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Sunday, March 11, 2018

Suicide-How Does Your State Compare


Washington State has been undergoing an outcomes-based, health systems improvement plan and a health outcomes scorecard is part of that process. While perusing the most recent health scores for the 2016 calendar year, I was astounded to learn that Washington has a much higher suicide rate which is 16 persons per 100,000 compared to the national average of 13 per 100,000. (Department of Health, 2018) In other words, there are 20% more suicides in Washington based on a population rate, than the average rate for the United States. Even more disturbing is the rate of suicide is increasing in Washington. This astounded me, so I reviewed national data from the Centers for Disease Control and here are the findings from the 2015 survey. (National Center for Health Statistics, 2018)

States posting the highest suicide rates per 100,000 lives were cold and sparsely populated outposts:
  1. 28.0-Wyoming
  2. 26.9-Alaska
  3. 25.3-Montana
States with the Lowest Suicide Rates per 100,000 lives were all on the east coast, which is a densely populated region with good health care access.
  1. 7.2-New Jersey
  2. 8.0-New York
  3. 8.8-Massachusetts

1    Despite all of the news coverage on murders, suicides outnumber murder in the U.S. two to one. It is estimated that there are 45 attempts for every suicide. A 2002 Harvard study of all fifty states found that where there are higher levels of gun ownership, suicide rates are higher. (Kiewra, 2008) For example, Wyoming has a 63% rate of gun ownership and the highest suicide rate in the country.

Comparing the U.S.’s Statewide Bipolarity of Suicide Rates to the World
Suicide is a global problem and though it is higher among poverty-stricken countries, even wealthy European nations have high suicide rates. In fact, the seat of the European Union, Belgium, has one of the highest rates of suicide in the world, with 20.5 deaths by suicide out of 100,000 in 2015. (World Health Organization, 2017) Eastern Europe led the pack for suicides, with Lithuanians doing the deed at a rate of 32.7 out of 100,000. In fact, Europeans collectively had the highest suicide rate in the world in 2015, according to the World Health survey. Even the beautiful country of France had a markedly higher suicide rate than the U.S. with 16.9 deaths per 100,000 people.
The highest suicide rate in the world in 2015 was in Sri Lanka with 35.1 deaths per 100,000, equal to the rate of deforestation of their tropical rain forests(49% loss of forests by 2005). Belgium was only in 2nd place, followed closely by Koreans at 32 deaths per 100,00 souls.
In the Americas, the U.S.A. ranked 6th for its overall suicide rate in 2015, with 14.3 suicides per 100,000 people. The worst suicide rate in the Americas was Guyana, with 29 self-inflicted deaths per 100K, followed by Surinam at 26.6, and Bolivia at 18.7. But even Cubans have a robust suicide rate of 14.1 deaths per 100,000. Amazingly, Canadians, the well-mannered neighbor to the north with national healthcare has a high suicide rate at 12.3 deaths per 100,000.
 In the Pacific, New Zealanders, in the dreamscape without predators, scored a relatively high rate of suicide as well, with 12.6 deaths per 100,000.
Good News
Now for the good news potential retirees, the least suicidal place in the world in 2015 was Barbados at  .40 or less than one half of a person per 100,000 very content souls. Brunei was next at 1.3 lives, followed by Jamaica at 1.4 lives lost to suicide per 100,000 happy folks.

Information on Which to Act
Given the prevalence of suicide, which occurs in both our youth and people in the prime of their earnings years (the Washington survey revealed that males aged 45-55 had the highest rate of suicide) this is a public health crisis. The most popular suicide method is a gun, causing 51% of the deaths. In a recently published study, examining 32 years of firearm ownership in households and suicide data across all fifty states these were the conclusions: (Michael Siegel)
  • ·         State levels of firearm ownership were associated with increased levels of firearm related suicide among males and females
  • ·         Higher levels of gun ownership were associated with increased rates of suicide by any means for males


Whites were found to have the highest suicide rates, followed by American Indians, Pacific Islanders, and Blacks. Speaking to gender, girls attempted suicide twice as often as boys, with Hispanic girls posting a 15.1% suicide rate, compared to 6.8% for White females. Further examination of methods to reduce this disturbing phenomenon is merited, but in the short term here are resources for those in need.

