Study to examine link between income inequality and deaths of despair

School of Public Health researchers will investigate the role of social-economic inequality on deaths of despair thanks to new funding from the Canadian Institutes of Health Research. 

Deaths of despair are defined as deaths attributed to suicide, cirrhosis of the liver due to excessive alcohol consumption, and fatal opioid-related overdoses. According to Roman Pabayo, an assistant professor in the School of Public Health and Canada Research Chair in Social and Health Inequities Throughout the Lifespan, these deaths are increasingly common in Canada. 

“The gap between rich and poor in Canada has been widening, and we have also been seeing an increase in these deaths of despair and declining life expectancy,” said Pabayo. “The pandemic has widened the existing gaps, especially in B.C. and Alberta where opioid-related overdose deaths have spiked.”

Income inequality has been rising across Canadian cities and provinces since the 1990s. This study aims to determine if social economic indicators or inequality, such as income inequality and labour force participation, are risk factors for deaths of despair among Canadians, specifically youth from ages 5-19. Data for this study comes from the long form Canadian Census (National Household Survey), which has been linked to administrative health data, such as mortality records.

Pabayo’s team hypothesizes that youth who live in areas with high income inequality will be at greater risk for deaths of despair, in comparison to those in more equitable areas.  High income inequality may lead to greater risk for adverse mental health outcomes such as depression and anxiety, which in turn are risk factors of deaths of despair.

“Existing studies show that people living in areas with wider gaps in income may have issues connecting with their peers and may experience lower self-esteem and feelings of shame which can manifest in harmful ways,” said Claire Benny, a PhD student working on the project. “It makes sense that people who live in areas with higher income inequality may have increased risk of deaths of despair.”

Pabayo’s team hopes to use the data from this study to identify and target areas to implement interventions to prevent such deaths. Policies and programs such as increasing minimum wage, universal basic income and cash transfers have been used to reduce income inequality and have had positive effects on population health. Additionally geographically targeted  interventions such as supervised injection sites, access to counselling and other health and wellness resources may also have a positive effect. 

“I think that addressing income inequality is of the utmost importance now, especially because people are struggling through the COVID-19 pandemic, both financially and emotionally. Upstream programs and policies can help to relieve some financial pressure and improve well-being, which can, in turn, reduce the rate of deaths of despair,” said Benny.