HEALTH MAY 20, 2013
Earlier this month, a report by the Centers for Disease Control and Prevention revealed that suicide rates among middle-age Americans have surged over the last decade: an increase of nearly 30 percent, to 17.6 deaths per 100,000 people, among ages 35-64. There's been rampant speculation about the reason for this rise, most recently Ross Douthat's weekend column ascribing it to the imbalanced economy and America’s “retreat from community”—particularly declining participation in traditional institutions like marriage and religion. The geography and history of suicide in the United States, though, suggest that the decline of such values has nothing to do with it.
If traditional institutions reduce suicide, as Douthat suggests, then suicide rates should be lower in the South, where religiosity is highest, or in the inland West, where marriage is most common. Instead, suicide rates are lowest in the northeastern corridor, with Washington, D.C., and New York rounding out the bottom of the list. Suicide is most common in the sparsely populated states of the interior West. If the 30 percent increase is worthy of a headline, then western states deserve a spot in the headlines, too: The suicide rate in states like Alaska or Montana is more than 300 percent higher than in D.C. or New York.
Contrary to what Douthat might expect, there’s no correlation—zero—between a states’ suicide rate and religion, marriage rates, or single occupancy homes. State economic growth or unemployment don’t line up, either. Economically struggling states like Michigan and Indiana, for instance, had suicide rates near the national average, while booming North Dakota was well above. Depression would seem to be a precursor to suicide, but depression, which is highest in the Deep South and Appalachia and low in the inland West, doesn’t correlate with suicide, either. Is it possible that there’s something about the inland West that makes depressed people more likely to commit suicide? That’s what the data suggests.
If anything correlates with suicide rates, it’s a states’ population density: In populous areas, suicide rates are low; in the sparsely populated hinterlands, suicide rates are high. Perhaps depression and loneliness is particularly harsh in desolate areas, and maybe it’s easier to cope in a major city like D.C. or New York. A more intriguing possibility is gun ownership, which, like suicide rates, is highest in the West and lowest in the Northeast. The relationship between gun ownership and suicide isn’t hard to envision, since more than half of suicides are by firearm. Therefore, accessible firearms could plausibly increase suicide rates. Then again, the South has high levels of gun ownership and higher levels of depression than the inland West, but suicide is rarer in Alabama than Montana.
But what about the increase in suicide rates? Couldn’t it be from declining religion and marriage rates, even though suicide rates in the West were higher in the first place? Nope. Suicide rates have increased incrementally across the board.
Although suicide rates have increased considerably since 1999, it should be noted that suicide rates reached an all-time low before the millennium at about 10.4 per 100,000—the recent surge has merely brought us back to the rate in 1990, when it was 12.5 per 100,000. The decline in the '90s and the increase over the last ten years seem consistent with an economic explanation, not the cultural theory. After all, suicide rates are lower today, even for the middle-aged, than they were in 1960 and 1970—that is, back in the good old days of traditional institutions that, if Douthat were right, should have discouraged people from killing themselves.