Study shows rural residency, gun shop prevalence, lack of insurance associated with higher suicide rates
A higher density of gun shops, lack of health insurance and larger populations of veterans are all associated with higher adult suicide rates across the United States, according to a new Ohio State University study that reviewed county-level data.
Deprivation and social fragmentation also are possible explanations for increased suicide rates, which are higher and have risen more rapidly in rural counties, said the study, published online Friday in the journal JAMA Network Open.
Researchers hope the findings will be use to target specific suicide prevention efforts, said Cynthia Fontanella, co-author and associate professor of psychiatry and behavioral health at Ohio State.
“Findings suggest that increasing social connectedness, civic opportunities, health insurance coverage, and limiting access to lethal means within communities have the potential to reduce suicide rates across the rural-urban continuum,” the study says. “Suicide rates in rural counties are especially susceptible to deprivation, suggesting that rural counties present special challenges and deserve targeted suicide prevention efforts.”
The study looked at the 453,577 suicides between 1999 and 2016 among people ages 25-64, and it compared the rates in three-year periods.
The first period, between 1999 and 2001, saw a median suicide rate of 15 per 100,000 people on the county level. The last period, between 2014 and 2016, saw a rate of 21.2 per 100,000 — a jump of 41%.
Men accounted for more than three-fourths of the suicides.
Counties with the highest suicide rates were mostly in Western states, Appalachia and the Ozarks.
Researchers also calculated a “standardized mortality ratio” for each U.S. county, or county equivalent, to compare the actual number of suicides with the expected number of suicides. Counties with a ratio of more than 1 are considered as having an excess risk of suicide.
Nationwide, the highest risk in the three-year period from 2014 to 2016 was found in the Wade Hampton (now Kusilvak) Census area in Alaska. It had a 4.2 ratio. The lowest ratio, 0.56, was in Kings County, New York.
The states with the highest average county-level mortality ratios were Montana, Utah, New Mexico, Nevada and Wyoming. Those with the lowest were New Jersey, Massachusetts, New York, Connecticut and Maryland.
In New York, the average county mortality ratio was 1, which is 32.3 percent lower than the national average of counties.
Pro Action Resilient Children & Families & the Steuben County Suicide Prevention Coalition have partnered to offer Youth Mental Health First Aid Training as Part of the National Initiative to Increase Mental Health Literacy.
On Tuesday, in recognition of World Suicide Prevention Day, Pro Action Resilient Children & Families will be offering Youth Mental Health First Aid training at the Hornell Community Arts Building. This groundbreaking eight-hour training course gives people the tools to identify when someone might be struggling with a mental health or substance use problem and to connect them with appropriate support and resources when necessary.
The American Foundation for Suicide Prevention, reports that suicide is the 10th leading cause of death nationally for all age groups and the Center for Disease Control reports that suicide has risen to the 3rd leading cause of death for adolescents and young adults. According to the Steuben County Community Health Assessment, "Recent data is showing sharp increases in emergency department visits for substance abuse, heroin overdose, and mental health diagnoses."
Suicide ranks among the top 5 causes of premature deaths in Steuben County. Unlike physical conditions, symptoms of mental health and substance use problems can be difficult to detect. For friends and family members, it can be hard to know when and how to step in. As a result, those in need of mental health services often do not get them until it is too late.
Additionally, the VA Finger Lakes Healthcare System at Bath will be hosting the Power of One Walk as an event to highlight and demonstrate the community’s support in suicide prevention on Thursday, Sept. 12 from 10:30 a.m. - 2:30 p.m. (opening ceremony to start promptly at 10:30) at the Bath VA Medical Center Campus
There are numerous activities planned for the day including a walk, art show, music, yoga, Tai Chi, food and refreshments, emotional support animals, t-shirt painting, rock painting and much much more. Over 40 health and human services will be supporting the event and providing additional activities and information. There are numerous activities planned for the day including a walk, art show, music, yoga, Tai Chi, food and refreshments, animals as part of therapy, t-shirt painting, rock painting and much much more.
All the community is invited to come and participate. Many community agencies will also be attending and supporting the event providing additional activities and information. There are numerous activities planned for the day including a walk, art show, music, yoga, Tai Chi, food and refreshments, animals as part of therapy, t-shirt painting, rock painting and much much, more. All the community is invited to come and participate. Many community agencies will also be attending and supporting the event providing additional activities and information.
One of the unique art works on display will be Christopher Cilento’s work titled – The Journey. Christopher Cilento is a 24-year Army Veteran who has seen multiple combat deployments. His creative work shows how art was used in his personal journey toward healing. There will be a reception held for his work on Tuesday, September 10 from 3 to 5 in the Auditorium, Building 92.
His art work will be on display for the public Sept. 10, 9-5 and Sept. 12, 10:30-2:30.
The Power of One event is being held during Suicide Prevention Awareness week which runs Sept. 9-14.
The gun shop association was most substantial in urban areas and present in all county types except the most rural, the study says.
Guns were used in about half of all suicides in 2017, according to the Suicide Prevention Resource Center.
Study researchers found no association between gun shops and suicides by methods other than firearms.
Jim Irvine is board president of the Buckeye Firearms Association, which also is involved in suicide prevention efforts. He said he hadn't seen the report's data, and noted that suicides with firearms often result in death, but they are not necessarily used in the most attempts.
"Suicide is a massive problem in our country, and we need to deal with it, and I welcome any study on it that helps us understand what's going on better and make some progress to reverse these trends and save lives," Irvine said.
Along with reducing access to lethal means among people at risk, Fontanella said, communities may benefit from enhancing coping and problem-solving skills and strengthening economic development, education and training, incentivizing mental health clinicians to work in underserved areas and using web-based telemedicine.
“Rural areas might also benefit from suicide prevention strategies that support social connection through community organizations and community engagement activities,” she said.
The study also showed that higher social capital — measured by the number of several groups, such as charities, business, political, civic and religious organizations, and opportunities to engage in art and recreation — was associated with reduced suicide rates.
Factors that showed no association with suicide rates were the ratios of physicians to residents and psychiatrists to residents and the number of drinking establishments.
"We know we can prevent suicide,” said Terry Russell, executive director of the Ohio affiliate of the National Alliance on Mental Illness. “But it takes gatekeepers to identify people early and make sure they know what services are available.”
If you or someone you know has thoughts of suicide, reach the national Suicide Prevention Lifeline at 1-800-273-8255/TALK.