Important Indicators: Suicide Charges …

Abstract
What’s already identified about this matter?
In 2022, roughly 49,000 individuals died by way of suicide in the US. A complete method that addresses health-related network elements, reminiscent of fitness care get admission to, social and network context, and financial steadiness, may just assist save you suicide.
What’s added by way of this file?
Suicide charges had been lowest in counties with the very best medical health insurance protection, broadband Web get admission to, and revenue. Those elements had been extra strongly related to decrease suicide charges in some teams which are disproportionately suffering from suicide.
What are the consequences for public fitness apply?
Imposing techniques, practices, and insurance policies that fortify the stipulations by which people are born, develop, reside, paintings, and age may well be the most important part of suicide prevention efforts. Determination-makers, authorities businesses, and communities can paintings in combination to handle community-specific wishes and save lives.
Shut
Summary
Creation: Roughly 49,000 individuals died by way of suicide in the US in 2022, and provisional information point out {that a} equivalent quantity died by way of suicide in 2023. A complete method that addresses upstream network chance and protecting elements is the most important part of suicide prevention. A greater figuring out of the function of those elements is wanted, in particular amongst disproportionately affected populations.
Strategies: Suicide deaths had been recognized within the 2022 Nationwide Important Statistics Gadget. County-level elements, recognized from federal information resources, incorporated medical health insurance protection, family broadband Web get admission to, and family revenue. Charges and ranges of things categorised by way of tertiles had been calculated and offered by way of race and ethnicity, intercourse, age, and urbanicity.
Effects: In 2022, the full suicide fee was once 14.2 in keeping with 100,000 inhabitants; charges had been very best amongst non-Hispanic American Indian or Alaska Local (AI/AN) individuals (27.1), men (23.0), and rural citizens (20.0). On moderate, suicide charges had been lowest in counties within the best one 3rd of share of individuals or families with medical health insurance protection (13.0), get admission to to broadband Web (13.3), and revenue >100% of the federal poverty point (13.5). Those elements had been extra strongly related to decrease suicide charges in some disproportionately affected populations; amongst AI/AN individuals, suicide charges in counties within the very best tertile of those elements had been roughly one part the charges of counties within the lowest tertile.
Conclusions and Implications for Public Well being Follow: Upper ranges of medical health insurance protection, family broadband Web get admission to, and family revenue in communities would possibly play a job in decreasing suicide charges. Upstream techniques, practices, and insurance policies detailed in CDC’s Suicide Prevention Useful resource for Motion may also be applied by way of decision-makers, authorities businesses, and communities as they paintings in combination to handle community-specific wishes and save lives.

Creation
In 2022, roughly 49,000 individuals died by way of suicide in the US (age-adjusted suicide fee = 14.2 in keeping with 100,000 inhabitants), and provisional information point out a equivalent choice of individuals died by way of suicide in 2023 (1). Suicide was once the second one main explanation for dying amongst individuals elderly 10–34 years in 2022 (1). A number of demographic teams are disproportionately suffering from suicide in the US (2). Those teams come with men, rural citizens, and individuals from sure racial and ethnic teams, in particular non-Hispanic American Indian or Alaska Local (AI/AN) individuals (1).
Suicide charges have higher all over the closing two decades and stay top (1): on moderate one particular person dies by way of suicide each and every 11 mins (1). Then again, in spite of those regarding information, suicide is a preventable public fitness challenge. Suicide prevention calls for a complete public fitness method that addresses more than one modifiable suicide chance and protecting elements on the person, dating, network, and societal ranges (3). Such an method comprises implementation of upstream insurance policies, techniques, and practices to forestall individuals from attaining a disaster level, and downstream prevention serious about remedy, disaster intervention, and postvention (i.e., actions that cut back chance and advertise therapeutic in suicide loss survivors after a suicide has taken position).
