suicide rates

US suicide rates rise after 2 years of decline

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Following 2 consecutive years of decline, total suicides in the U.S. rose from nearly 46,000 in 2020 to just over 48,000 in 2021, researchers wrote in Morbidity and Mortality Weekly Report.

The report noted that suicide rates in this timespan increased the most among American Indian or Alaskan Native individuals, while the greatest decrease in suicide rates was among white individuals.

depression
U.S. suicide rates had declined for 2 years, but increased from 2020 to 2021.

“Research indicates that suicide is preventable through a comprehensive public health approach that relies on data to drive decision-making, multisectoral partnerships to expand reach, and implementation and evaluation of multiple culturally relevant prevention strategies,” Deborah M. Stone, ScD, of the CDC’s National Center for Injury Prevention and Control, and colleagues wrote. “CDC’s Suicide Prevention Resource for Action supports states and communities to prioritize interventions with the best available evidence that can save lives.”

Stone and colleagues analyzed changes in racial and ethnic suicide rates from 2018 to 2021 National Vital Statistics System multiple cause-of-death mortality files. Researchers calculated 95% CIs with the direct method and the 2000 U.S. standard population. Included Hispanic individuals could be of any race, and those with unknown ethnicity were excluded from race and ethnicity groups but were included in the overall total.

The researchers reported that suicide rates were highest among non-Hispanic American Indian or Alaskan Native individuals at 28.1 per 100,000 overall. This group experienced the highest relative percentage change from 2018 to 2021 at 22.3 to 28.1 per 100,000 (26% increase).

Rates also increased significantly among non-Hispanic Black individuals, from 7.3 to 8.7 per 100,000 (19.2% increase) and among Hispanic individuals, from 7.4 to 7.9 per 100,000 (6.8% increase) from 2018 to 2021. Non-Hispanic white individuals showed the greatest overall decline in suicide rates, from 18.1 to 17.4 (3.9% decline).

Suicide rates of Black individuals aged 10 to 24 years increased significantly, from 8.2 to 11.2 (36.6% increase). Overall, suicide rates increased among those aged 25 to 44 years at 5%, American Indian or Alaskan Native at 33.7%, Black at 22.9%, Hispanic at 19.4% and non-Hispanic multiracial at 20.6% from 2018 to 2021.

The researchers reported that overall, suicide rates of individuals aged 45 to 64 years decreased significantly at –12.4%, among non-Hispanic Asian at –15.9%, Hispanic at –9.3% and white at –11.5%. Suicide rates of individuals aged at least 65 years showed no significant changes.

“Significant increases among young Black persons aged 10 to 24 years and across multiple racial and ethnic populations aged 25 to 44 years raise particular concern,” Stone and colleagues wrote. “Suicide is a complex problem related to multiple risk factors such as relationship, job or school, and financial problems, as well as mental illness, substance use, social isolation, historical trauma, barriers to health care and easy access to lethal means of suicide among persons at risk.”

Military Suicides, Deployment Unrelated.

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No increased suicide risk seen in troops sent to war zones..

Military suicides may be more likely after members leave the service than during active duty deployment, particularly if their time in uniform is brief, a U.S. study finds.

“It was certainly intuitive as the wars went on and suicides went up for people to assume that deployment was the reason, but our data show that that is too simplistic; when you look at the total population, deployment is not associated with suicide,” said lead author Mark Reger, of Joint Base Lewis-McChord in Tacoma, Washington.

While the U.S. military has traditionally experienced lower suicide rates than the civilian population, suicides among active duty service members have surged in the past decade, almost doubling in the Army and the Marines Corps, Reger said.

To understand the link between deployment and suicide, Reger and colleagues analyzed military records for more than 3.9 million service members in active or reserve duty in support of the conflicts in Iraq and Afghanistan at any point from October 7, 2001 to December 31, 2007.

A total of 31,962 deaths occurred, including 5,041 suicides, by December 31, 2009, according to the April 1 online report in JAMA Psychiatry.

Suicide rates were similar regardless of deployment status. There were 1,162 suicides among those who deployed and 3,879 among those who didn’t, representing suicide rates per 100,000 person-years of 18.86 and 17.78, respectively.

Leaving the military significantly increased suicide risk, however, with a suicide rate of 26.06 after separating from service compared with 15.12 for those who remained in uniform. Those who left sooner had a greater risk, with a rate of 48.04 among those who spent less than a year in the military.

