Citation

Katz IR, Dent KR, Morley SW, Hein TC, Hoff RA, McCarthy JF. Psychiatry Res. 2020; 285: e112841.

Affiliation

VA Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, MI 48109, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, United States.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.psychres.2020.112841

PMID

32050146

Abstract

Deaths of despair, a composite outcome including suicide and drug- and alcohol-related deaths, have been increasing, especially in subpopulations and geographic areas sensitive to economic and social hardships. The Veterans Health Administration (VHA) has begun evaluating the utility of this concept to guide planning and evaluations of clinical and preventive services for Veterans. In this study, mortality rates for middle-aged American men for 2013 to 2017 were from CDC WONDER, and rates for all Veterans, those using VHA healthcare services (VHA-utilizers, and other (non-VHA) Veterans were derived from National Death Index data.

FINDINGS demonstrated that rates for the composite were higher in VHA-utilizers and lower in non-VHA Veterans than middle-aged American men, consistent with use of VHA services by Veterans with the greatest needs. State rates in Veteran men were significantly and positively correlated with state rates for American men, and both were correlated with other characteristics of the social environment. The lack of correlation between rates for suicide and drug-related deaths indicates that deaths of despair cannot be modeled by assuming parallel paths from reactions to community-based stressors to the component outcomes; models should allow for an impact of community characteristics on partitioning between outcomes.

Published by Elsevier B.V.

Language: en

Keywords

Alcohol use disorder; Mortality; Substance use disorder; Suicide