The suicide rates in the US increased 43.1% in 2000~2017, decreased 3.9% in 2017~2020, but returned to its peak in 2022 [Figure 1]. This study aims to find out the crucial factors that impacted suicide rates in the US.
Deaths due to suicides are identified in ICD-10. For our study, we extracted suicide rates data from CDC based on ICD-10 codes, including X60-X84 (death from intentional harm), and Y87.0 (death from sequelae of intentional self-harm/event of undetermined intent) [1].
Among the population that committed suicide in the US within 2000 and 2022, the suicide rates for male is on average 4 to 5 times higher than female [Figure 2].
Overall, the white demographic has the highest suicide rates in the US, with American Indians/ Alaskan Natives being the second highest.
We examined multiple demographic, socioeconomic, and psychosocial factors such as unemployment rates, median income, and drug usage, but low correlations with suicide rates have been discovered among these factors.
The three states with the highest average suicide rates from 2000 to 2022 are Montana, Alaska, and Wyoming [Figure 3]. Our study delves deeper to the underlying possible factors that may have caused higher suicide rates among these states.
- Household Firearm Ownership:
The three states with the highest suicide rates also have the highest household firearm ownership [Figure 4]. Gun access in impulsive moments is a key factor in suicides [2], which make up over half of all firearm deaths [3].
- Population Density:
The three states that have the highest suicide rates also have the lowest population density [Figure 5]. This may be caused by geographic disparities such as limited access to mental health care, and greater social isolation [4].
- Veteran Suicides:
In Wyoming and Montana, veteran suicide rates are among the highest in the US. Among US adults who died from suicide in 2021, firearms were involved in 72.2% of veteran deaths, compared to 52.2% for non-veterans [5].
- Depression:
The symptoms caused by major depressive disorder could directly and indirectly increase the risk of suicidal attempts [6]. In our study, we discovered that there is a higher rate of depression in Alaska (85 per 100k population) and Wyoming (53 per 100k population), which may be one of the contributing factors to suicides in these 2 states.
- Race:
In Alaska and Montana, American Indians/Alaskan Natives have the highest suicide rates compared to other races. The reasons behind the suicide of American Indians could possibly be due to relationship/interpersonal challenges, substance use, lack of mental health treatment access, historical traumas, rural isolation, and socioeconomic issues [7].
For future work, we could further examine suicide by firearm of different age and race groups, various mental health issues (e.g. anxiety, PTSD) and psychosocial factors (e.g. substance use, alcohol disorder) to deepen our understandings of other issues that may contribute to suicidal actions.
- National Center for Health Statistics. (2023). All valid ICD-10 codes: Detailed titles and headings. Centers for Disease Control and Prevention. Retrieved from https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10/allvalid2020%20(detailed_titles_headings).pdf
- Anestis, M. D. (2018). Guns and suicide: An American epidemic. Oxford University Press.
- Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: Bringing epidemiologic research to policy. Annals of Epidemiology, 25(5), 366–376. https://doi.org/10.1016/j.annepidem.2014.03.004
- Kegler, S. R., Stone, D. M., & Holland, K. M. (2017). Trends in suicide by level of urbanization—United States, 1999–2015. MMWR Morbidity and Mortality Weekly Report, 66(10), 270–273. https://pubmed.ncbi.nlm.nih.gov/28301448/
- Office of Mental Health and Suicide Prevention. (2023). 2023 national veteran suicide prevention annual report. U.S. Department of Veterans Affairs. https://www.mentalhealth.va.gov/docs/data-sheets/2023/2023-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf
- Cai, H., Xie, X.-M., Zhang, Q., Cui, X., Lin, J.-X., Sim, K., Ungvari, G. S., Zhang, L., & Xiang, Y.-T. (2021). Prevalence of suicidality in major depressive disorder: A systematic review and meta-analysis of comparative studies. Frontiers in Psychiatry, 12, 690130. https://doi.org/10.3389/fpsyt.2021.690130
- Stone, D., Trinh, E., Zhou, H., et al. (2022). Suicides among American Indian or Alaska Native persons — National Violent Death Reporting System, United States, 2015–2020. MMWR Morbidity and Mortality Weekly Report, 71, 1161–1168. https://doi.org/10.15585/mmwr.mm7137a1
- Repository (Github)
- Visualization (Github)
- State suicide mortality rates (2000 to 2022)
- State Suicide Mortality Rates by Year, State, Age Group, Gender (2000 to 2022)
- State Suicide Mortality Rates by Year, State, Gender, Race (2000 to 2022)
- Veteran suicide data and reporting
- Geographic area measurement - state land areas
- Unemployment in America, per US state
- Median household income by state
- State-level estimates of household firearm ownership
- Illicit drug use in America: National Survey on Drug Use and Health (NSDUH) state data
- Mental Health America (depression dataset)