Service members with a dishonorable discharge were about twice as likely to commit suicide as those who had an honorable separation.

“This is the first time such a huge, comprehensive study has found an increased suicide risk among those who have separated from service, particularly if they served for less than four years or had an other than honorable discharge,” said Rajeev Ramchand, a researcher in military mental health and suicide prevention at Rand Corporation who wasn’t involved in the study.

It’s possible that pre-deployment examinations may screen out people who have mental health problems, making those who deploy several times a healthier, more resilient group, said Dr. Alan Peterson, a psychologist at the University of Texas Health Science Center in San Antonio who specializes in combat-related post traumatic stress disorder (PTSD).

“Those who really struggle with a deployment don’t go the second time,” said Peterson, a retired military psychologist who wasn’t involved in the study. “Early separation from the military is often a marker for something else.”

For those contemplating suicide, access to firearms can exacerbate the problem, Peterson said. “It’s a risk factor that sometimes gets overlooked, but we’ve seen when they don’t have access to weapons they are less likely to kill themselves.”

http://www.medpagetoday.com/newad_native.php

Some service members who leave the military early may have had risk factors for suicide such as mood disorders or substance abuse problems that contributed to their separation, particularly if they had a dishonorable discharge, said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention.

“Some of the dishonorable discharges may be related to having a mental health disorder and being unable to keep that behavior in check and breaking the rules, and some of the early separations may be people in distress who appropriately opted out of service,” said Moutier, who wasn’t involved in the study.

It isn’t realistic to expect former service members to instantly reintegrate into their former civilian lives, but they may be experiencing serious mental health problems if they’re not eating or sleeping or if they’re extremely agitated or irritable, Moutier said.

“The lack of an association between deployment and suicide risk isn’t surprising,” she said. “At a very high level, these findings highlight the need for us to pay closer attention to what happens when people leave the military.”

SOURCE: http://bit.ly/1BMzKsh

JAMA Psychiatry 2015.

SMOKING MAY CONTRIBUTE TO SUICIDE RISK.

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Cigarette smokers are more likely to commit suicide than people who don’t smoke, studies have shown. This reality has been attributed to the fact that people with psychiatric disorders, who have higher suicide rates, also tend to smoke. But new research at Washington University School of Medicine in St. Louis finds that smoking itself may increase suicide risk and that policies to limit smoking reduce suicide rates.

In a study published online July 16 in the journal Nicotine & Tobacco Research, a team led by Richard A. Grucza, PhD, reports that suicide rates declined up to 15 percent, relative to the national average, in states that implemented higher taxes on cigarettes and stricter policies to limit smoking in public places.

“Our analysis showed that each dollar increase in cigarette taxes was associated with a 10 percent decrease in suicide risk,” said Grucza, associate professor of psychiatry. “Indoor smoking bans also were associated with risk reductions.”

Grucza’s team analyzed data compiled as individual states took different approaches to taxing cigarettes and limiting when and where people could smoke. From 1990 to 2004, states that adopted aggressive tobacco-control policies saw their suicide rates decrease, compared with the national average.

The opposite was true in states with lower cigarette taxes and more lax policies toward smoking in public. In those states, suicide rates increased up to 6 percent, relative to the national average, during the same time period. From 1990 to 2004, the average annual suicide rate was about 14 deaths for every 100,000 people.

“States started raising their cigarette taxes, first as a way to raise revenue but then also as a way to improve public health,” Grucza explained. “Higher taxes and more restrictive smoking policies are well-known ways of getting people to smoke less. So it set a natural experiment, which shows that the states with more aggressive policies also had lower rates of smoking. The next thing we wanted to learn was whether those states experienced any changes in suicide rates, relative to the states that didn’t implement these policies as aggressively.”

Suicide is the 10th leading cause of death in the United States, according to the Centers for Disease Control and Prevention. In 2010, nearly 40,000 people died of suicide across the nation.

Every death that occurs in the United States is recorded in a database managed by the National Center for Health Statistics. Grucza’s team classified each suicide death based on the state where the victim had lived, as well as how aggressive that state’s tobacco policies were.

Using statistical methods, the researchers compared rates of suicide in states with stricter tobacco policies to rates in states with more lenient laws and lower taxes. They also determined whether people who had committed suicide were likely to have smoked. They learned that suicide risk among people most likely to smoke was associated with policies related to tobacco taxes and smoking restrictions.

