More Michigan children are losing parents to overdose, suicide, homicide

Michigan has higher parental mortality rates than the national average, said Sean Esteban McCabe, professor at the U-M School of Nursing and lead author of a new the study, which appears in JAMA Network Open. 

McCabe and his team wanted to better understand the state landscape of stigmatized deaths. The goal was to provide bereavement services to the children left behind in the areas that need it most.

"Parental deaths from overdoses, homicides, suicides, and other substance-related causes are associated with more adverse health outcomes and higher rates of early mortality in their children, so more attention is needed in this area, because no child should ever have to grieve alone," said McCabe, who is also the director of U-M's Center for the Study of Drugs, Alcohol, Smoking and Health. 

McCabe and colleagues formed a collaboration with the Michigan Department of Health and Human Services, the Community Foundation of Southeast Michigan and HopeHQ, a research group focused on children who are grieving parental overdose deaths. 

To understand the state- and county-level trends in parental deaths, researchers linked death certificates of individuals who died between 2000 and 2023 to birth certificates from 1989 to 2023 to establish a cohort of biological children aged 17 or younger who had experienced a parental death. 

Other key findings: 

• Between 2000 and 2023, 115,558 children in Michigan experienced a parental death for any cause.
  Between 2000 and 2023, 38,429 children experienced a parental death due to suicide, homicide, overdose or other substance-related death.
• Stigmatized deaths represented 1,372 deaths, or 28%, in 2008.
• Stigmatized deaths represented 2,222 deaths, or 42%, in 2023.
• At the county level, the percentage of children who experienced stigmatized parental deaths relative to all other causes ranged from 21% to 47%.
• "Despite some recent declines in fatal drug overdoses, the number of children who have experienced a parental death due to a drug overdose continues to rise in Michigan and nationally because of the tremendous surge in fatal drug overdoses over the past decade," McCabe said.

One notable finding, he said, is that counties experiencing high levels of parental deaths due to drug overdose, homicide, suicide and other substance-related causes are spread across the state rather than concentrated in one area. Some counties that topped the list include: Marquette, Luce, Alger, Dicknson, Baraga, Menominee, Charlevoix, Manistee, St. Clair, Monroe, Calhoun and Crawford. 

"Taken together, these findings offer key metrics to make sure that there are adequate bereavement services to meet the increased needs at the county and state levels," McCabe said. "We are fortunate to live in a state that prioritizes public health and is willing to make data-driven decisions to make sure no child or family grieves alone."

Because the study focused on biological parents and did not include step parents or other caregivers, it underestimates the true impact of bereaved children in Michigan, he said. 

"It's a great first step and more work is clearly needed," McCabe said.

Co-authors include Luisa Kcomt, Wayne State University, Rececca Evans-Polce, U-M School of Nursing; Samuel Tennant, U-M School of Public Health; Eric Hulsey, Institute for Research, Education and Training in Addictions; and Vita McCabe, Michigan Medicine.