The research, published recently in PLOS One, discover key factors relating to premature adult deaths by analyzing autopsy reports and medicolegal death investigation records of 1,282 people between the ages of 25 and 59 who died in Harris County in 2013. According to landmark research publish in 2015, there has been a dramatic surge in the mortality rate of middle-aged white Americans since 1999. Premature adult deaths are define as deaths before the expect mortality age.

They had notice younger people dying when they work at the IFS; so they set out to identify the causes in Harris County,” said Stacy Drake, PhD, MPH, RN, who is the lead author of the study and now an assistant professor at Cizik School of Nursing at UTHealth.

Interventional strategies

Drake’s team believes this study is unique because they identify characteristics within two growing categories of premature adult deaths: those from natural causes and those from drug toxicity. Identification of common characteristics within these groups, especially modifiable characteristics; so guide interventional strategies for health care providers and public health experts, the authors report.

They were looking for factors that can change, e.g. individual, interpersonal, organizational, or community modifications, she said. They need to dive into what is going on with these folks; also find out where they can break the chain of events leading to their deaths. Coauthor and Harris County IFS deputy chief medical examiner Dwayne A. Wolf, MD, PhD, said the collaboration with Drake gave his office; so the unique opportunity to shape the conversation about premature adult deaths.

As medical examiners, they perform autopsies and present findings in court. As physicians, they appreciate the opportunity to translate our findings into improvements in health care; so in injury prevention, or even in preventing deaths,” Wolf said. “Dr. Drake shares that goal and recognizes; so the unique value of the data that they gather in the course of our investigations. She has forged a collaborative relationship with our office, and this latest publication is an example of the power of this collaboration.

Attention of health care

They had symptoms and knew they were getting worse. Yet, they didn’t seek the attention of a health care provider. They need to conduct further research to answer the question of why? Drake said. To do that, they need to talk to family members. They could find that some people may have had an undiagnosed mental illness. Others may not have had access to care. Still others may have had bad experiences with providers, they said.

As for the community characteristics, researchers identify three areas with clusters of premature natural adult death: North Central (Trinity Gardens); South (Sunnyside); and East (Baytown). All three were in portions of the county identified as lower education, higher unemployment, lower income, and considered medically underserved, Drake said.

Of the 370 drug-related deaths, 91 percent were classified as accidental and 9 percent suicide. Cocaine was detected in toxicology tests 165 times, opioids 187, benzodiazepine anti-depressants 107, and alcohol 103. Most of those dying of drugs also used alcohol and tobacco. Whites were 2.22 times more likely to die from drug-related deaths than blacks.