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A new government reports shows that suicide rates in the U.S. have soared since 1999, with the most dramatic increases occurring among young white females and Native Americans. So why are Americans suddenly killing themselves in droves? It’s a major public health issue with no easy explanations.

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The suicide rate in the United States has jumped 24 percent in the years between 1999 to 2014, according to a new report put out by the U.S. Centers for Disease Control and Prevention. That’s a rise from 10.5 to 13 suicides per every 100,000 people. From 1999 to 2005, the suicide rate went up about a single percentage point each year, but since 2006 it’s been escalating at an annual rate of 2 percent. It’s a disheartening finding, especially considering that suicide rates were actually going down from 1986 to 1999.

Age-adjusted suicide rates, by sex: United States, 1999–2014. (Image: CDC).

The CDC report shows that suicide rates for both males and females were higher in 2014 than in 1999 among those between the ages 10 and 75. On a (lone) positive note, people over 75 are killing themselves less (this was the only demographic to show a downward trend). The biggest spike for females were among those aged 10-14, and the biggest increase for males was for those between the ages of 45 to 64.

Suicide rates for females, by age: United States, 1999 and 2014. (Image: CDC).

In 2014, the most frequent suicide method among males involved guns (55.5 percent), while poisoning was the most frequent method for females (34.1 percent).

Suicide deaths, by method and sex: United States, 1999 and 2014. (Image: CDC).

In 2014 alone, some 42,773 Americans killed themselves, making it the tenth leading cause of death for all ages. Yet it’s something we rarely discuss or think about in the context of a health crisis. Part of the problem is that suicide is a complex phenomenon, one driven by psychological, biological, and social factors.

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So what’s changed since 1999? One explanation is the economic downturn, which may explain the sudden increase in suicides after 2006. Another factor is easy access to guns. As psychotherapist Katherine King told Gizmodo, “Means is a very important part of any suicide risk assessment. If people with suicidal ideation also have the means available to them, they’re more likely to do it.” She said there’s a certain impulsiveness to suicide, and when the tools are readily available, there is an increase in risk.

But it would be a gross oversimplification to suggest that easy access to guns, pills, or poisons is the only problem. In fact, the CDC suggests a shift away from these methods. In 2014, 25 percent of all suicides were by suffocation, including hanging, which is up by five percent.

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Other factors include social isolation and depression. But as King explained, depression and thoughts about suicide are two separate things. A person can have suicidal thoughts, but not be depressed, and vice versa. Yes, it’s generally associated with depression and other mood disorders, but it has also been linked to other factors, especially life and family events (such as losing one’s job or a life partner).

“There’s also a contagious aspect to it,” said King. “Vulnerable people who have more exposure to suicide do have an elevated risk of dying by suicide themselves.” Social contagion may explain why suicide rates have increased dramatically among Native Americans, both in the United States and elsewhere. In Canada, the northern Ontario community of Attawapiskat is currently grappling with a suicide epidemic among young aboriginal youth; the small community recorded 28 suicide attempts in March, and already a dozen attempts in April.

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Age is also a factor. Girls between the ages of 10-14 are particularly vulnerable, for reasons that aren’t entirely clear. Tweens and teens experience strong feelings of stress, confusion, self-doubt, and pressure to succeed. This, combined with a lack of life experience and perspective, makes for a potent combination.

Middle aged men are also extremely vulnerable. According to the new CDC report, almost 30 in 1,000 men between the ages of 45 to 64 killed themselves in 2014. That’s a whopping 43 percent increase over 1999's rate—making them the most vulnerable group for suicide among all demographics. So why do middle aged men find life so difficult? Some possible explanations include the infamous “mid-life crisis,” and associated feelings of depression, hopelessness, and loss. Easy access to guns and prescription painkillers may also be a contributing factor, as is the poor state of the U.S. economy.

The CDC report should serve as a wake-up call. This should be a public health issue of paramount importance, alongside cardiovascular disease, obesity, and cancer.

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[US Centers for Disease Control and Prevention]