Mark Olfson (
Candace Cosgrove is a statistician in the Mortality Research Group at the Census Bureau, in Washington, D.C.
Health Aff (Millwood). 2021 Mar;40(3):505-512. doi: 10.1377/hlthaff.2020.01573.
Discourse on deaths of despair, which include suicide, poisoning, and chronic liver disease, has focused on middle-aged White working-class adults with less than a college education. Yet longitudinal research has not examined what groups are at highest risk for these causes of death. Respondents to the 2008 American Community Survey were followed through 2015 for mortality from suicide, poisoning, or chronic liver disease. The overall mortality rate for deaths of despair was 41.3 per 100,000 person-years. The highest-risk groups were adults with functional disabilities (102.8 per 100,000 person-years), American Indian/Alaska Native people (102.6), working-age adults who are not employed (77.3), separated or divorced people (76.5), people with net income losses (70.6), and people with military service (67.0). Most of these groups remained at increased risk after several potential confounders were controlled for. These findings offer a deeper perspective on which adults are at highest risk for deaths of despair.
关于自杀、中毒和慢性肝病等“绝望致死”的讨论，主要集中在受教育程度较低的中年白人工人阶级群体。然而，纵向研究尚未探讨哪些群体面临这些死因的风险最高。通过 2008 年美国社区调查（American Community Survey）收集的数据，对受访者进行了为期 2015 年的随访，以了解自杀、中毒或慢性肝病导致的死亡率。“绝望致死”的总死亡率为每 10 万人中有 41.3 人。风险最高的群体包括有功能障碍的成年人（每 10 万人中有 102.8 人）、美国印第安人/阿拉斯加原住民（每 10 万人中有 102.6 人）、未就业的劳动年龄成年人（每 10 万人中有 77.3 人）、分居或离婚的人（每 10 万人中有 76.5 人）、净收入损失者（每 10 万人中有 70.6 人）和有兵役经历者（每 10 万人中有 67.0 人）。在控制了几个潜在的混杂因素后，这些群体中的大多数仍面临较高的风险。这些发现为哪些成年人面临最高的“绝望致死”风险提供了更深入的视角。
