So-called 'deaths of despair' are rising in the UK. Labour must act on this silent epidemic

Recently released data from the Office of National Statistics has revealed a very worrying trend – that so-called “deaths of despair” are dramatically increasing in the UK.

Rates of suicide, alcohol and drug fatalities (collectively known as “deaths of despair”) have increased by 9%, 45% and 81% respectively in England and Wales over the last decade. Given that mortality rates for most other causes are stable or decreasing, this increase is deeply concerning.

In total, in 2022 these three causes accounted for 18,947 fatalities in England and Wales, almost one in 30 of the deaths recorded that year. The figures are even starker for younger people, with “deaths of despair” making up more than 40% of fatalities in the 25 to 29 age group.

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The term “deaths of despair” was first coined by Anne Case and Angus Deaton, two professors from Princeton. They had set out to try and understand the reasons why white, working class men in America were dying younger than before. They concluded that this was due to the sharp increases in deaths from suicide, drugs and alcohol and that, in their words, these “three causes of death are deeply related … [all] show great unhappiness with life”. The source of this, they argued, was the devastating impact of economic insecurity and the breakdown of social support structures, especially in communities ravaged by the end of manufacturing in America. Now, it seems, what started in the US, is coming to our side of the Atlantic.

It is worth saying that many people, myself included, don’t like the term “deaths of despair”. The term can oversimplify the multiple and often complex and structural reasons behind suicide or addiction. It also doesn’t take into account the role of increasingly strong synthetic opioids like fentanyl in causing overdoses among drug users. Nonetheless, the term has been widely adopted by researchers and policymakers, and has helped raise awareness of the growing crisis.

At the same time, using data to report on deeply sensitive issues can feel wholly inadequate. Every early death is a tragedy, regardless of the cause, and discussing percentages and mortality trends doesn’t reflect the pain and hurt felt by the family and friends of those who have died. All we can hope is to use the data as best as we can to try to highlight issues and find solutions.

As with so many things in modern Britain, there are huge differences in rates of “deaths of despair” by region, which follow existing patterns of economic inequality. Research by the University of Manchester shows that rates are much higher in the North of England, and especially in the North East. They also found that coastal towns and cities were badly affected, with rates on average 30% higher than the rest of the country. The more wealthy regions of London, by contrast, had rates less than half the level of those in the North East.

The starkest differences can be seen at the local authority level. Here the data shows that the worst impacted areas of Middlesbrough, Hartlepool and Blackpool had rates a staggering four times higher than the affluent London suburbs of Barnet and Bromley. Such disparities should make our leaders wake up to the real human impact of inequality in this country.

Recent research by the Museum of Homelessness published by the Big Issue also show that homeless people are especially impacted by this. Their analysis shows that with “deaths of despair” accounted for 47% of deaths of homeless people where the cause of death was known.

It’s time for the government to act on this silent epidemic. A two pronged strategy is required. First the government should look to deal with the immediate impact of the current crisis. This will require targeted investment in mental health and addiction management services in the areas most impacted. The government has already announced a scheme to increase access to naloxone, the life saving drug which can reverse an opioid overdose, among high risk communities, and these plans should be accelerated.

Treating the symptoms is only half the answer, however, and the second element is harder but more important – addressing the root causes of inequality and deprivation. There needs to be a real strategy to bring good jobs and economic opportunity back to the areas of the UK that have been left behind. The Conservatives were right when they talked about the need to “level up” – now Labour must make that a reality, and quickly.

James Rose is a journalist specialising in demographics.

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