AUTHOR=Wyatt Steven , Spencer Jonathan , Seamer Paul , Jones Andrew , Turner Alison , Stafford Mai , Marszalek Kathryn , Mohammed Mohammed Amin 
  
TITLE=Deaths of despair in England, 2014–2022: trends by sex and socioeconomic deprivation before and after COVID-19
  
JOURNAL=International Journal of Public Health
  
VOLUME=Volume 71 - 2026
  
YEAR=2026
  
URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2026.1609841
  
DOI=10.3389/ijph.2026.1609841
  
ISSN=1661-8564
  
ABSTRACT=ObjectivesDeaths of despair—alcohol, substance use, suicide and non-organic mental health related—have attracted international attention, but English evidence remains limited. We examined trends in deaths of despair in England (2014–2022), including COVID-19 impacts and inequalities by sex and deprivation.MethodsWe analysed all registered deaths in England (2014–2022), identifying deaths of despair by ICD-10 code. Age-standardised mortality rates, years of life lost, and inequalities by sex and deprivation were calculated. Log-linear regression estimated pre-pandemic trends and deviations during COVID-19.ResultsThere were 133,600 deaths of despair (2.9% of all deaths). Age-standardised mortality rates rose 33%, from 22.6 to 30.1 per 100,000. Mortality was consistently higher in men and deprived areas, with widening inequalities. During COVID-19, mortality temporarily exceeded the pre-pandemic trend, particularly among women and deprived groups, before returning to trend. Deaths of despair accounted for a rising share of years of potential life lost (13.9%–16.6%).ConclusionDeaths of despair increased substantially in England, contributing a growing burden of premature mortality. Persistent, widening inequalities highlight a public health challenge requiring surveillance and interventions addressing immediate causes and social determinants.