Ecological factors associated with suicide mortality among non-Hispanic whites
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RESEARCH ARTICLE
Open Access
Ecological factors associated with suicide mortality among non-Hispanic whites Nick Graetz* , Samuel H. Preston, Morgan Peele and Irma T. Elo
Abstract Background: In this paper, we examine the ecological factors associated with death rates from suicide in the United States in 1999 and 2017, a period when suicide mortality increased in the United States. We focus on NonHispanic Whites, who experienced the largest increase in suicide mortality. We ask whether variation in suicide mortality among commuting zones can be explained by measures of the social and economic environment and access to lethal means used to kill oneself in one’s area of residence. Methods: We use vital statistics data on deaths and Census Bureau population estimates and define area of residence as one of 704 commuting zones. We estimate separate models for men and women at ages 20–64 and 65 and above. We measure economic environment by percent of the workforce in manufacturing and the unemployment rate and social environment by marital status, educational attainment, and religious participation. We use gun sellers and opioid prescriptions as measures of access to lethal means. Results: We find that the strongest contextual predictors of higher suicide mortality are lower rates of manufacturing employment and higher rates of opiate prescriptions for all age/sex groups, increased gun accessibility for men, and religious participation for older people. Conclusions: Socioeconomic characteristic and access to lethal means explain much of the variation in suicide mortality rates across commuting zones, but do not account for the pervasive national-level increase in suicide mortality between 1999 and 2017. Keywords: Suicide, Non-Hispanic white, Opioids, Religion, Manufacturing, Gun control, Education, Marriage
Background Roughly 800,000 deaths from suicide occur every year globally [56]. In the United States, 47,000 deaths from suicide were recorded in 2017 [31]. Between 1999 and 2017, the age-adjusted suicide rate rose 33% from 10.5 per 100,000 to 14.0 per 100,000. Females exhibit a sharp peak in suicide rates at ages 45–64 while rates for males are relatively flat across the working ages and then show a large increase at ages 75+ (Ibid.). For Americans 40 years and younger, suicide deaths are only exceeded by motor vehicle fatalities [32]. * Correspondence: [email protected] Department of Sociology and Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104, USA
Suicide is often understood as an intensely private and personal act, with the focus of analysis on the mental and emotional health of an individual [37]. While most individuals who die by suicide have a history of mental illness, many of the circumstances and conditions that precipitate suicide are properties not of individuals themselves but of relations between individuals and groups [57]. Durkheim [23] proposed that a key factor in suicide risk was one’s degree of social integration- the sense of social belongin
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