Q. How much should we care about suicide?

Q. How much should we care about suicide? April 27, 2016

http://www.publicdomainpictures.net/view-image.php?image=101954&picture=fresh-grave; public domain

A.  More than we care about breast cancer — at least, based on causes of death data.

The CDC put out a Data Brief recently on trends in suicides over the last 15 years which is unsettling, and worrisome.  I’m not going to try to get into any in-depth discussion of causes, but the key item is this:  the death rate by suicide has climbed 24% since 1999.  The rate for women climbed by 45%, from 4 per hundred thousand to 5.8 per hundred thousand, and the rate for men, which was 4 1/2 times as high as that for women in 1999, at 17.8, at least climbed at a slower pace, to 20.7 — though in absolute terms, the men’s rate increased by 2.9 per 100,000, vs. 1.8 for women.

Here are the two key tables:

4-27-2016 10-05-00 PM

4-27-2016 10-05-54 PM

Now, don’t be misled by the fact that these tables are the same size — read the numbers.  The women’s rates are much smaller than the men’s, and even at the age group where the women’s rates have the most dramatic increase over this period, the men’s rate grew, in absolute terms, by twice as much.

And what else jumps out at you?  I had already know that the image we have of suicide being a problem primarily for teens and young adults is wrong, but I find it startling that the patterns are so different between men and women:  for women, there’s a steady increase until middle age,then a drop back down.  For men, the age 75+ rates are significantly higher than any other year.  Did you know this?

I suppose it’s encouraging that the rate has come down slightly in the past 15 years, unlike the other age groups.  I have a vague memory of reading somewhere that there is an increasing awareness, and diagnosis and treatment of depression in the elderly, rather than just shrugging it off as “eh, that happens when you get old” — perhaps, presuming that I’m remembering correctly, this is an indicator that this is making a difference.

It also continues to be striking to me just how common suicide is.  Considering all ages, it is the 7th most common cause of death for men, according to a causes-of-death table based on CDC data.  More strikingly, if I look only at men and women under age 75, and raw numbers of deaths, 50% more people die from suicide than breast cancer (39,186 vs. 26,326); looking at the under-65s, the number is double (35,076 vs. 16,706).

When is Suicide Awareness Month?  What color is its “awareness ribbon”?  Do we focus on breast cancer because we know there are medical treatments, and suicide seems somehow unavoidable and inevitable?  Or because breast cancer victims are more sympathetic?

UPDATE:

One further datapoint:  despite the increase in the number of firearms, the proportion of suicides by firearm has decreased.  Here’s the relevant table (my table, based on data in the CDC report):

4-28-2016 7-16-01 AM

In other words, the increase is almost all due to “not-by-firearm” deaths, if one were to split these out separately as if they’re two wholly separate occurrences.

Another comment:  Wesley J. Smith, writing at the National Review, connects this increase to the growing promotion of assisted suicide.

I believe the assisted suicide movement bears partial responsibility. Suicides have increased at the very time the assisted suicide movement has been vigorously and prominently promoting self-killing as a proper means to alleviate suffering.

Moreover, assisted suicide is often portrayed sympathetically in popular entertainment and the media is completely on board the assisted suicide bandwagon. Don’t tell me that doesn’t give despairing people lethal ideas.

Is he right?  Is there even any way to prove or disprove his theory?  I don’t know; it’s just food for thought.

 

Imagine:  http://www.publicdomainpictures.net/view-image.php?image=101954&picture=fresh-grave; public domain

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