Minnesota Department of Health
Preventable Deaths in MN: Substance Use & Suicide Mortality
by Gabriel Reynolds
Introduction
Deaths resulting from substance use and suicide are health outcomes of great public concern both in Minnesota and across the United States. The effects of these deaths on health statistics have been made apparent largely through the work of individuals such as Anne Case and Angus Deaton. They were among the first to raise alarm about the impacts of substance use and suicide mortality on health metrics such as life expectancy. In 2015, they reported that declining life expectancies among white middle aged Americans were statistically linked with increased mortality rates from substance use and suicide. These “deaths of despair” (as coined by Case and Deaton) have gone on to receive considerable attention within the sphere of public health and represent an important point of public health intervention.
In the summer of 2021, I worked alongside another Macalester student and a Senior Epidemiologist at the Minnesota Department of Health to conduct epidemiological research on injury and violence prevention in Minnesota. Using Case and Deaton’s “Deaths of Despair” as a framework to monitor public health, we conceptualized opioid overdoses, alcohol-related deaths, and suicide as preventable. Despite being preventable, the rates of substance use and suicide mortality are not only increasing, but are are also not experienced equally across national and statewide populations. Our research sought to identify recent trends in preventable death data, identify disparities, and begin the process of developing effective and upstream health interventions.
About Minnesota Department of Health
The Minnesota Department of Health (MDH) is committed to protecting, maintaining and improving the health of all Minnesotans. In functioning as the central public health apparatus for Minnesota, MDH strives to achieve health equity, where all communities are thriving and all people have what they need to be healthy. More specifically, the Health Promotion and Chronic Disease Division of MDH provides leadership for the prevention and management of chronic diseases, disabilities, and injuries in Minnesota. This involves working to reduce the risk of injury and violence for all Minnesotans by providing data, resources and consultation to assist in the development of community intervention and prevention programs.
My Internship
On a day to day basis, I worked alongside another Macalester student and our supervisor, a senior epidemiologist, to help the Department with epidemiological research. We regularly met with our supervisor and other stakeholders at MDH in the Health Promotion and Chronic Disease Division to develop research methodology. This often involved educational opportunities for my research and I to better understand the thought processes that inform public health practice. After establishing a plan for the research, my work largely entailed organizing and analyzing vital record and other mortality data available both via MDH and the CDC. I learned to navigate large databases, and I used relatively simple statistical techniques to compare age-adjusted mortality rates across various explanatory indicators. From this analysis, my research partner and I collaborated to create various data visualizations and conduct a literature review on substance use and suicide mortality. After completing our analysis, we moved on to developing data briefs and other shareable items such as a presentation for use by MDH.
In addition to conducting this research, I also was involved in biweekly Fetal and Infant Mortality Reviews where I was able to learn more about the diverse range of responsibilities MDH has taken on. My participation in these review sessions also provoked an ongoing relationship with a MN pediatrician interested in epidemiological research on Sudden Death in Youth (SDY). In our available time, my research partner and I conducted epidemiological research on disparities in SDY rates in Minnesota. We regularly met with the pediatrician and other SDY surveillance experts to better understand our research.
Takeaways
I am sincerely grateful for the opportunity I was given to work with MDH. This internship confirmed for me that I want to pursue a career in epidemiology and/or public health practice, and it also helped me consider which disciplines within public health most interest me. By engaging with data, consulting experts, and thinking through effective interventions, this internship helped me better understand just how complex and interdisciplinary public health practice can be. I saw firsthand the thought-processes that governmental agencies such as MDH go through to practice public health, and I learned that I don’t agree entirely with how the Department chooses to conduct research and address health inequities. Nonetheless, I see this internship as an opportunity to be critical of epidemiological practices in a way where I hope I can be a better public health practitioner in the future because of this experience.
References
Case, A., &; Deaton, A. (2015). Rising morbidity and mortality in midlife among White non-Hispanic Americans in the 21st Century. Proceedings of the National Academy of Sciences, 112(49), 15078–15083. https://doi.org/10.1073/pnas.1518393112
Gabriel Reynolds
Hi! My name is Gabe, I’m an Environmental Studies major with a Community & Global Health concentration and Data Science minor. I was born in St. Paul, MN and have been happy to continue calling the Twin Cities my home throughout my time at Macalester. My research interests include quantitative public health, climate justice, and infectious disease epidemiology. Outside of school, I love biking, playing games with friends, and making meals with my housemates!