Authors: Alison L. Cammack, PhD1; Mark R. Stevens, MSPH1; Rebecca B. Naumann, PhD1; Jing Wang, MD1; Wojciech Kaczkowski, PhD; Jorge Valderrama, PhD2; Deborah M. Stone, ScD1; Robin Lee, PhD1

Journal: Morbidity and Mortality Weekly Report

Publication Year: September 10, 2024

Keywords: Health Care Access, Misclassification of AI/AN, Social Determinants of Health (SDOH), Suicide and Suicide Prevention, Internet Access, Socioeconomic factors

Abstract:

Introduction: Approximately 49,000 persons died by suicide in the United States in 2022, and provisional data indicate that a similar number died by suicide in 2023. A comprehensive approach that addresses upstream community risk and protective factors is an important component of suicide prevention. A better understanding of the role of these factors is needed, particularly among disproportionately affected populations.

Methods: Suicide deaths were identified in the 2022 National Vital Statistics System. County-level factors, identified from federal data sources, included health insurance coverage, household broadband Internet access, and household income. Rates and levels of factors categorized by tertiles were calculated and presented by race and ethnicity, sex, age, and urbanicity.

Results: In 2022, the overall suicide rate was 14.2 per 100,000 population; rates were highest among non-Hispanic American Indian or Alaska Native (AI/AN) persons (27.1), males (23.0), and rural residents (20.0). On average, suicide rates were lowest in counties in the top one third of percentage of persons or households with health insurance coverage (13.0), access to broadband Internet (13.3), and income >100% of the federal poverty level (13.5). These factors were more strongly associated with lower suicide rates in some disproportionately affected populations; among AI/AN persons, suicide rates in counties in the highest tertile of these factors were approximately one half the rates of counties in the lowest tertile.

Conclusions and Implications for Public Health Practice: Higher levels of health insurance coverage, household broadband Internet access, and household income in communities might play a role in reducing suicide rates. Upstream programs, practices, and policies detailed in CDC’s Suicide Prevention Resource for Action can be implemented by decisionmakers, government agencies, and communities as they work together to address community-specific needs and save lives.

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Type of Resource: Peer-reviewed journal article