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"This book is the biography of Marine General William Rupertus, who led his troops in a series of blistering battles in the Pacific that paved the way for the ultimate American victory there. This is an American story of love, loss, shock, horror, tragedy, and triumph that focuses on Rupertus and the 1st Marine Division in World War II"--
In: Substance use & misuse: an international interdisciplinary forum, Band 52, Heft 1, S. 71-81
ISSN: 1532-2491
In: Social psychiatry and psychiatric epidemiology: SPPE ; the international journal for research in social and genetic epidemiology and mental health services
ISSN: 1433-9285
Abstract
Purpose
Deaths due to substance poisoning, alcohol-related disease, and suicide pose a critical public health issue, and have been categorized as "deaths of despair" in the US. Whether these deaths represent a distinct phenomenon requires exploration, particularly in other countries.
Methods
This retrospective observational study examines age-period-cohort trends of (combined and cause-specific) substance poisoning, alcohol-related disease, and suicide deaths among Australians aged ≥15-years that occurred between 1980 and 2019 and compares trends between males and females.
Results
Combined mortality rates were initially (1980–1999) relatively stable, reflecting a reduction in alcohol-related disease deaths offset by an increase in substance poisoning deaths. A decline (2000–2006) and subsequent increase (2007–2019) in combined rates were primarily attributable to corresponding changes in both substance poisoning and suicide deaths among males. Distinct age-period-cohort trends were observed between cause of death sub-types, with net drifts: increasing for male (net drift [95% CI]: 3.33 [2.84, 3.83]) and female (2.58 [2.18, 2.98]) substance poisoning deaths; decreasing among male alcohol-related disease (− 1.46 [− 1.75, − 1.16]) and suicide deaths (− 0.52[− 0.69, − 0.36]); and remaining relatively stable for female alcohol-related disease (− 0.28 [− 0.66, 0.09]) and suicide deaths (− 0.25 [− 0.52, 0.01]).
Conclusions
Although combined age-specific trends were relatively stable over the study period, different and distinct patterns were observed within cause-specific deaths, challenging the notion that these causes of death represent a distinct epidemiological phenomenon. These data indicate a critical need to review the appropriateness of guidance for clinical practice, prevention strategies, and policy initiatives aimed at preventing future deaths.
