Heterogeneity in deaths of despair: excess mortality in the US during the Covid-19 pandemic (preprint)

ABSTRACT

The impact of Covid-19 on mortality includes both direct effects of the virus and indirect effects mediated through other causal pathways. In the United States, the indirect effects, particularly from suicides, overdoses and alcohol-induced causes (i.e. deaths of despair) (1) are understudied. Here, we estimated excess non-Covid deaths and deaths of despair, in the US overall, in each state and in 72 demographic strata. Nationally, 114,230 (127,597) excess non-Covid deaths, 19,074 (33,559) excess poisoning deaths and 8,746 (13,771) excess alcohol-induced deaths were estimated during 2020 (2021). Excess poisoning and alcohol-induced mortality were highest among the 35-44 and the 55-64 year groups, respectively. The Black and the American Indian/Alaskan Native populations had the highest excess poisoning and alcohol-induced mortality, respectively. Fewer suicides than expected occurred nationally, but excess suicides were estimated among Black youth. These findings suggest that additional resources need to be mobilized to limit increases in deaths of despair.