The Tsunamic Model of LGBTQ+ Deaths of Despair: A Systemic Review to Identify Risk Factors for Deaths of Despair Among LGBTQ+ People

The term Deaths of Despair (DOD) was introduced to capture the phenomenon of mortality associated with suicide, drug overdose, and alcoholic liver disease. The LGBTQ+ population consistently evidences disproportionately high rates of DOD. This study reviewed the literature on DOD within this community to create a conceptual model that identifies risk factors that work together to potentiate DOD in the LGBTQ+ community. Ten DOD-Related Factors were identified and used to create The Tsunamic Model of LGBTQ+ Deaths of Despair. DOD-Related Factors include: (1) Stigma, (2) Demographics, (3) Identity Development, (4) Internalized Homophobia, (5) Depression, (6) Victimization, (7) Isolation/Rejection, (8) Sensation Seeking, (9) Risky Behavior, and (10) Uninformed Care. Each factor is associated with increased risk for DOD among the LGBTQ+ community. This model can help health professionals by providing a framework for prevention and early intervention programs.

Deaths of Despair in Florida: Assessing the Role of Social Determinants of Health

Deaths of despair (DOD) is a new term appearing in public health literature to describe deaths attributable to suicide, liver disease, and drug overdose. In Florida, suicide and liver disease are the 8th and 10th leading causes of death, respectively. Additional mortality data show that the rate of drug overdose deaths in Florida is 12.5% higher than the suicide death rate. Some have hypothesized that economic social determinants of health (SDH) may be responsible for the recent increase in DOD. The current study, using secondary data, sought to identify what county-level SDH were significantly associated with county-level DOD. Using backward regression methodology, the results of the analysis indicate that 44% of the variance in county-level DOD is significantly associated with six county-level SDH: (a) Recent Medical Checkup, (b) Income, (c) Education Level, (d) Age, (e) Mental Health Professionals, and (f) the Income × Age interaction term. Higher than average income, age, and mental health professionals in a Florida county was associated with significantly higher rates of DOD. Higher than average levels of education and recent checkups in a Florida county were associated with a significant decrease in DOD. Possible explanations and implications are discussed.