How deaths of despair shape life expectancy across sexes and regions in Sweden

AIM: The sim of this study was to quantify contributions of mortality from drugs, alcohol and suicide (termed as 'deaths of despair' (DoD)) to changes in life expectancy at birth across sexes and regions in Sweden. METHODS: We obtained annual data on underlying causes of deaths by age, sex and region from the National Cause of Death Register. We constructed abridged life tables for two periods: 2001-2005 and 2020-2024. A continuous-change model was used to quantify the age- and cause-specific contributions of DoD to the changes in life expectancy at birth between these periods. RESULTS: Between two periods, life expectancy at birth increased by 2.5/3.5 years for females/males. All three DoD combined had negligible but opposite contributions to the changes in life expectancy at birth among females (-0.017 years) and males (+0.101 years). In both sexes, drugs- (alcohol)-related deaths contributed to decrease (increase) in life expectancy at birth. In both sexes, deaths from suicide in the age group 10-19 years (negative contributions), drugs in the age group 30-39 years (negative contributions) and alcohol in the age groups 40-59 years (positive contributions) and 70-89 years (negative contributions) had a greater absolute contribution to the changes in life expectancy at birth than the other two DoD causes. Across regions, the changes in life expectancy at birth attributable to DoD ranged from -0.219 to +0.159 years among females and from -0.235 to +0.267 years among males.