American Indian, Alaska Native people show highest ‘deaths of despair’
“Deaths of despair” — such as suicide, drug overdose and alcohol-related disease — are highest among American Indian and Alaska Native people, and have been for decades, new research shows.
The rate of deaths of despair for American Indian and Alaska Native people was more than double that of both Black and white people in 2022, according to new research published April 10 in JAMA Psychiatry.
The findings counter much-touted research from 2015 that found deaths of despair in the U.S. were occurring primarily among white people. The earlier research did not include data on American Indian and Alaska Native people, however.
The new research, conducted at the University of California-Los Angeles, found that deaths of despair among white Americans ages 45 to 54 increased from about 72 per 100,000 people in 2013 to about 102 per 100,000 in 2022. The rate tripled for Black Americans during the same period, rising from about 36 deaths of despair per 100,000 people in 2013 to about 103 per 100,000 in 2022.
But rates of the deaths among American Indian and Alaska Native people far outpaced both of those groups, soaring from around 125 per 100,000 people in 2013 to about 241 per 100,000 people in 2022 — the highest rate among all racial and ethnic groups.
The main causes of deaths varied by race and ethnicity. Alcohol-related liver disease deaths were six times higher among American Indian and Alaska Native people than white people. Both the Black and American Indian and Alaska Native populations had higher rates of drug overdoses than white people, and of the three groups, Black people had the lowest suicide rates.
Rates for deaths of despair did not rise significantly for Asian or Pacific Islander people during the study period. Death rates for Hispanic people rose somewhat, but were only about half the rate of Black and white people as of 2022.
Heart disease risks remain high for low-income people
While heart disease deaths have fallen in recent decades for high- and middle-income people in the U.S., those who don’t earn as much have not seen the same benefits.
Thanks to advances in both prevention and treatment, cardiovascular disease-related deaths fell 60% between the 1980s to 2016, previous research has found. In the new study, published April 3 in Circulation: Cardiovascular Quality and Outcomes, researchers examined the role income played in those outcomes.
Overall, the risk of having a cardiovascular incident such as a heart attack during a 10-year period fell almost 18% in the U.S. across three decades, the study found. For high-income people, 10-year cardiovascular disease risks fell about 34%, compared with a 20% decline for middle-income people.
But for those with the lowest incomes, cardiovascular disease risks remained unchanged at an 8% risk of experiencing a cardiovascular event. People with low incomes often face barriers to attaining better health, such as a lack of transportation or accessible places to exercise and poor or no health insurance.
Heart attacks and strokes have remained the leading cause of death in the U.S. for 100 years, with about 805,000 Americans experiencing a heart attack annually.
Rising temperatures may lead to more strokes
Hotter temperatures, which are becoming more common with climate change, are linked to nearly 50,000 stroke deaths annually around the world, a new study estimates.
Published April 10 in Neurology, the study found that 521,000 temperature-related stroke deaths occurred in 2019, including 18,300 in the U.S. About 91% of the global deaths were associated with cold temperatures, with the remainder linked to hot temperatures.
But while strokes related to cold temperatures have been falling over the past three decades, heat-related strokes have been on the rise, according to the research, which examined 1990 to 2019 data from more than 200 countries.
As global temperatures continue to soar with climate change, the stroke burden may increase sharply as well, especially in low-income countries.
More than half of strokes associated with high temperature were intracerebral, meaning that a ruptured blood vessel caused bleeding in the brain. Men and older adults were at highest risk. By region, South Asia had the highest temperature-related stroke burden in 2019, and Mali had the highest burden at the national level.
High temperatures may raise stroke risks by increasing dehydration, affecting cholesterol levels and slowing blood flow, the researchers suggested. Cold temperatures may increase risks by constricting blood vessels and raising blood pressure.
Drinking water sources have high levels of PFAS
Many water sources around the world that are used as the basis for drinking water contain potentially unsafe levels of “forever chemicals,” according to a study released April 8.
The new findings came just days before the U.S. Environmental Protection Agency announced a final standard that will limit allowable levels of the chemicals in the nation’s drinking water.
Per- and poly-fluoroalkyl substances, also known as PFAS, are referred to as forever chemicals because they don’t break down in the environment or in humans. PFAS is used in both consumer and industrial products, including pesticides, cookware, clothing and firefighting foam.
In the new study, published in Nature Geoscience, researchers assessed PFAS contamination in surface and groundwater from more than 45,000 samples taken around the world. They found that about a third exceeded EPA’s new drinking water hazard index, which takes exposure to a mixture of PFAS chemicals into account.
When measured against Canada’s stricter drinking water criteria, 69% of the samples surpassed limits for PFAS contamination. Some of the samples had PFAS levels as high as 50% above recommendations, researchers said.
The study only examined source water, such as found in dams or rivers, which is treated before being used for drinking water supplies. Research published last year estimated that at least one type of PFAS is present in about 45% of U.S. drinking water samples.
EPA officials are hoping the agency’s new standard will help keep more environmental PFAS from reaching American drinking glasses. The standard requires the nation’s more than 66,000 drinking water systems to complete initial monitoring for the chemicals within three years. If high levels are found, systems must reduce PFAS within five years by installing treatment measures or switching to uncontaminated sources.
PFAS exposure has been linked to heart attacks, low birthweight, cancers and numerous other health conditions.
Other public health news of note this week includes:
• An herbicide used on crops such as broccoli, cabbage and onions poses risks to farmworkers, especially if they are pregnant, the Environmental Protection Agency said April 1. Dimethyl tetrachloroterephthalate, also known as DCPA, is associated with “serious, permanent and irreversible” harms, according to the EPA, which issued a letter to the pesticide’s manufacturer and plans further actions.
• The number of mental health providers who are willing to serve people covered by Medicare and Medicaid is inadequate, hindering access for people in need of care, according to an inspector general report released April 3.
• Greenhouse gas emissions caused by humans continued to climb last year, the National Oceanic and Atmospheric Administration said April 5. Despite dire warnings of the impact on human health, levels of carbon dioxide, methane and nitrous oxide all increased.
• Asian Americans who are uninsured, have low education levels and other negative social determinants of health have high risks for cardiovascular disease, a new study in the Journal of the American Heart Association finds. Risk factors vary widely by subgroup.
• Many women face challenges to attaining mammograms, according to a new study from the Centers for Disease Control and Prevention. About a quarter of woman ages 50 to 74 missed a mammogram in the past two years, with factors such as transportation, cost and insurance playing a role.
The Watch is written by Michele Late, who has more than two decades of experience as a public health journalist.