Washington State has a number of suicide prevention coalitions which may be found at:  https://www.doh.wa.gov/YouandYourFamily/InjuryandViolencePrevention/SuicidePrevention/Coalitions

Other Washington State Resources include a Suicide Prevention Resource Center at the capital in Olympia: https://www.sprc.org/states/washington

Harvard’s Injury Control Research Center created a campaign to reduce suicide called Means Matter, which educates the public to keep guns out of the hands of the vulnerable and youth.[1] Reducing access to guns can reduce suicide in the depressed. Other initiatives to reduce suicides in the U.S. include:

National Institute for Mental Health has a suicide hotline-800-273-TALK (2735)

American Foundation for Suicide Prevention has a support network for those with suicidal thoughts and their family members found at: https://afsp.org/find-support/

This is the healthpolicymaven signing off wishing you fully informed consent and a more positive outlook. The healthpolicymaven is a trademark, continuously in use since 2007, owned by Roberta E. Winter, a freelance journalist and healthcare analyst. Winter is the author of a consumer’s guidebook to the U.S. healthcare system, https://www.amazon.com/Unraveling-U-S-Health-Care-Personal/dp/1442222972

References

Department of Health, W. S. (2018). Washington State Public Health Survey 2016 Results. Washington State Department of Health. Retrieved March 11, 2018, from https://www.doh.wa.gov/DataandStatisticalReports/StateHealthAssessment
Kiewra, K. (2008). Guns and Suicide: A Fatal Link. Retrieved March 11, 2018, from https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/
Michael Siegel, M. M. (n.d.). Firearm Ownership and Suicide Rates Among US Men and Women, 1981–2013. 106(7)(July 2016). doi:https://dx.doi.org/10.2105%2FAJPH.2016.303182
National Center for Health Statistics. (2018). Suicide Mortality By State. U.S. Centers for Disease Control, Department of Health and Human Services. Centers for Disease Control. Retrieved March 11, 2018, from https://www.cdc.gov/nchs/pressroom/sosmap/suicide-mortality/suicide.htm
World Health Organization. (2017). Suicide Mortality Rates in 2015. World Health Organization . World Health Organization. Retrieved March 11, 2018, from http://apps.who.int/gho/data/node.sdg.3-4-viz-2?lang=en









8 comments:

C59 said...

A disturbing but good article. I was surprised to learn that the age group in men with the highest suicide rate was the age group 44-55 years of age. I thought that men of that age would have more coping skills so I thought that the age group would be younger. But I can see how in that age group there is a lot of pressure and expectations. So much to think about and it's a good reminder to always be available to listen.

healthpolicymaven said...

Washington State has funded projects to prevent youth suicides, but more needs to be done for the adult age group. I think it reflects a variety of things in U.S. society, which is the hyper individualistic culture and the patchwork of health care services, which are especially poor in rural areas for mental health services, AKA, counseling.

healthpolicymaven said...

I am posting another comment I received:
Suicides are almost always considered a tragedy, first for the dead person and secondly for those close to them. All this is understandable but what about another opinion…one in support of suicide? Taking one’s life rates high as a personal choice. Irreversible (if you don’t succeed) and final, but for some that is just what they want and most all others do everything they can to prevent it. We even haggle about peoples right to die when they are old, informed or have a terminal malady. Right to die people don’t agree and it gets confused with the right to lifers.

Many see life theologically others as a right but few as a choice. But what if a person sees life differently, not as any of the forging but rather “a condition” of existence?

I support suicide as a choice. I believe we should have the right to chose and a safe, dignified and “clean” way to accomplish it. There is a point where some just don’t want to go on for a myriad of reasons and we should let them opt out no matter what their age or situation…it is the ultimate choice. Many will disagree with my position saying the chooser is/was not well informed but what is the standard of informed…their definition or the individuals? Like all choices in life and death there is the potential for abuse. If we devote even a small effort to looking at suicide as a respectable choice, as much as we do to preventing it perhaps we can come up with better policies. Forcing one to live seems not the only choice and an imposition on a persons most private considerations.

It remains curious that abortion and right to life is not considered to start the very instant of conception.

jk

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Unknown said...

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