Ripples of Despair -  Shining a light on the impact of lives lost to alcohol, drugs, and suicide (2024)

Where we live has a significant impact on our health. Disadvantaged urban environments with high levels of noise, crime, rubbish and limited green spaces can increase psychological distress and depression, both risk factors for drug-related deaths and suicide (51,52). There are links with suicidal behaviours being increased when experiencing poverty and deprivation at an individual level, along with living in a more deprived community (53).

Deaths to alcohol, drugs and suicide are not equally distributed across England. Like many health outcomes, there is a marked North-South divide as well as a Coastal-Inland divide (3). Between 2019 and 2021, the rate of deaths by alcohol, drugs, and suicide was highest in the Northeast (54.7 deaths per 100,000 people). The rate in Gateshead was 48.7 deaths per 100,000 people, significantly above the England rate of 33.5 per 100,000 population. The geographical inequalities are visualised in the map below.  

Map of age-standardised mortality rate for deaths of despair across local authorities in England (2019-2021)(3).

The relationship between deaths by alcohol, drugs and suicide and factors such as living alone, living in an urban environment, being economically inactive, and unemployment are amplified in the North of England compared to other parts of England (3).

When looking at deaths due to alcohol, drugs and suicide in isolation, the geographical picture is very similar. The North East has the second highest rate of deaths by suicide of any region in England and Wales in 2023 (14.5 deaths per 100,000 people) (54,55).

The North East is the region with the highest rate of deaths due to drug use (10.9 deaths per 100,000 in 2023); this has been the case for the past eleven years (56).The alcohol-specific death rate is also highest in the North East (20.4 deaths per 100,000 in 2021), as it has been for the seven preceding years as well (57).

Social cohesion and fragmentation  

Areas with high social deprivation and low community cohesion, such as places where people frequently move in and out, or many single-person households, are more likely to see higher rates of drug-related deaths and suicide (52). By contrast, strong social ties and support networks, often referred to as social capital, act as protective factors, reducing the risk of harm (34).

VCS case study - Edberts House

Established in 2009, Edberts House is an organisation working with over 4000 people across Gateshead.

Their four community houses offer individual support and group activities, including men's groups, refugee support group, training courses and children clubs. These have encouraged residents to have autonomy over decisions affecting their lives, as well as strong partnerships across the wider community, supporting residents' mental health in particular, and improving social connections, forming relationships with groups of people residents would not usually interact with. It has had strong positive outcomes since its inception, with those involved in one of their houses reporting life satisfaction on a par with the English national average, whilst outperforming scores for levels of trust, sense of belonging and levels of anxiety (58). 

Their Community Linking Project offers social prescriptions to patients of 25 GP surgeries in Primary Care, addressing the wider determinants of health, such as housing, finances and loneliness.   Their Health Equity project tackles health inequalities, including their children, young people and families team, who build trusting relationships, asking 'what matters to you?' and work with people to achieve their dreams.   Knitting people together in peer support groups is a vital part of this approach - building connection and healthy interdependence.  Innovative social prescribing work in secondary care is now being piloted, including their Palliative Care Link Worker, and Midwifery Social Prescribers.  Evidence collected through the project has been analysed by Northumbria University, and has demonstrated that the interventions, advice and/or support provided by Edbert's House yielded a statistically significant improvement in emotional well-being.