Title : Geographic disparities in deaths of despair in the UK: A systematic review

“Deaths of Despair” (DoD) is a term increasingly used to describe the mortality due to suicide, drugs, and alcohol in specific sub-populations who share similar socio-economic factors. Whilst the term was coined in the context of the US, subsequent studies have suggested that this trend is found in other industrialised countries, including the UK. The geographic factors influencing DoD within the UK, however, remain unclear.

This review aims to synthesise the scholarly literature describing the spatiality of DoD in the UK and identifies possible explanations for intranational disparities.

A systematic search of peer-reviewed studies was conducted over six electronic databases (EMBASE, MEDLINE, PsychINFO, The Cochrane Library, Web of Science, and SCOPUS). The search strategy was verified by a medical librarian. The review included a mixture of qualitative and quantitative studies which were analysed and links made to relevant theory. The review was registered with PROSPERO (CRD42025637969).  

Ten studies were identified after screening against our inclusion and exclusion criteria. The extraction of data revealed patterns across the literature which allowed results to be grouped, by narrative synthesis, into four themes for comparison. These were: a North-South divide in England; an Urban-Rural divide; high coastal prevalence; and differences between nations within the UK. 

We conclude that variation in DoD is shaped not only by material deprivation, but by how disadvantage is socially and spatially organised across place. Sociocultural factors including work and self-worth, social fragmentation, and the effects of deindustrialization shape how these conditions are experienced, while economic processes including poverty, austerity, financialisation, and rentier dynamics influence how they are distributed and concentrated geographically.

Luke Yaxley is a fifth year Medical Student completing his degree at Brighton and Sussex Medical School before beginning work as a Foundation Doctor in Brighton from August of this year. He has a particular interest in Public Health and inequalities in healthcare which he is keen to develop further throughout his career as a Doctor.