Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, NE1 4LP, Newcastle upon Tyne, UK.
Int J Equity Health. 2024 Nov 19;23(1):242. doi: 10.1186/s12939-024-02334-w.
Deaths related to suicide, drug misuse, and alcohol-specific causes, known collectively as "deaths of despair" are of growing interest to researchers in England. Rates of death from these causes are highest in deprived northern communities and are closely tied to the social determinants of health and the policy decisions that have shaped them. The aim of this paper is to explore how stakeholders and community members living in Middlesbrough and South Tyneside, two Northern towns with above average rates of deaths of despair, understood the relationship between austerity policies and rates of deaths from these causes in their areas.
I conducted interviews and one focus group with a total of 54 stakeholders and community members in Middlesbrough and South Tyneside. Data were analysed using the iterative categorisation technique and the findings were interpreted through thematic analysis.
The findings highlight four primary ways through which austerity exacerbated rates of deaths of despair in Middlesbrough and South Tyneside: reduced access to mental health services, diminished substance abuse treatment capacity, loss of youth services, and the closure of community institutions. Participants linked these cuts to rising social isolation, declining mental health, and increased substance misuse, which collectively deepened geographic inequalities in deaths of despair.
This study underscores the urgent need for reinvestment in local services to reduce inequalities and prevent further unnecessary deaths due to drug, suicide, and alcohol-specific causes. Prioritising the restoration and enhancement of services lost to austerity is critical. Such reinvestment will not only help to alleviate some of the most immediate need but also form a foundation for addressing the wider structural inequalities that perpetuate deaths of despair.
与自杀、药物滥用和酒精相关原因导致的死亡，统称为“绝望致死”，这些死亡事件引起了英格兰研究人员越来越多的关注。这些原因导致的死亡率在贫困的北方社区最高，与健康的社会决定因素和塑造这些因素的政策决策密切相关。本文旨在探讨生活在米德尔斯堡和南泰恩赛德的利益相关者和社区成员（这两个北方城镇的“绝望致死”率高于平均水平）如何理解紧缩政策与该地区这些原因导致的死亡率之间的关系。
我在米德尔斯堡和南泰恩赛德共采访了 54 位利益相关者和社区成员，并进行了一次焦点小组讨论。使用迭代分类技术对数据进行分析，并通过主题分析解释研究结果。
研究结果突出了紧缩政策在米德尔斯堡和南泰恩赛德加剧“绝望致死”率的四种主要方式：获得心理健康服务的机会减少、减少药物滥用治疗能力、青年服务的丧失以及社区机构的关闭。参与者将这些削减与社会孤立的增加、心理健康的下降和药物滥用的增加联系起来，这些因素共同加剧了“绝望致死”的地域不平等。
本研究强调了急需对当地服务进行再投资，以减少不平等现象，并防止因药物、自杀和酒精相关原因导致更多不必要的死亡。优先恢复和加强因紧缩而失去的服务至关重要。这种再投资不仅有助于缓解最紧迫的需求，还为解决导致“绝望致死”的更广泛结构性不平等奠定基础。
