Did the ‘deaths of despair’ crisis spur a homicide epidemic? A panel analysis of homicide trends among large US Counties, 2010–2022

Between 2014 and 2021, the national homicide rate increased by more than 50%. This dramatic increase in homicide occurred during the same period as similar patterns in so-called deaths of despair. Yet, few have examined the connection between these trends. The current study examines whether deaths of despair (drug overdose, alcohol-related deaths, and suicide), or their underlying causes, impacted homicide trends among 200 large counties in the United States from 2010 through 2022. After accounting for relevant controls in both random effects and fixed effects panel analyses, there was a robust association between each type of death of despair and the homicide rate. Additionally, there was a significant association between the homicide rate and a disadvantage index (positive) and percentage Hispanic (negative) under some model specifications. Overall, this study suggests that the deaths of despair crisis and recent homicide increase are interrelated.