School of Health and Related Research, University of Sheffield, UK; Leverhulme Centre of Demographic Science, Department of Sociology, University of Oxford, UK.
Department of Automatic Controls and Systems Engineering, University of Sheffield, UK.
Public Health. 2023 May;218:92-96. doi: 10.1016/j.puhe.2023.02.019. Epub 2023 Feb 27.
The COVID-19 pandemic significantly impacted mental health, health-related behaviours such as drinking and illicit 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, drugs and suicide in the United States and the United Kingdom 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.
Data were taken from publicly available mortality figures for England and 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 drug use.
Alcohol-specific deaths increased in all countries between 2019 and 2021, most notably in the United States and, to a lesser extent, England and Wales. Suicide rates did not increase markedly during the pandemic in any of the included nations. Drug-related mortality rates rose dramatically over the same period in the United States 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, whereas deaths due to alcohol have risen across the United Kingdom and in the United States and across almost all age groups. Scotland and the United States had similarly high levels of drug-related deaths pre-pandemic, but the differing trends during the pandemic highlight the different underlying causes of these drug death epidemics and the importance of tailoring policy responses to these specific contexts.
新冠疫情大流行对心理健康、饮酒和非法药物使用等与健康相关的行为以及卫生和社会保健服务的可及性产生了重大影响。这些疫情冲击对不同国家的“绝望”相关死亡率的影响尚不明确。本研究利用公共数据比较了美国和英国的酒精、药物和自杀导致的死亡人数，以确定疫情对两国重要非新冠死亡原因的影响是否存在相似或差异，并探讨这些趋势对公共卫生的影响。
数据来自英格兰和威尔士、北爱尔兰、苏格兰以及美国 2001-2021 年公开的死亡率数据，通过自杀、酒精和药物使用的年龄标准化和年龄特异性死亡率进行描述性分析。
2019 年至 2021 年期间，所有国家的酒精特异性死亡人数都有所增加，其中美国的增幅最大，而英格兰和威尔士的增幅则较小。在所有纳入的国家中，疫情期间自杀率并未显著增加。同期，美国的药物相关死亡率急剧上升，但其他国家则没有。
疫情期间“绝望致死”的死亡率呈现出不同原因和国家之间的不同趋势。人们对自杀死亡人数增加的担忧似乎没有根据，而英国和美国的酒精相关死亡人数都有所上升，且几乎涵盖了所有年龄段。苏格兰和美国在疫情前的药物相关死亡人数水平相似，但疫情期间的不同趋势突出了这些药物死亡流行的不同潜在原因，以及针对这些特定情况制定政策应对措施的重要性。
