May 27, 2013

Suicide: Data versus Assumptions

SternheimerBy Karen Sternheimer

Back in 2007, I blogged about the many misperceptions about suicide. Many assumptions surround suicide, specifically the notion that suicide is a much bigger problem now than in the past and one that disproportionally affects young people. Both of these assumptions are incorrect.

As you can see from the graph below, over the past two decades suicide rates have been relatively flat. While there have been slight increases since 2000, over the past two decades rates have fallen slightly for both males and females. Note that males are consistently more likely to commit suicide, with rates more than four times that of females. And while we are familiar with the term “teen suicide,” which has been described frequently as a social problem, the problem of “male suicide” might be more apt.

U.S. Suicide Rates 1991-2009, Age Ten and Over, by Sex

General suicide trends

Source: Centers for Disease Control, 2012

So why do we often consider suicide—and teen suicide in particular—a growing problem? High profile cases might help us think so. As I write about in the new edition of Connecting Social Problems and Popular Culture, tragic stories involving bullied young people who later commit suicide have been in the headlines in recent years.

Young people who have been the target of homophobia have gotten a lot of attention, particularly as the push for gay rights has expanded recently. Take the death of Rutgers University student Tyler Clementi, who jumped off the George Washington Bridge after his roommate streamed his encounter with another man live on the internet. This case made national news, including the cover of People magazine. His roommate was charged and tried and later convicted on several counts, including invasion of privacy and bias intimidation. Suicides that seem to involve young people, bullying, the internet and social networking are likely to make headlines.

This tragic incident helped the public focus on suicides among young people. As you can see below another very interesting trend has emerged that has been practically ignored: the decline in elder suicides and uptick amongst those in the middle age group.

U.S. Suicide Rates, by Age

Suicide by age

Why might suicides among the elderly decline? Perhaps people stay healthier later in life, and are more likely to access mental health care now than in the past. Learning from this decline can help us better understand what may help lower suicide rates in other age groups.

The Centers for Disease Control (CDC) recently released data that demonstrate significant increases in suicide rates among adults in their 50s, nearly doubling from a decade earlier. Why might this be? The CDC  isn’t sure. “Most suicide research and prevention efforts have focused on youths and older adults. Although the analysis in this report does not explain why suicide rates are increasing so substantially among middle-aged adults, the results underscore the importance of prevention strategies.”

Citing a recent Surgeon General’s report, the CDC concludes:

Suicide prevention strategies such as those that enhance social support, community connectedness, and access to mental health and preventive services, as well as efforts to reduce stigma and barriers associated with seeking help, are important for addressing suicide risk across the lifespan. Other strategies are likely to be particularly critical for addressing the needs of middle-aged adults, such as those that help persons overcome risk factors, which include economic challenges, job loss, intimate partner problems or violence, the stress of caregiver responsibilities (often for children and aging parents), substance abuse, and declining health or chronic health problems.

These are issues that seldom make the news as precipitating events for suicide, since we focus so much attention to challenges in adolescence and young adulthood. The CDC has data on the most common events that precede suicide, as seen below.

Suicide_circumstances

Data from the CDC tell us that the risk of suicide rates increases with age, until age 65, and that access to mental health care is important across the life span—it does not end with adolescence. As noted above, men are also at much greater risk for suicide than women, as are Native Americans and non-Hispanic whites, whose rates are more than double those of African Americans, Latinos, and Asian Americans.

Looking at actual data is a great way to test whether commonly held assumptions are correct. In this case, we have a lot to learn about why people might decide to take their own lives. Suicide is not caused just by personal psychological problems; challenges with relationships, work, and physical health are central to understanding suicide, and are central to helping to create other solutions for people in desperate situations. Addressing broader social issues like access to health care, the economy, and family stressors can play significant roles in reducing suicides, particularly among people who might be facing financial problems after the Great Recession with aging parents and children of their own to care for.

How we think about suicide matters, so much so that the American Society for Suicide Prevention offers suggestions for reporters to provide the public with a more accurate picture. For instance, they suggest checking CDC data before claiming that rates are “skyrocketing” or part of a new epidemic. They warn against sensationalizing individual cases, and emphasize that suicide is a public health issue.

What hypotheses can we create based on these data? About the relationship between gender and suicide? Race/ethnicity and suicide? The recent increase among people in their 50s?

What other assumptions do we often hold about suicide—or another social issue—that we can use data to study more closely?

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