The deaths of despair theory is influential in understanding the declining health status among people in the US.1,2 The seminal analysis1 on the topic highlighted that midlife deaths from suicide, drug overdose, and alcoholic liver disease were driving a unique decrease in life expectancy among White individuals. Deaths from these causes have been collectively referred to as deaths of despair and have been argued to be associated with declining social and economic conditions and a perceived loss of status, especially among White US individuals without a college degree.3 We assessed trends by race and ethnicity in deaths of despair, especially in the years following the seminal analysis,4 during which increases in racial and ethnic inequalities were reported for numerous causes of death.