How and where growing numbers of Americans are taking their own lives

The statistics of self-destruction

United StatesMar 28th 2018 edition

THIRTY-THREE people leapt from the Golden Gate Bridge last year, plunging 75 metres to their deaths. Yet the tally could have been much worse. Another 245 contemplating suicide were talked down by the police patrols who diligently comb America’s most famous suicide site. Plans to construct a suicide-prevention barrier (a large net) have now been agreed on: it will be completed in 2021 and cost $204m.

Though jumping is a relatively rare way to end one’s life, it is on the rise. There were 1,123 such deaths in 2016 compared with 788 in 2010. The same trend holds for suicides by gunshot, overdose and hanging, according to an analysis by The Economist of mortality files from the Centres for Disease Control. In almost every demographic category—men and women, young Asians and elderly whites, city dwellers and rural folk—the problem is getting worse.

In nearly all other OECD countries, suicide has declined since 2000 (Greece and South Korea are exceptions). In America, however, from 2003 the number began to grow by 1,000 a year and did not stop. This climb has been almost perfectly constant. In 2016, the latest year for which detailed data are available, there were 45,000 suicides in America: 23,000 of them by gun, 11,700 by hanging and 5,300 by overdose. Because of suicide’s stigma, these numbers are thought to be an underestimate.

Though there has been an alarming increase among women—the number rose by 39% between 2006 and 2016—men are still much more likely to kill themselves. For every two women who committed suicide in 2016, so did seven men. White men kill themselves at nearly three times the rate of black, Hispanic and Asian men. Only Native American men have higher rates. Similar racial differences exist in the rates among women, making suicide one of very few public-health crises that disproportionately affects whites.

The suicide rate in rural counties is 78% higher than that in big cities. Alaska and Montana, two of the states with the lowest population density, are the worst-afflicted—suicide is five times as likely there as in the District of Columbia, which has America’s lowest rate. And suicides are increasing more rapidly in states that already have high rates, deepening the disparities.

There is a strong correlation between the suicide rate and the Republican share of the vote in the presidential election. Solidly Democratic east-coast states like New York and Massachusetts have some of the lowest rates—a phenomenon that long predates Donald Trump’s election.

America is an extraordinarily violent country. Its firearm-murder rate is far above the rest of the rich world. Yet there are roughly two gun suicides for every gun homicide. Easy access to guns undoubtedly worsens matters. Guns are perhaps the most efficient means of getting the job done: 83% of attempted suicides by gun are successful, compared with 61% of hangings and a mere 1.5% of intentional drug overdoses. Those who try to commit suicide and fail can receive therapy and recover. According to a Harvard study, only one in ten people who survive a suicide attempt go on to kill themselves. In Britain, where guns are much less easily available, hangings make up nearly 60% of suicides.

White men, especially older ones, overwhelmingly favour guns as a means of suicide. Young women have turned from drug overdoses to guns and hanging. Hanging has surged from 21% of all suicides in 2003 to 26% in 2016. Researchers who interview survivors find that those who choose this method often imagine a painless death.

Determining the cause of these dispiriting trends has proved hard. The suicide rate seems to have risen independently of the lurches in America’s economy. Anne Case and Angus Deaton, two Princeton economists, have argued that a toxic cocktail of opioid addiction and stagnating economic prospects is worsening the problem of premature death, including by suicide, among middle-aged whites.

All suicides are, by definition, preventable. Yet detecting them in time is hard. Depression and other mental illnesses are clear correlates of suicide, but only a small proportion of the millions of Americans diagnosed with depression will attempt it. Matthew Nock, a Harvard professor, has tried to train an algorithm to comb through patients’ medical records and produce advance warnings of suicide risk, but these methods are still plagued by false positives. Machine-learning may one day help. Until then, the vigilance of friends and family will be the best defence.

This article appeared in the United States section of the print edition under the headline "Self-destructing"

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