Inequality study finds so called ‘deaths of despair’ pushing up middle-age mortality

Middle-age mortality rates have risen as “deaths of despair” from suicide, drug and alcohol overdoses, and drink-related liver disease increase, according to a new study into inequality.

Deaths of despair for 45-54-year-olds in England went up between 1993 and 2017, and are now higher than fatalities caused by heart disease among women of that age group, and almost level-pegging with those among men, a report by the Institute for Fiscal Studies (IFS) has said.

Deaths of despair for women increased from 14.7 per 100,000 population in 1993 to 25.8 per 100,000 in 2017.

In the same period, deaths from heart disease for women dropped from 33.5 per 100,000 to 18.4 per 100,000, the study states.

Among men in that age group in the same period, deaths of despair rose from 29.8 per 100,000 to 60.6 per 100,000.

While heart disease deaths for men fell from 143.2 per 100,000 to 61.2 per 100,000 in the same period.

Research in the US, where deaths from despair are rising at a faster rate, suggest they may be linked to a process of “cumulative disadvantage for less-educated people”, according to the study.

Deteriorating job prospects, social isolation and relationship breakdown “may slowly being taking their toll on people’s mental and physical health”, the study said.

“In the UK, this new trend has contributed to a small rise in middle-age mortality overall in the last few years, bringing to an end decades of continual improvement,” according to the study.

Research suggests that rates of long-standing illness and disability among 25-54-year-olds have been increasing since at least 2013, the report said.

Income inequality is higher in the UK than any other major economy apart from the US, the IFS said.

However, inequality in total net household income has changed little since rising sharply in the 1980s.

The UK system of state transfers, especially tax credits, has been “very successful at mitigating rising inequality”, according to the study.

The report said that about one in six children in the UK are born to single parents, a situation “heavily concentrated in low-income and low-educated families”, and one that is much more prevalent than on the continent.

The gender hourly wage gap is strongly associated with childbirth and rises from less than 10% at the point of childbirth to 30% 12 years after the first child is born, according to the study.

It found stark geographical inequalities in the UK with average weekly earnings in London 66% higher than those in the North East.

And men in the most affluent areas can expect to live nearly 10 years longer than those in the most deprived areas, and this gap is widening.

The study was released to mark the launch by the IFS of a major five-year investigation into the causes of inequality funded by the Nuffield Foundation and chaired by Nobel Laureate Professor Sir Angus Deaton.

He told the Guardian: “There’s a real question about whether democratic capitalism is working, when it’s only working for part of the population.

“There are things where Britain is still doing a lot better [than the US]. What we have to do is to make sure the UK is inoculated from some of the horrors that have happened in the US.”

He said geographic inequality appeared to be a factor in the UK, with London benefiting disproportionately compared with other parts of the country.

“People really feel that not everybody is having a fair crack anymore. There’s a sense that if you live in one part of Britain away from the capital, lots of bad things are happening, while lots of good things are happening in the capital – and you don’t see why you should be left behind that way.”

IFS director Paul Johnson said: “I can’t think of anything more important than understanding what drives the inequalities we see today and working out what we might do to influence them.”

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