Details:

Alternative Title:
MMWR Surveill Summ
Personal Author:
Ivey-Stephenson, Asha Z. ; Crosby, Alex E. ; Jack, Shane P. D. ; Haileyesus, Tadesse ; Kresnow-Sedacca, Marcie-jo
Ivey-Stephenson, Asha Z. ; Crosby, Alex E. ; Jack, Shane P. D. ; Haileyesus, Tadesse ; Kresnow-Sedacca, Marcie-jo Less -
Description:
Problem/Condition

Suicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts.

Reporting Period

2001–2015.

Description of System

Mortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60–X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001–2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme.

Results

Suicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons aged 35–64 years. For mechanism of death, greater increases in rates of suicide by firearms and hanging/suffocation occurred across all urbanization levels; rates of suicide by firearms in nonmetropolitan/rural counties were almost two times that of rates in larger metropolitan counties.

Interpretation

Suicide rates in nonmetropolitan/rural counties are consistently higher than suicide rates in metropolitan counties. These trends also are observed by sex, race/ethnicity, age group, and mechanism of death.

Public Health Action

Interventions to prevent suicides should be ongoing, particularly in rural areas. Comprehensive suicide prevention efforts might include leveraging protective factors and providing innovative prevention strategies that increase access to health care and mental health care in rural communities. In addition, distribution of socioeconomic factors varies in different communities and needs to be better understood in the context of suicide prevention.


Subjects:
[+]
Adolescent Adult Aged Age Distribution Cause Of Death Child Ethnicity Female Humans Male Middle Aged Racial Groups Sex Distribution Suicide Surveillance Summaries United States Urbanization Young Adult
Source:
MMWR Surveill Summ. 66(18):1-16
Pubmed ID:
28981481
Pubmed Central ID:
PMC5829833
Document Type:
Journal Article
Collection(s):
Morbidity and Mortality Weekly Report (MMWR)
Main Document Checksum:
[+]
urn:sha256:7022886a13c2c2cffd09e16f70fbc82b89a388d242461bc6fafabd85309894a5
Download URL:
https://stacks.cdc.gov/view/cdc/111583/cdc_111583_DS1.pdf
File Type:

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