013–2017 and 2012–2017, respectively). Suicide rates were more constant from 2000 to 2017. 

Overall, the data show that from 2000 to 2017, drug poisoning, suicide, and alcohol caused 1.45 million premature deaths—450,000 more deaths than would be expected from 2000 rates. Though economic factors may have played a role in these unexpected increases, the researchers conclude that no single cause, demographic group, or region explains these trends, suggesting the need for numerous specifically targeted interventions.  

Dr. Thomas says, “In the United States, we have an urgent and growing problem of premature deaths.  While despair is one critical element related to these deaths, the complex distribution of deaths underscores the need to study and address them in a manner that takes factors like sex, age, and geographical region into account.”

This research was supported by the National Cancer Institute (NCI), the National Health, Lung, and Blood Institute (NHLBI), and the National Institute on Minority Health and Health Disparities (NIMHD).  


Shiels et al. 2020. JAMA Netw Open. PMID: 32915234.