“If you’re not a smoker, or not likely ever to become a smoker, then your suicide risk shouldn’t be influenced by tobacco policies,” Grucza said. “So the fact that we saw this influence among people who likely were smokers provides additional support for our idea that smoking itself is linked to suicide, rather than some other factor related to policy.”

Although scientists have known for years that people who smoke have a higher risk for suicide, they had assumed the risk was related to the psychiatric disorders that affect many smokers. These new findings, however, suggest smoking may increase the risk for psychiatric disorders, or make them more severe, which, in turn, can influence suicide risk.

“We really need to look more closely at the effects of smoking and nicotine, not only on physical health but on mental health, too,” Grucza said. “We don’t know exactly how smoking influences suicide risk. It could be that it affects depression or increases addiction to other substances. We don’t know how smoking exerts these effects, but the numbers show it clearly does something.”

He explained that many states still have low cigarette taxes, while other states haven’t adopted comprehensive smoke-free air policies. Grucza predicts that if these states raise their cigarette taxes and restrict smoking in public, their suicide rates likely would fall.

Grucza suspects nicotine may be an important influence on suicide risk. Based on the study’s results, he said he is concerned that many new restrictions on public smoking don’t cover newer e-cigarettes, which deliver nicotine but release vapor rather than smoke. This mechanism purportedly allows those addicted to nicotine to get a “fix” without affecting the air others breathe.

“Nicotine is a plausible candidate for explaining the link between smoking and suicide risk,” Grucza said. “Like any other addicting drug, people start using nicotine to feel good, but eventually they need it to feel normal. And as with other drugs, that chronic use can contribute to depression or anxiety, and that could help to explain the link to suicide.”

Climate change linked to increase in Australia’s suicide rates.

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QUT researcher is predicting suicide rates will rise as a result of climate change after finding a link between high and varied temperatures and people taking their own life.Researcher Xin Qi, from QUT’s Institute of Health and Biomedical Innovation, studied the socioenvironmental drivers of suicide rates in Australia over 20 years and found variations in temperatures coupled with spikes in unemployment were significant risk factors for suicide.His research, completed as part of his PhD, has helped to pinpoint who and when people might be at higher risk of suicide.”What we found was that when the difference of the monthly average temperature in the current month compared with the previous one month increased by 1 degree, there was a 3 per cent increase in suicide in Brisbane and Sydney,” Dr Qi said.”For example, when looking at Sydney, if the temperature difference between September and October (2.55 degrees) was 1.5 degrees higher than that between August and September (1.05 degrees), then we saw a 4.5 per cent increase of suicide in October compared with September.

“Based on Australia’s climate the high risk seasons for Brisbane and Sydney are spring and early summer, so it is therefore necessary to strengthen current monitoring systems on attempted suicide especially in areas with high unemployment rates.

“As global climate change and financial recession continue, it is vital to develop local interventions to reduce suicidal risk.”

Dr Qi said when unemployment rates were added to the mix, suicide rates increased significantly.

“For example a 1 per cent increase in unemployment rate is associated with a 5 per cent risk of higher suicide in Brisbane and Perth,” he said.

“In months with a higher unemployment rate, the temperature difference between adjacent months had more of a significant association with suicide in Brisbane compared with months with a low unemployment rate.”

While Dr Qi’s research did not reveal why this occurred, he said previous studies had shown temperature could be attributed to seasonal changes in physiological conditions of the body such as levels of serotonin – which is related to wellness and happiness.

Dr Qi said the study also found there were two significant suicide clusters in Australia – Mornington Shire (northwest of Queensland) and the Bathurst-Melville area (north of the Northern Territory), especially after the mid-1990s.

“We also found some suburbs of Adelaide identified as major clusters in male suicide.

“These areas were low socio-economic areas or with high Indigenous populations.”

Dr Qi said the study had important implications for evidence-based public health policy on suicide control and prevention.

He said unemployment and temperature change had an interactive effect on suicide.

“Even though Australia has suicide control and prevention plans, few consider the impact of environmental factors in suicide prevention programs,” he said.

“There needs to be more attention to the potential of increased suicide risks posed by climate change, especially in vulnerable groups like the unemployed or Indigenous communities.”