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Title:          Trends in cause-specific mortality: deaths of despair in Spain, 1980–2019
Subject:        AcademicSubjects/MED00860, DOI: 10.1093/pubmed/fdad133, Journal of Public Health, 00, 00, 11 7 2023. Abstract: Background: Research from various countries has shown increases in alcohol- and drug-related deaths and suicide, known as ‘deaths of despair’ over recent decades, particularly among low-educated middle-aged individuals. However, little is known about trends in death-of-despair causes in Spain. Therefore, we aim to descriptively examine this among 25–64-year-olds from 1980 to 2019 and by educational attainment for the years 2017–19. Methods: We obtained mortality and population data from the National Institute of Statistics to estimate age-standardized mortality rates and assess educational inequalities using the relative index of inequality (RII). Results: Deaths of despair as a share of total mortality slightly increased from 2000 onwards, particularly among 25–64-year-old men (from 9 to 10%). Only alcohol-related mortality declined relatively more since 1980 compared with all-cause mortality. Regarding educational differences, low-educated men presented higher mortality rates in all death-of-despair causes (alcohol-related: RII 3.54 (95% CI: 2.21–5.66); drug-related: RII 3.49 (95% CI: 1.80–6.77); suicide: RII 1.97 (95% CI: 1.49–2.61)). Women noteworthy differences were only observed for alcohol-related (RII 3.50 (95% CI: 2.13–5.75)). Conclusions: Findings suggest an increasing proportion of deaths of despair among 25–64-year-olds since 2000, particularly among men. Public health policies are needed to reduce and prevent these premature and preventable causes of mortality. 
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    Title: Trends in cause-specific mortality: deaths of despair in Spain, 1980 2019
    Author: 
    Subject: AcademicSubjects/MED00860, DOI: 10.1093/pubmed/fdad133, Journal of Public Health, 00, 00, 11 7 2023. Abstract: Background: Research from various countries has shown increases in alcohol- and drug-related deaths and suicide, known as ‘deaths of despair’ over recent decades, particularly among low-educated middle-aged individuals. However, little is known about trends in death-of-despair causes in Spain. Therefore, we aim to descriptively examine this among 25 64-year-olds from 1980 to 2019 and by educational attainment for the years 2017 19. Methods: We obtained mortality and population data from the National Institute of Statistics to estimate age-standardized mortality rates and assess educational inequalities using the relative index of inequality (RII). Results: Deaths of despair as a share of total mortality slightly increased from 2000 onwards, particularly among 25 64-year-old men (from 9 to 10%). Only alcohol-related mortality declined relatively more since 1980 compared with all-cause mortality. Regarding educational differences, low-educated men presented higher mortality rates in all death-of-despair causes (alcohol-related: RII 3.54 (95% CI: 2.21 5.66); drug-related: RII 3.49 (95% CI: 1.80 6.77); suicide: RII 1.97 (95% CI: 1.49 2.61)). Women noteworthy differences were only observed for alcohol-related (RII 3.50 (95% CI: 2.13 5.75)). Conclusions: Findings suggest an increasing proportion of deaths of despair among 25 64-year-olds since 2000, particularly among men. Public health policies are needed to reduce and prevent these premature and preventable causes of mortality. 
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   Type: CRC32
  Checksum: 218dcc8485337fa54b470133b66a6f43
   Type: MD5
  Checksum: 816b19fc7b7748af254a472b278f605bbc9b5c57
   Type: SHA-1