Suicide rates are rising, especially in rural areas of America

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Suicide rates are on the rise, especially in rural America, according to a study released Friday.

From 1999 to 2016, the suicide rate among Americans aged 25 to 64 increased by 41%, researchers at the JAMA Network Open reported. Rates among rural county residents were 25% higher than those in large metropolitan areas.

A number of factors appear to be contributing to rising suicide rates in rural America, including poverty, low income, and underemployment, said lead author Danielle Steelesmith, a postdoctoral fellow at the medical center. Wexner from Ohio State University.

"These factors are really bad in rural areas," said Steelesmith.

The study also found that counties with high levels of social fragmentation – based on levels of single-person households, unmarried residents and residents in transit – and that one high percentage of veterans had higher suicide rates. All these factors were more pronounced in rural counties.

The presence of a larger number of weapons stores was also associated with an increase in suicide rates in all counties, with the exception of more rural ones, the researchers said.

To take a closer look at suicide rates in America, Steelesmith and his colleagues turned to data from the vital statistics system, a database containing information on suicide deaths, including the number of deaths. 39, year of death, sex, age and country of residence.

Researchers also used information from several other databases, including the US Census, the US Community Survey, county activity models, health resource files, and the classification system. industries in North America.

They found that between 1999 and 2016, there were 453,577 suicides among Americans aged 25 to 64, the largest proportion having occurred in the last three years studied. The majority of those killed were men (349,082) and suicides were more common among middle-aged adults than among younger and older adults.

The counties with the highest suicide risk were in the West, including Colorado, New Mexico, Utah and Wyoming; The Appalachians, including counties of Kentucky, Virginia and West Virginia; and the Ozarks, including the counties of Arkansas and Missouri.

A "growing American tragedy"

Rising suicide rates in rural counties is "alarming," said Oren Miron, a researcher at the Clalit Research Institute in Israel, who is also studying suicide rates in collaboration with Harvard Medical School.

Miron, who did not participate in the new research, said that two of the factors identified in the study – high rates of veterans and the unemployment rate – "may interact in a dangerous way".

"If a veteran returns from a deployment in a jobless county, he could lose all hope of rejoining civilian life," Miron said. "Reintegration into civilian life is a time of high suicidal risk, hence the need to help rural county veterans get their first job."

Special programs, such as vocational training, could help improve the situation, said Steelesmith.

Suicide "is a growing American tragedy," said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. "It has become a major cause of death in the United States and a major public health problem."

In rural areas, "many of the most pernicious health problems and social problems intersect," said Wu.

Lack of access to health care in rural areas further aggravates the problem. "Insurance can be an indirect indicator of people's access to mental health care," said Steelesmith.

Wu agreed. "The lack of health insurance kills people," he said. "More insurance, including the expansion of Medicaid, could help."

Nevertheless, "the social determinants of health are really important," said Dr. David Brent, holder of the Suicide Research Chair and Professor of Psychiatry at the University of Pittsburgh. "We can not tackle these kinds of public health problems without doing something to fix the problem. [those social determinants]. Yes, you can provide more services to the poor, but nothing has been done to help people out of poverty. "

If you or someone you know is in crisis, call the National Life Line for Suicide Prevention at 800-273-8255, text HOME at 741741 or visit SpeakingOfSuicide.com/resources for additional resources. .

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Linda Carroll is a regular contributor to NBC News and Reuters Health's health programs. She is co-author of "The Crisis of Concussions: The Anatomy of a Silent Epidemic" and "Breaking Out of the Clouds: The Unlikely Rider and the Unwanted Colt That Conquered the Sport of Kings".

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