The U.S Centers for Disease Control and Prevention (CDC) reported on May 3, 2013 that “recent evidence suggests there have been substantial increases in suicide rates among middle-aged adults in the United States.”
CDC analyzed National Vital Statistics System mortality data from 1999–2010, and found that the suicide rate among Americans aged 35–64 years increased 28.4 percent (from 13.7 per 100,000 population in 1999 to 17.6 per 100,000 in 2010).
Among American men aged 35–64, the suicide rate increased 27.3 percent from 1999 to 2010, and among American women aged 35-64, the suicide rate increased 31.5 percent. Among men, the greatest increases were in those aged 50–54 years old (49.4 percent increase) and those aged 55–59 (a 47.8 percent increase). Among women, suicide rates increased with age, and the largest percentage increase in suicide rate was observed among those aged 60–64 years, a 59.7 percent increase for this group of women.
The suicide rate of those grouped as “whites” increased 40.4 percent from 1999 to 2010, the second highest increase among ethnic/racial groups. The highest increase among ethnic/racial groups was for “American Indian/Alaska Natives,” who saw a 65.2 percent increase in suicides.
Why the Increase in Suicide among Middle-Aged Americans
The CDC notes, “Possible contributing factors for the rise in suicide rates among middle-aged adults include the recent economic downturn (historically, suicide rates tend to correlate with business cycles, with higher rates observed during times of economic hardship).” Other researchers point to the recent economic downturn with more certainty as the major culprit.
The medical journal the Lancet (“Increase in State Suicide Rates in the USA During Economic Recession,” November 2012) reports, “Coinciding with the onset of the recession, the suicide rate accelerated.” Specifically, the Lancet reports that in the years before the onset of the financial crisis (from 1999 to 2007), the U.S. suicide rate was rising on average at a rate of 0.12 per 100,000 per year; while after the recession, there were an additional 0.51 deaths per 100 000 per year, and the Lancet calculates that “this acceleration corresponds to an additional 1,580 suicides per year.”
The Lancet details the relationship between unemployment and suicide, concluding “rising unemployment could account for about a quarter of the excess suicides noted in the USA during this time,” and it adds that “future research should explore other risk factors such as foreclosures and job and income losses, and modifying factors such as gun control policies.
Another telling study is “Impact of Business Cycles on US Suicide Rates, 1928–2007,” published in the American Journal of Public Health (June 2011). As would be expected, the study authors report that “analyses showed that the overall suicide rate generally rose during recessions and fell during expansions.” Suicide rates of those aged 25 to 64 years rose during economic contractions and fell during expansions; however, suicide rates of the groups aged 15 to 24 years and aged 65 and older were significantly less affected by economic downturns and upturns. This finding echoes the May 3, 2013 CDC report that states suicide increases among those aged 10–34 years and those older than 65 were “comparatively small and not statistically significant.”
One explanation for differences among age groups with respect to suicide increases is that Americans aged 10–34 years and those older than 65 are more insulated from financial hard times. Those younger than 34 may not yet be on their own and are less likely to lose a home in foreclosure; and Americans aged 65 and older have social security and Medicare. Americans aged 34-64 are more likely to have no financial safety nets, making the threat of unemployment more likely to create debilitating anxiety, and the consequences of unemployment more likely to result in depression and suicide.
Preventing Suicide in Middle-Aged Americans
The CDC speculates that another possible reason for the substantial increases in U.S. suicide rate for middle-aged Americans might be a baby boomer generation cohort effect, as the baby boomer generation had unusually high suicide rates during their adolescent years, and so CDC recommends that special attention with regards to mental health prevention strategies be provided to this possibly more vulnerable group. The CDC report also offers up the 2012 Surgeon General’s National Strategy for Suicide Prevention approaches that “enhance social support, community connectedness, and access to mental health and preventive services, as well as efforts to reduce stigma and barriers associated with seeking help.”
What neither the CDC, the U.S. Surgeon General, the National Institute of Mental Health, nor other major U.S. mental health institutions emphasize is this: Suicide, depression and many other serious emotional difficulties can be most easily prevented by political courage and different public policies, not by medical treatments.
While the CDC acknowledges that “possible contributing factors” for increased suicide rates include the recent economic downturn, the research, history, and common sense make it obvious that the recent financial meltdown is the major culprit for the substantial increase in suicides among middle-aged Americans.
The Lancet estimates that the three-year recessionary period from 2008 thru 2010 was a source in the United States for “4,750 excess suicide deaths.” This increase was not caused by genetically induced biochemical brain imbalances, but by criminal Wall Street practices. If Wall Street scoundrels caused the economic meltdown, and the financial meltdown resulted in increased suicides, more important suicide prevention than increased mental health treatment would be incarcerating some of these criminals so as to serve as a deterrent for future irresponsible behavior, practices that have proven to be quite deadly.
Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics and psychology intersect. His latest book is Get Up, Stand Up: Uniting Populists, Energizing the Defeated, and Battling the Corporate Elite. His Web site is www.brucelevine.net
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.