40% surge in US suicides driven by rural ‘desperation,’ study finds

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Rates of suicide were highest in rural counties in the Western US, Appalachia and the Ozarks (dark red) and increased sharply starting in 2016, according to a map from the new study


Suicides have surged by 40 percent since 1999, driven by poverty, easy gun access and isolation in the Western US, study finds

  • Researchers at Ohio State University analyzed suicide data by county 
  • Suicide rates increased 40 percent between 199 and 2016, with the sharpest rise from 2014 to 2016 
  • Poor people in isolated rural areas who lack insurance were the most at-risk of suicide 
  • Appalachia, the Ozarks and the Western US had the highest rates  

Suicides are surging in the US – especially in rural areas, a new study suggests. 

Between 1999 and 2016, 453,577 Americans died by suicide in the US – and the 20 percent of them died in just the last three years of that time period. 

In less than 20 years, suicides in the US have increased by 40 percent, the Ohio State University researchers found. 

Counties in the Western US, Appalachia and the Ozarks suffered the highest rates, with rural areas and urban ones with many gun shops seeing more deaths by suicide. 

The study authors hope their findings will help public health advocates and policy makers focus their efforts in on the most at-risk communities. 

Rates of suicide were highest in rural counties in the Western US, Appalachia and the Ozarks (dark red) and increased sharply starting in 2016, according to a map from the new study  

‘While our findings are disheartening, we’re hopeful that they will help guide efforts to support Americans who are struggling, especially in rural areas where suicide has increased the most and the fastest,’ said lead researcher Danielle Steelesmith, a postdoctoral fellow at Ohio State. 

Suicide is among the causes of deaths of despair – which also includes drug- and alcohol-related deaths – that have gripped the US, and particularly its rural areas in recent years. 

The new study, published in JAMA Network Open found that the sharpest increases occurred in these areas for all adult age groups and genders. 

The overwhelming majority – 77 percent – of the suicide deaths were among men, consistent with past trends. 

People between 45 and 54 were at the greatest risk of committing suicide, making up 30.1 percent of all suicide deaths between 1999 and 2016. 

Rates were fairly consistent the other age groups, ranging between 21.2 percent and 26.5 percent. 

The study also shed much-need light on more nuanced factors that shaped these lost lives. 

Counties where more people lived in the greatest ‘deprivation’ – meaning poverty or low-income – had the highest rates of suicide and saw steeper increases over time. 

Economic strain is unsurprisingly closely linked to suicide, leaving people feeling hopeless, trapped and under constant stress – risk factors for all manner of mental health struggles. 

And that economic insecurity has a cascading effect. People with low incomes are less likely to be insured or to be under-insured. 

Lack of insurance, more than any other healthcare factor (such as mental healthcare professionals or proximity to a hospital), was closely linked to higher rates of suicide.

Rates were also high anywhere that had a high density of gun shops, which make access to lethal means much easier and more immediate. 

Though rates of suicide were generally higher in rural areas, urban areas with a high number of gun shops also had unusually high numbers of suicides.  

Less obvious factors played a significant role in suicide risks too. The Ohio State researchers also gauged how socially engaged people in various counties were. 

They found those who were more socially isolated were also at higher risk, as were veterans – 28 percent of whom live in rural areas. 

‘Suicide is so complex, and many factors contribute, but this research helps us understand the toll and some of the potential contributing influences based on geography, and that could drive better efforts to prevent these deaths,’ said Steelesmith. 

The study’s findings underscore the importance of closely monitoring gun stores and who has access to firearms, as well as more tangential preventive measures. 

‘For example, all communities might benefit from strategies that enhance coping and problem-solving skills, strengthen economic support and identify and support those who are at risk for suicide,’ study co-author Dr Cynthia Fontanella, a professor of psychiatry and behavioral health said.    

  • For confidential help, call the National Suicide Prevention Lifeline at 1-800-273-8255 or click here
  • For confidential support on suicide matters in the UK, call the Samaritans on 08457 90 90 90, visit a local Samaritans branch or click here
  • For confidential support in Australia, please call Lifeline on 13 11 14 or click here



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