Deaths of despair (DOD) are highest among less-educated White Americans. Educational level is highly correlated with type of occupation such that many “working class” jobs involve higher risk of injury. In this paper, the authors focused on a logical question about connections between deaths of despair and occupational hazards. Are people in occupations prone to on-the-job injury more likely to die from DOD because of opioid overdose?
The authors pulled death certificates in Massachusetts from 2005-2015 for people aged 16-64. The death certificates identified cause of death as well as occupation of the deceased. The occupational categories were coded for analysis based on rates of injury or illness, perceived job insecurity, and the temporary nature of work. Note: the authors could not determine whether the deceased had experienced on-the-job injury based on the death certificates! Instead, the authors were looking at associations between DOD rates and occupations known to be hazardous (and therefore likely to cause injury/illness).
Their results (no surprise!) found that the highest number of DOD occurred among people in occupations with higher injury rates. Specifically, opioid overdose deaths were higher than alcohol and suicide deaths for these occupations. Further, there were also more DOD for occupations that had perceived job insecurity and non-standard (temporary) work arrangements. This study could not determine if overdose deaths were due to on-the-job injuries or some other factor.
These results are fraught with limitations and potentially confounding intercorrelations. Future research needs to directly assess occupational category, illness and injury rates for people who die from drug and alcohol overdose and suicide.
Hawkins, D., Punnett, L., Davis, L. & Kriebel, D. (2021). The contribution of occupation-specific factors to the deaths of despair, Massachusetts, 2005-2015. Annals of Work Exposures and Health, 65(7), 819-832, https://doi.org/10.1093/annweh/wxab017.
©Jennie Dilworth, Ph.D