The Mexican drug war: Homicides and deaths of despair, 2000-2020

In 2006, the Mexican government deployed their army on Drug Trafficking Organizations (DTOs). The attempt to remove cartel leaders spurred further conflict between DTOs and led to substantial increases in Mexico's homicide rate. The public display of homicide victims and the media coverage of violence may have elicited feelings of fear and depression, increasing the risk of deaths of despair. We examined whether, in Mexico, homicides correspond positively with region-specific rates of deaths of despair.

We applied a fixed effects Poisson count model controlling for population-at-risk, unemployment rates, marriage rates, year indicators, and general seasonality and trend in deaths of despair.

We utilize data from the National Institute of Statistics, Geography and Informatics to obtain homicides (per 100,000 population) as our exposure and the count of deaths of despair (e.g., alcoholic liver disease, suicide, and drug-related deaths) as our outcome. Our sample size comprised 8064 state-months from 32 Mexican states between 2000 and 2020. We applied a fixed effects Poisson count model controlling for population-at-risk, unemployment rates, marriage rates, year indicators, and general seasonality and trend in deaths of despair.

Homicides (per 100,000 population) correspond with a 1.8 % increase in deaths of despair ([IRR] = 1.018; 95 % CI, 1.007-1.029). When examining type of death, alcoholic liver disease deaths drive this relation with a 1.6 % increase ([IRR] = 1.016; 95 % CI, 1.003-1.030) as a function of homicides (per 100,000 population).

Large and public acts of violence may induce adverse mental health, and in turn, greater deaths of despair (specifically alcoholic liver disease deaths) among Mexican populations not directly connected to homicide-related violence. Prevention efforts should target alcohol misuse and liver disease patients in Mexico.