Numerous nonmedical elements that have an effect on fitness results, frequently described as social determinants of fitness, play the most important function in shaping upstream suicide prevention efforts (4). Those elements are the stipulations by which people are born, develop, paintings, reside, and age.* As an example, insurance plans, get admission to to broadband Web, and better family revenue would possibly lower suicide chance by way of bettering fitness care get admission to, expanding task alternatives, and offering get admission to to resources of fortify and knowledge (5–7). Then again, even if proof of associations between increased ranges of those elements and lowered suicide chance exists (5–7), this proof is extra restricted amongst teams disproportionately suffering from suicide. To lead alternatives for prevention, CDC tested variations in suicide charges in line with 3 particular county-level elements, general and inside of demographic teams: 1) medical health insurance protection, 2) broadband Web get admission to, and three) revenue.

Strategies
Ascertainment of Suicide Deaths
Suicide deaths from the 2022 Nationwide Important Statistics Gadget (NVSS) mortality recordsdata had been recognized the use of the Global Classification of Illnesses, 10th Revision underlying explanation for dying codes X60–X84, Y87.0, and U03.†,§ Demographic elements had been extracted, together with information on decedent race and ethnicity (i.e., AI/AN, Asian and Local Hawaiian or Pacific Islander [Asian and NH/PI],¶ Black or African American [Black], White, Hispanic or Latino [Hispanic], and multiracial), intercourse, and age staff (10–24,** 25–44, 45–64, and ≥65 years). Hispanic decedents may well be of any race; all different racial and ethnic teams had been non-Hispanic. Decedent county of place of dwelling was once related to the 2023 U.S. Division of Agriculture Rural-City Continuum Codes and categorised as city or rural.††
County-Stage Components
3 county-level elements (medical health insurance protection, broadband Web get admission to, and family revenue) had been measured and related with decedent county of place of dwelling. Those 3 elements had been decided on according to printed literature and their relevance to more than one suicide prevention methods, together with the ones in CDC’s Suicide Prevention Useful resource for Motion (3). Medical health insurance protection was once assessed as the proportion of individuals within the county who had medical health insurance, measured the use of 2021 Small House Well being Insurance coverage Estimates (SAHIE).§§ Broadband Web get admission to was once outlined as the proportion of families within the county that had a broadband Web subscription, measured the use of 5-year estimates from the 2018–2022 American Neighborhood Survey.¶¶ Source of revenue point was once derived from the proportion of individuals within the county with family earning >100% of the federal poverty point, measured the use of 2022 Small House Source of revenue and Poverty Estimates.*** Counties had been categorised into tertiles of each and every person issue (i.e., counties with the very best, center, and lowest 3rd for share of individuals or families with an element).†††
Information Research
Suicide charges (suicide deaths in keeping with 100,000 inhabitants) had been calculated by way of tertiles of medical health insurance protection, family broadband web get admission to, and family revenue, general and by way of demographic subgroups. Charges had been calculated the use of U.S. postcensal unmarried race estimates of the July 1, 2022, residential inhabitants as denominators. Age-adjusted charges had been calculated by way of the direct means,§§§ the use of the 2000 U.S. same old inhabitants. Variations (tested for each and every issue for my part) in suicide charges between the counties within the very best and lowest tertiles for each and every issue and counties within the intermediate and lowest tertiles for each and every issue had been when compared the use of Z-tests when the choice of suicide deaths was once ≥100; p-values <0.05 had been thought to be statistically important. When the choice of suicide deaths was once <100, variations in charges had been thought to be important if CIs, according to a gamma distribution, didn’t overlap. Fee ratios (RRs) had been additionally computed to quantify associations between ranges of things and suicide charges (i.e., RRs for counties within the very best as opposed to lowest tertiles of things and RRs for counties within the intermediate as opposed to lowest tertiles of things). Analyses had been performed the use of SAS tool (model 9.4; SAS Institute) and R tool (model 4.4.0; The R Basis). This job was once reviewed by way of CDC, deemed no longer analysis, and was once performed in step with acceptable federal legislation and CDC coverage.¶¶¶

Effects
Suicide Deaths and Charges, Total and by way of Demographic Components
In 2022, a complete of 49,476 suicides took place in the US (age-adjusted fee = 14.2 in keeping with 100,000 inhabitants) (Desk 1). Amongst all racial and ethnic teams, the very best charges had been amongst AI/AN individuals (27.1), adopted by way of White individuals (17.6); roughly 75% of all suicides had been amongst White individuals (37,481). The suicide fee amongst men (23.0) was once just about 4 instances that amongst women (5.9) and was once increased amongst rural citizens (20.0) than amongst city citizens (13.4). By means of age staff, charges had been very best amongst individuals elderly 25–44 (18.9) and 45–64 years (19.0).
