Summary: Social determinants of health are linked to suicide risk, with the suicide rate nearly doubling between the least and most socially vulnerable counties.
The study proposes several public health and economic policies that could reduce suicide rates by targeting social vulnerability in communities, such as improving access to mental health services and quality health care, and building stronger social networks.
Key points:
- Social vulnerability is strongly linked to higher suicide risk, with suicide rates nearly doubling between least and most vulnerable counties.
- To address the social determinants of health that contribute to suicide risk, the study suggests improving access to mental health services, health care and strengthening social networks.
- The research underscores the importance of targeted interventions to high-risk communities and highlights the need to address social and economic disparities to prevent unnecessary deaths.
Source: University of Chicago
More than 45,000 Americans died by suicide in 2020, a 30% increase from 2000, making it the 12e leading cause of death in the United States
Studies have shown that the social and environmental factors where people live, such as exposure to violence and crime, access to quality health care, food insecurity, employment opportunities and air pollution, are linked to suicide rates.
Now, a new research study from the University of Chicago provides more statistical evidence that the social determinants of health are closely linked to suicide risk.
The study, published in Open JAMA Network, shows that the suicide rate nearly doubled between the least socially vulnerable and most socially vulnerable counties, making it clear that programs designed to address health and economic disparities in these areas could prevent unnecessary deaths.
“A huge factor in the suicide rate in the United States is the social vulnerability of the community you live in,” said Robert Gibbons, PhD, Blum-Reise Professor of Medicine and Public Health Sciences at UChicago and author. principal of the study. .
“A doubling of the suicide rate is an earthquake. It is enormous. If you can stratify risk and know that members of a community are going to be at much higher risk, that’s huge because you can target interventions to those communities.
The study began as a class project for a course Gibbons teaches on statistical applications for graduate and undergraduate students. A previous course examined associations between lithium in groundwater and diagnoses of bipolar disorder and dementia in the United States, which was published in JAMA Psychiatry in 2018.
The new project builds on recent work published in Health Services Research by Loren Saulsberry, PhD, Assistant Professor of Public Health Sciences, Diane Lauderdale, Professor and Chair of Public Health Sciences, Gibbons, and others, who have developed a new metric for measuring the social determinants of health called Social Vulnerability Metric (SVM).
The SVM extracts more than 200 variables from 17 nationally representative, publicly available databases, focusing on demographics such as age, education, employment status, housing and transportation, and health insurance coverage.
The resulting model produces a score that summarizes a person’s vulnerability due to social risk factors and provides a measure of a person’s ability to overcome different events or cope with long-term challenges.
The SVM is strongly correlated with county-level death rates, and it has tracked zip code-level outcomes like COVID-19 death and vaccination rates, and asthma ER visits.
Gibbons students split the statistical work to see how SVM was associated with suicide rates, using publicly available data on suicide deaths provided by the Centers for Disease Control (CDC) for 2016 to 2020. Shuhan Liu , who is a master’s student in statistics at UChicago and recently accepted into the PhD program in statistics at Northwestern University, led the analytical work, and Samuel Morin, a fourth-year student at UChicago, led the work of extraction of data from CDC sources.
The team calculated SVM scores for US counties and divided them into 10 tiers, from least vulnerable counties to most. They saw an 82% increase in the suicide rate from the lowest level to the highest level, as measured by the SVM.
The team also evaluated another tool developed by the CDC called the Social Vulnerability Index (SVI), which measures the impact of social determinants of health. By this measure, there was a 56% increase in the suicide rate from the lowest risk group to the highest risk group.
Gibbons said this shows an undeniable link between the impact of these factors and suicide.
“We didn’t want to assume that the measure of social vulnerability and its relationship to suicide was a simple linear function in our data analysis, but it turns out that the higher the SVM, the higher the suicide rate. “
The research team proposes several common-sense public health and economic policies that could reduce suicide rates by targeting social vulnerability in communities, such as improving access to mental health services by opening more clinics and changing the availability of insurance coverage and the cost of these services.
Social isolation is another factor that contributes to vulnerability, and community programs, shared public spaces, and volunteer services could create stronger social networks.
Increasing access to quality health care in general would also make a difference, especially in rural areas by expanding Medicaid coverage and increasing the number of health care workers in underserved areas. It’s a long list of solutions to address a multitude of social and health disparities, with sufficient support.
“All of these are major factors in measuring social vulnerability, and we can improve this by improving the quality of and access to general mental and physical health care,” Gibbons said. “These are malleable social characteristics. We don’t need to wait for a social revolution to invoke change.
About this mental health research news
Author: Matt wood
Source: University of Chicago
Contact: Matt Wood – University of Chicago
Picture: Image is credited to Neuroscience News
Original research: Free access.
“Social Vulnerability and Suicide Risk Among American Adults, 2016-2020” by Robert Gibbons et al. Open JAMA Network
Abstract
Social vulnerability and suicide risk among American adults, 2016-2020
Importance
There were over 45,000 suicides in the United States in 2020, making suicide the 12th leading cause of death. If social vulnerability is associated with suicide rates, targeted interventions for at-risk segments of the population can reduce suicide rates in the United States.
Objective
To determine the association between social vulnerability and suicide in adults.
Design, framework and participants
This cohort study analyzed 2 county-level social vulnerability measures (the Social Vulnerability Index (SVI) and the Social Vulnerability Measure (SVM)) and county-level suicides reported by the Centers for Disease Control and Prevention from 2016 to 2020. Data was analyzed. November and December 2022.
Exhibitions
County-level variability in social vulnerability.
Main results and measures
The primary outcome measure was the number of county-level adult suicides from 2016 to 2020, offset by the county’s adult population in those years. The association between social vulnerability (measured using the SVI and the newly created 2018 SVM) and suicide was modeled using a Bayesian censored Poisson regression model to account for suppression by the CDC count of county-level suicides under 10, adjusted for age, racial and ethnic minorities, and urban-rural county characteristics.
Results
From 2016 to 2020, there were a total of 222,018 suicides in 3,141 counties. Comparing the least socially vulnerable counties (0% to 10%) to the most socially vulnerable (90% to 100%), there was a 56% increase in the suicide rate (17.3 per 100,000 people to 27 .0 per 100,000 people) as measured by SVI (incidence rate ratio, 1.56; 95% credible interval, 1.51-1.60) and an 82% increase in the suicide rate (13.8 per 100,000 people to 25.1 per 100,000 people) measured by SVM (incidence rate ratio, 1.82; 95% credibility interval, 1.72-1.92).
Conclusions and relevance
This cohort study found that social vulnerability had a direct association with suicide risk in adults. Reducing social vulnerability can lead to a vital reduction in the suicide rate.