Suicide in the United States
Suicide is a major national public health issue in the United States. The country has one of the highest suicide rates among wealthy nations. In 2018, there were 48,344 recorded suicides, up from 42,773 in 2014, according to the CDC's National Center for Health Statistics. On average, adjusted for age, the annual U.S. suicide rate increased 24% between 1999 and 2014, from 10.5 to 13.0 suicides per 100,000 people, the highest rate recorded in 28 years. Due to the stigma surrounding suicide, it is suspected that suicide generally is underreported. In April 2016, the CDC released data showing that the suicide rate in the United States had hit a 30-year high, and later in June 2018, released further data showing that the rate has continued to increase and has increased in every U.S. state except Nevada since 1999. Surging death rates from suicide, drug overdoses and alcoholism, what researchers refer to as "deaths of despair", are largely responsible for a consecutive three year decline of life expectancy in the U.S. This constitutes the first three-year drop in life expectancy in the U.S. since the years 1915–1918.
In 2015, suicide was the seventh leading cause of death for males and the 14th leading cause of death for females. Additionally, it was the second leading cause of death for young people aged 15 to 34 and the third leading cause of death for those between the ages of 10 and 14. From 1999 to 2010, the suicide rate among Americans aged 35 to 64 increased nearly 30 percent. The largest increases were among women aged 60 to 64, with rates rising 60 percent, then men in their fifties, with rates rising nearly 50 percent. In 2008, it was observed that U.S. suicide rates, particularly among middle-aged white women, had increased, although the causes were unclear. As of 2018, about 1.7 percent of all deaths were suicides.
The American Foundation for Suicide Prevention reported that in 2016 suicide was the 10th leading cause of death in the U.S., imposing a cost of $69 billion to the US annually. Other statistics reported are:
- The annual age-adjusted suicide rate is 13.42 per 100,000 individuals.
- Men die by suicide 3.53x more often than women.
- On average, there are 123 suicides per day.
- White males accounted for 7 of 10 suicides in 2016.
- A firearm is used in almost 50% of all suicides.
- The rate of suicide is highest in middle age—white men in particular.
Suicide has been associated with tough economic conditions, including unemployment rate.
There are significant variations in the suicide rates of the different states, ranging from 28.89 per 100,000 people in Montana to 8.11 per 100,000 people in New York.
Approximately half of suicides are committed using a firearm, accounting for two-thirds of all firearm deaths. Firearms were used in 56.9% of suicides among males in 2016, making it the most commonly used method by them.
Trends in suicide attempts
The spike in suicide rates in the United States during the 21st century has gained public and clinical attention. Studies have found that despite all efforts to minimize suicide rates, rates have steadily increased by approximately 2% per year from 2006 to 2014. A national epidemiologic survey of 69 341 US adults found the percentage of adults attempting suicide increased from 0.62% in 2004 through 2005 to 0.79% in 2012 through 2013. Because of this, clinicians aim to determine whether this is a coincident national increase in suicide attempts. In order to achieve this, trends in suicide attempts are characterized among sociodemographic and clinical groups. It was found that suicide attempts impact "younger adults with less formal education and those with antisocial personality disorder, anxiety disorders, depressive disorders, and a history of violence” at disproportional rates. It is important for trends in suicide attempts to be investigated and researched for they help to determine the cause of the increase in suicide rates. Knowing the trends in suicide also allow preventative measures to be taken. Suicide prevention is possible through early identification and treatment of individuals deemed high risk.Suicide as a public health crisis
has been thought of as the responsibility of mental health professionals within clinical settings between 2000–2010. As of 2019, suicide prevention is being recognized as a public health responsibility rather than within clinical settings due to the trend in increasing suicide rates. In 1960–2010, population-based risk reduction approaches have been used for other diseases such as myocardial infarction. However, as of 2019, the urgency of development of effective suicide prevention has been recognized by the CDC. While suicide is often thought of as an individual problem, suicides may impact families, communities, and society in general. The responsibility of public health would be to develop policies to reduce people's risk of suicidal behavior through addressing factors at the individual to societal levels. "Public health emphasizes efforts to prevent violence before it happens. This approach requires addressing factors that put people at risk for, or protect them from, engaging in suicidal behavior."The CDC has created a National Suicide Prevention Lifeline where they provide free and confidential support for people in distress, prevention and crisis resources for people who are in need of such help, and best practices for professionals. In May 2019, Bloomberg reported that in spite of the recent mental health crisis, insurance companies, including UnitedHealth Group, are doing what they can to limit coverage and deny claims for mental health related issues.