Suicide Charges by way of County-Stage Components
Total, moderate suicide charges had been inversely associated with each and every of the 3 county-level issue tertiles (Determine 1). Suicide charges had been very best in counties within the lowest tertile of medical health insurance protection (16.4), broadband Web get admission to (19.2), and family revenue (15.2), adopted by way of counties within the intermediate tertiles (14.3, 16.5, and 14.8, respectively). The bottom suicide charges took place in counties within the very best tertiles (13.0, 13.3, and 13.5, respectively). Those findings correspond to 26%, 44%, and 13% decrease suicide charges in counties within the very best as opposed to lowest tertiles of medical health insurance protection, broadband Web get admission to, and family revenue, respectively.****
Suicide Charges and RRs by way of County-Stage Components and Demographic Teams
Amongst AI/AN individuals, White individuals, men, and adults elderly 25–44 years, suicide charges had been considerably decrease amongst those that lived in counties within the very best and intermediate tertiles for medical health insurance protection, broadband Web get admission to, and revenue than they had been amongst individuals who lived in counties within the lowest tertiles for those elements (Desk 2). The magnitude of the RRs (i.e., fee in counties within the very best tertile when compared with fee in counties within the lowest tertile) tended to be lowest (indicating that presence of the issue was once maximum protecting) in those teams and was once in particular low for AI/AN individuals, for whom the RRs ranged from 0.44 to 0.49 for counties within the very best as opposed to the bottom issue tertiles (Determine 2). In different demographic teams, suicide charges had been much less constantly related to those elements. As an example, amongst women dwelling within the lowest-income tertile counties, suicide charges had been very similar to the ones amongst women dwelling within the highest-income tertile counties (RR = 0.98), and a equivalent development was once noticed amongst Black individuals with recognize to medical health insurance protection (RR = 1.03). ††††

Dialogue
Those findings spotlight the significance of 3 county-level elements (medical health insurance protection, family broadband Web get admission to, and family revenue) relating to suicide charges. Total, suicide charges in counties with increased ranges of medical health insurance protection, family broadband Web get admission to, and family revenue had been not up to charges in counties with decrease ranges of those elements. There are a number of doable explanations for the way those elements would possibly give protection to in opposition to suicide. Medical health insurance would possibly facilitate get admission to to intellectual fitness products and services, in addition to number one care and disaster intervention (8,9). Broadband Web, just lately known as a superdeterminant of fitness (10), can attach individuals to task potentialities, alternatives for social connectedness and fortify, and expanded get admission to to clinical products and services by way of telehealth (7,10). Dwelling in higher-income communities is related to talent to satisfy fundamental wishes, reminiscent of meals safety and housing steadiness (11,12).
