Now that we have defined suicidal behavior, we can discuss its prevalence. Suicide prevalence has to do with the number of people who commit suicide in a given time period, such as within a year. We know that throughout recent history, suicide has been one of the leading causes of death in the USA. However, the accuracy of our statistics is not clear since there are methodological (data collection) problems with existing studies that complicate how accurately suicide attempts and completions are measured.
Attempted suicides resulting in emergency room visits are typically "counted" in studies, but researchers really don't know how many other people attempt suicide and do not end up at the hospital. Some scientists have simply asked groups of people whether or not they have ever attempted suicide and extrapolated from those percentages, but it is unclear whether respondents are entirely honest in answering this sort of question. As a result, there are no entirely reliable national statistics for the numbers of suicide attempts. Estimates suggest that approximately 800,000 Americans attempt suicide per year. This number most probably underestimates the true magnitude of the issue, but there is no way to tell for sure.
We have a clearer picture of the number of completed suicides, although some accidents may still be mistakenly considered suicides and vice versa. According to official statistics, suicide was the 11th leading cause of death in the US in 2001. Even though we typically think of suicide as a teenage problem, other age groups also commit suicide. Older Caucasian males (85 years or older) committed suicide at the highest rate of any age group.
Demographic Contributions To Suicide Risk
Some factors that can help predict whether someone is at risk of committing suicide have to do with their demographics or how they fit into the various segments of the population. Certain groups of people tend to be more at risk for completing suicide than others. For instance, as we just noted, older Caucasian males are at a greater risk for completing suicide than other groups.
While it is certainly useful to know this demographic information, it is important to keep in mind that the predictive power that this knowledge confers is rather weak. Even within high risk groups, actual suicide is a low frequency event. Many more people will show signs of possible suicidality (such as suicidal ideation) than will ever actually commit suicide. Predicting who will commit suicide on the basis of demographics alone is impossible. Combining knowledge of those demographic risks and other life circumstances/triggering factors that cause someone to commit suicide can provide greater (but still quite imprecise) insight into the true risks.
Here are some of the demographic (social group membership) characteristics that have been associated with recent suicides in the United States:
- Suicide is the third leading cause of death for adolescents and young adults from age 15-24. Between 1970 and 1990, suicide rates for adolescents (ages 15 through 19) nearly doubled. Since 1990, the overall suicide rate for this age group has stabilized at approximately 11 deaths per 100,000. Younger people are more likely to attempt and less likely to complete a suicide than older people.
- Increased alcohol and substance use, the increased availability of firearms, and the fact that many mental disorders (such as depression and schizophrenia) begin or worsen during these ages all contribute to these statistics. Suicide victims under the age of 30 are also more likely to have dual diagnoses (a combination of a mental illness and a substance abuse disorder), impulsive and/or aggressive behavior disorders, and legal problems than people over 30 who commit suicide. However, the challenges of adolescence alone are enough for some teens to commit or attempt suicide.
- As mentioned previously, older Caucasian males commit suicide at the highest rate of any population group. Older men are more likely to use lethal methods (e.g., firearms) than older women and people of other ages. Older individuals in general make fewer suicide attempts per completed suicide than other age groups, and have often spent a fair amount of time planning their suicide. However, although many older adults who kill themselves give indirect warnings (saying things like "there is nothing left for me anymore", or tying up lose ends with wills, etc.), they are less likely to directly communicate their intent to die. Widowhood, serious medical illness, and social isolation are particularly common risk factors for this demographic group.
- Whites and Native Americans (especially adolescents) have the highest suicide rates than any other ethnic group in the US. In addition, the rate of suicide among young African American males has been steadily increasing.
- Men are more likely to commit suicide than women. Researchers suggest that men suffering from depression are more likely to go unrecognized and untreated than women suffering from depression, in part because men may avoid seeking help (viewing it as a weakness). Men who are depressed are also more likely to have co-occurring alcohol and substance use disorders than women.
- Men are more likely than women to use highly lethal methods to commit suicide. Men are more likely than women to use a gun, carbon monoxide, to hang themselves, or to jump from a height to commit suicide. In addition, men who are intoxicated and suicidal are more likely to use a gun than females who are intoxicated and suicidal.
- Women are more likely than men to attempt suicide. In terms of method, women tend to overdose or to cut their wrists.
- Marital status is associated with suicide risk. Living alone and being single both increase the risk of suicide. Marriage is associated with lower overall suicide rates; and divorced, separated and widowed people are more likely to commit suicide. Gender seems to affect this relationship; divorced and widowed men are more likely than divorced and widowed women to commit suicide.
- Being a parent, particularly for mothers, appears to decrease the risk of suicide. Even pregnant women have a lower risk of suicide than women of childbearing age who are not pregnant.
- The Rocky Mountain and Western states have the highest rates of suicide in the U.S. Interestingly, this statistic isn't weather-related (it's a myth that cold, rainy, snowy and/or cloudy weather results in a higher rate of suicide; most suicides occur in the springtime), but is related to the concentration of people in these states. Even though there are certainly large cities in these states, overall, the population is more "spread out" than in other parts of the country. See the next bullet point.
- Suicide rates are higher in rural areas. People in rural ares are more likely to attempt suicide with a firearm. Because people who use a firearm are more likely to die (than others who choose a less lethal method), more people in rural areas die from suicide.
- Industrialized countries generally have higher rates of suicide than non-industrialized countries. Among industrialized countries, the U.S. has a moderate rate of suicide.
- There may be some suicide rate differences between groups of people employed in certain careers or occupations, but there isn't enough evidence to know for sure. Dentists, psychiatrists, police officers, and other groups have all claimed to have the highest rates of suicide, but since no nationwide data has been collected and many of the studies that have been conducted are substantially flawed, no one really knows whether this is true.
- Religiosity seems to have a protective effect against suicide. Exactly which religion(s), during what ages/developmental periods, and among which ethnicities remain unanswered questions. Many of the studies of the relationship between religion and suicide have been too small, contradictory, or flawed to make overall conclusions. However, research suggests that in the United States, areas with higher percentages of individuals without religious affiliation have correspondingly higher suicide rates. Involvement with a religion may provide a social support system, a direct way to cope with stressors, a sense of purpose and/or hope, and may lead to a stronger belief that suicide is wrong. Religiosity also seems to be related to other demographic factors; religious North Americans are much less likely than nonreligious people to abuse drugs/alcohol and to divorce (which are both associated with increased suicide risk).
- Economic status has not been found to be a predictor in the simple way that social scientists once thought. Early suicide researchers theorized that poverty was a significant risk factor for suicide. The theory was that being poor could make one feel depressed, desperate or ashamed at times. This isn't entirely wrong, but research has shown that both the lowest-low and the highest-high incomes are more strongly associated with rates of suicide than other income levels. In other words, it's the extremes of either poverty or wealth that are associated with higher suicide rates.
- Unemployment is associated with increased rates of suicide. Obviously, people who are unemployed often experience financial stress. In addition, alcohol consumption and marital discord can increase with financial difficulties, which can also increase someone's risk of suicide.