A 2019 study by a private non-profit called National Bureau of Economic Research says there is a direct causal link between worker's wages and suicide rates, and that raising the minimum wage would result in a quick drop in the suicide rate.
Subgroups
Age and sex
The National Violent Death Reporting System keeps data on U.S. suicides.| Age | 10 – 14 | 15 – 24 | 25 – 34 | 35 – 44 | 45 – 54 | 55 – 64 | 65 – 74 | 75+ | Unknown | All |
| Males | 265 | 4575 | 5887 | 5294 | 6198 | 5745 | 3463 | 3291 | 2 | 34727 |
| Females | 171 | 1148 | 1479 | 1736 | 2239 | 2014 | 940 | 510 | 1 | 10238 |
| Male/Female Ratio | 1.5 | 4.0 | 4.0 | 3.0 | 2.8 | 2.9 | 3.7 | 6.5 | 2.0 | 3.4 |
| Total | 436 | 5723 | 7366 | 7030 | 8437 | 7759 | 4403 | 3801 | 3 | 44965 |
Based on the NVDRS 2016 data, the New York Times acknowledged that, among men, those over 65—who make up a smaller proportion of the population—are at greatest risk of death by suicide. The NVDRS 2015 data showed that, among men of all races, men over 65 were the most likely to die of suicides, closely followed by men 40–64. Men 20–39 and 15–19 were less likely to die of suicides.
By state
There are significant variations in the suicide rates of the different states. A number of theories for these differences have been suggested, ranging from socioeconomics to access to firearms and isolation, and a study in 2011 found a correlation between altitude above sea level and suicide.| Rank | State | Suicide rate per 100,000 people |
| 1 | Montana | 28.9 |
| 2 | Alaska | 27.0 |
| 3 | Wyoming | 26.9 |
| 4 | New Mexico | 23.3 |
| 5 | Idaho | 23.2 |
| 6 | Utah | 22.7 |
| 7 | South Dakota | 22.5 |
| 8 | West Virginia | 21.1 |
| 9 | Arkansas | 20.8 |
| 10 | Nevada | 20.3 |
| 11 | Colorado | 20.3 |
| 12 | North Dakota | 20.1 |
| 13 | Oklahoma | 19.1 |
| 14 | Kansas | 19.1 |
| 15 | Oregon | 19.0 |
| 16 | New Hampshire | 18.9 |
| 17 | Maine | 18.9 |
| 18 | Missouri | 18.5 |
| 19 | Vermont | 18.3 |
| 20 | Arizona | 18.2 |
| 21 | Washington | 16.9 |
| 22 | Kentucky | 16.9 |
| 23 | Tennessee | 16.8 |
| 24 | Alabama | 16.6 |
| 25 | South Carolina | 16.3 |
| 26 | Indiana | 16.3 |
| 27 | Wisconsin | 15.4 |
| 28 | Louisiana | 15.2 |
| 29 | Hawaii | 15.2 |
| 30 | Pennsylvania | 15.0 |
| 31 | Mississippi | 15.0 |
| 32 | Iowa | 15.0 |
| 33 | Ohio | 14.8 |
| 34 | Nebraska | 14.7 |
| 35 | North Carolina | 14.3 |
| 36 | Michigan | 14.1 |
| 37 | Florida | 14.0 |
| 38 | Minnesota | 13.8 |
| 39 | Georgia | 13.6 |
| 40 | Virginia | 13.4 |
| 41 | Texas | 13.4 |
| 42 | Rhode Island | 11.8 |
| 43 | Delaware | 11.6 |
| 44 | Illinois | 11.2 |
| 45 | Connecticut | 10.5 |
| 46 | California | 10.5 |
| 47 | Maryland | 9.8 |
| 48 | Massachusetts | 9.5 |
| 49 | New Jersey | 8.3 |
| 50 | New York | 8.1 |
College students
For college students, suicide is the second highest cause of death. The risk tends to be underestimated, as many falsely believe that young people do not have thoughts about suicide. The suicide rate for male students is about three times higher than that of female students. The study of suicide rates and trends was not common in the past, but it has gained more attention in 2019. From 1990 to 2004, about 1,404 college students committed suicide. This is about 6.5 percent of those who committed suicide nationwide. In 2014, the adjusted age rate was higher for male than female: the suicide rate for males was 20.7 per 100,000 while the rate for females was 5.8 per 100,000.While counseling services can help prevent suicide, resource availability may be insufficient. Students who do not go to counseling services are at 18 times more at risk of suicide compared to those who do. If a college student has any suicidal thoughts, it is always critical to let others, such as members of the school, family, or friends know.