As well as, this research discovered that general, increased suicide charges proceed to have an effect on sure sociodemographic teams, together with rural citizens, men, and AI/AN and White populations. For some sociodemographic teams incorporated within the analyses, particularly AI/AN individuals, the 3 county-level elements tested may well be in particular vital. Those findings are particularly significant taking into consideration that a few of these teams, reminiscent of AI/AN individuals, are much more likely to reside in communities with decrease ranges of those elements, together with broadband Web get admission to (13). The discovering that increased ranges of the 3 assessed elements are extra strongly associated with decrease suicide charges amongst AI/AN individuals and men aligns with earlier research analyzing financial elements (14,15). By contrast, the criteria thought to be on this research had been much less obviously related with suicide charges for some teams, reminiscent of Black individuals. Different chance elements or protecting elements no longer tested on this file may well be extra related amongst those populations. Further network or societal elements, reminiscent of signs of structural racism and stigma and norms round help-seeking, would possibly affect the connection between county-level elements and lowered suicide chance in sure populations (16,17). Those findings spotlight the wish to read about chance and protecting elements inside of populations and incorporate the findings of such analysis into suicide prevention practices.
A complete strategy to suicide prevention that goals each upstream and downstream prevention can advertise those elements. This method is specified by the brand new 2024 Nationwide Technique for Suicide Prevention ( which in particular highlights the significance of upstream prevention methods. CDC’s Suicide Prevention Useful resource for Motion ( aligns with the Nationwide Technique and describes insurance policies, techniques, and practices with the most productive to be had proof that states and territories, tribes, and communities can put into effect to handle suicide chance and protecting elements on the person, dating, network, and societal ranges (3). Related upstream methods come with strengthening financial helps (e.g., strengthening family monetary safety, reminiscent of in the course of the Supplemental Diet Help Program and stabilizing housing), bettering get admission to and supply of suicide care (e.g., 0 Suicide§§§§), selling wholesome connections (e.g., network engagement), educating coping and problem-solving abilities, and developing protecting environments (e.g., developing wholesome organizational insurance policies and tradition). Those methods are being applied in populations disproportionately suffering from suicide via CDC’s Complete Suicide Prevention Program (CSP) ( As an example, along with carrying out a public fitness marketing campaign to scale back stigma and coaching suppliers in health center and emergency departments on suicide prevention approaches, the CSP recipient in Vermont is in particular supporting rural populations, together with farmers, via peer fortify networks and extending suppliers’ talents to succeed in and ship tele-mental fitness to those populations the use of telehealth. The CSP recipient in Colorado isn’t just running with counties and native organizations to advertise connectedness for populations at top chance for suicide and offering gatekeeper trainings to assist establish and fix individuals in peril for suicide with the fortify products and services they want however may be running to improve network elements that give protection to in opposition to suicide by way of creating partnerships to fortify financial steadiness projects, reminiscent of meals safety, reasonably priced housing, and transportation (
Obstacles
The findings on this file are matter to a minimum of 5 obstacles. First, even if those findings spotlight associations between medical health insurance protection, family broadband Web get admission to, family revenue, and lowered suicide charges, this find out about had an ecologic design and thus didn’t make causal inferences. The opportunity of confounding rather then by way of demographic elements was once no longer addressed. 2nd, it was once no longer imaginable to inspect some disproportionately affected populations, together with veterans, individuals with disabilities, and sexual and gender minorities (2). 3rd, elements had been measured on the county point; smaller geographic devices (e.g., legit U.S. census tracts) would possibly higher constitute communities and be extra carefully related to lowered suicide chance (18). Fourth, charges by way of race and ethnicity may just replicate underreporting of deaths within the essential statistics information, in particular for AI/AN and Hispanic individuals, thereby underestimating charges in those populations (19,20). After all, different county-level elements that may well be related to suicide prevention weren’t tested on this research.
Implications for Public Well being Follow
Bettering the stipulations the place people are born, develop, paintings, reside, and age would possibly cut back suicide deaths (4). Determination-makers, authorities businesses, and communities can paintings in combination to put into effect techniques, practices, and insurance policies that building up get admission to to medical health insurance and broadband Web and advertise financial helps; this method is particularly vital for populations disproportionately suffering from suicide. Blended with downstream movements that fortify individuals at higher or rapid chance for suicide (e.g., disaster care or the 988 Suicide & Disaster Lifeline; an upstream method that promotes those elements may well be the most important part of suicide prevention. Extra consideration to such upstream methods that save you suicide crises earlier than they begin has the possible to boost up public fitness’s talent to avoid wasting lives.

