Publication

Structural vulnerabilities? Trends in preventable deaths of despair in the Netherlands, 2013-2023

In this article, Martín Hernán Di Marco, Marieke Liem and colleagues examine trends in deaths of despair in the Netherlands and how these relate to socioeconomic vulnerability.

Author: Martín Hernán Di Marco, Marieke Liem, and others
Date: 24 September 2026
Links: Read the article

Using nationwide mortality data for people aged 15 to 60, the researchers analysed Dutch trends in suicide, drug-related and alcohol-related deaths, and homicide between 2013 and 2023.

Suicide remained the leading cause of death among the external causes studied. Rates declined among middle-aged adults but increased among people aged 15 to 30. Drug-related mortality rose across age groups, particularly among working-age adults, while alcohol-related deaths also increased. Homicide remained rare.

The risks were concentrated among socially and economically vulnerable groups. Labour-market exclusion, social isolation and lower socioeconomic position were associated with several causes of death. The findings suggest that the Dutch welfare system may buffer some patterns seen in the United States, but rising substance-related mortality reveals persistent structural vulnerabilities. The authors call for integrated prevention that addresses mental health, substance use and socioeconomic inequalities.