Ecological factors associated with suicide mortality among non-Hispanic whites

Nick Graetz,Irma T Elo,Morgan Peele,Samuel H Preston

doi:10.1186/s12889-020-09379-w

Nick Graetz, Irma T Elo + Show 2 more

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https://doi.org/10.1186/s12889-020-09379-w

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Abstract

BackgroundIn this paper, we examine the ecological factors associated with death rates from suicide in the United States in 1999 and 2017, a period when suicide mortality increased in the United States. We focus on Non-Hispanic Whites, who experienced the largest increase in suicide mortality. We ask whether variation in suicide mortality among commuting zones can be explained by measures of the social and economic environment and access to lethal means used to kill oneself in one’s area of residence.MethodsWe use vital statistics data on deaths and Census Bureau population estimates and define area of residence as one of 704 commuting zones. We estimate separate models for men and women at ages 20–64 and 65 and above. We measure economic environment by percent of the workforce in manufacturing and the unemployment rate and social environment by marital status, educational attainment, and religious participation. We use gun sellers and opioid prescriptions as measures of access to lethal means.ResultsWe find that the strongest contextual predictors of higher suicide mortality are lower rates of manufacturing employment and higher rates of opiate prescriptions for all age/sex groups, increased gun accessibility for men, and religious participation for older people.ConclusionsSocioeconomic characteristic and access to lethal means explain much of the variation in suicide mortality rates across commuting zones, but do not account for the pervasive national-level increase in suicide mortality between 1999 and 2017.

Highlights

In this paper, we examine the ecological factors associated with death rates from suicide in the United States in 1999 and 2017, a period when suicide mortality increased in the United States
Failure to account for the dramatic rise in suicide mortality across all commuting zones in the United States over this period is a critical finding from our analysis
Despite a relative lack of comprehensive analyses on the correlates of suicide mortality over the past two decades, popular hypotheses for the rise in suicide mortality often cite the measures of socioeconomic depression and access to lethal means that we have analyzed here

Summary

Introduction

We examine the ecological factors associated with death rates from suicide in the United States in 1999 and 2017, a period when suicide mortality increased in the United States. We focus on NonHispanic Whites, who experienced the largest increase in suicide mortality. 800,000 deaths from suicide occur every year globally [56]. In the United States, 47,000 deaths from suicide were recorded in 2017 [31]. For Americans 40 years and younger, suicide deaths are only exceeded by motor vehicle fatalities [32]. Suicide is often understood as an intensely private and personal act, with the focus of analysis on the mental and emotional health of an individual [37]. Durkheim’s profound insights about the centrality of social relations to human well-being have been supported by evidence that the evolution of the human brain was Graetz et al BMC Public Health (2020) 20:1339 driven by the advantages larger brains offered for engaging in complex social relationships [24]

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