Acknowledgment
Shikhar Kumar, Guidehouse.
1Division of Damage Prevention, Nationwide Heart for Damage Prevention and Regulate, CDC; 2Guidehouse, McLean, Virginia.

References

CDC. Nationwide Heart for Well being Statistics mortality information on CDC WONDER. Atlanta, GA: US Division of Well being and Human Services and products, CDC; 2024. Accessed July 25, 2024.
CDC. Suicide prevention: fitness disparities in suicide. Atlanta, GA: US Division of Well being and Human Services and products, CDC; 2024.
CDC. Suicide prevention useful resource for motion. Atlanta, GA: US Division of Well being and Human Services and products, CDC; 2022.
Pirkis J, Gunnell D, Hawton Ok, et al. A public fitness, whole-of-government strategy to nationwide suicide prevention methods. Disaster 2023;44:85–92. PMID:36960842
Steelesmith DL, Fontanella CA, Campo JV, Bridge JA, Warren KL, Root ED. Contextual elements related to county-level suicide charges in the US, 1999 to 2016. JAMA Netw Open 2019;2:e1910936. PMID:31490540
Kerr WC, Kaplan MS, Huguet N, Caetano R, Giesbrecht N, McFarland BH. Financial recession, alcohol, and suicide charges: comparative results of poverty, foreclosures, and task loss. Am J Prev Med 2017;52:469–75. PMID:27856114
Benda NC, Veinot TC, Sieck CJ, Ancker JS. Broadband web get admission to is a social determinant of fitness! Am J Public Well being 2020;110:1123–5. PMID:32639914
Sommers BD, Gawande AA, Baicker Ok. Medical health insurance protection and fitness—what the hot proof tells us. N Engl J Med 2017;377:586–93. PMID:28636831
Walker ER, Cummings JR, Hockenberry JM, Druss BG. Insurance coverage standing, use of intellectual fitness products and services, and unmet want for intellectual fitness care in the US. Psychiatr Serv 2015;66:578–84. PMID:25726980
Bauerly BC, McCord RF, Hulkower R, Pepin D. Broadband get admission to as a public fitness factor: the function of legislation in increasing broadband get admission to and connecting underserved communities for higher fitness results. J Regulation Med Ethics 2019;47(Supp 2):39–42. PMID:31298126
Leonard T, Hughes AE, Donegan C, Santillan A, Pruitt SL. Overlapping geographic clusters of meals safety and fitness: the place do social determinants and fitness results converge within the U.S? SSM Popul Well being 2018;5:160–70. PMID:29998188
Hepburn P, Rutan DQ, Desmond M. Past city displacement: suburban poverty and eviction. City Aff Rev 2023;59:759–92.
US Census Bureau. Broadband get admission to in tribal spaces lags remainder of the country. Washington, DC: US Division of Trade, US Census Bureau; 2024.
Reeves A, McKee M, Stuckler D. Financial suicides within the Nice Recession in Europe and North The united states. Br J Psychiatry 2014;205:246–7. PMID:24925987
Akee R, Feir D, Gorzig MM, Myers S Jr. Local American “deaths of depression” and financial stipulations. Res Soc Stratification Mobility 2024;89:100880.
Alvarez Ok, Polanco-Roman L, Samuel Breslow A, Molock S. Structural racism and suicide prevention for ethnoracially minoritized formative years: a conceptual framework and representation throughout techniques. Am J Psychiatry 2022;179:422–33. PMID:35599542
Misra S, Jackson VW, Chong J, et al. Systematic evaluate of cultural facets of stigma and intellectual sickness amongst racial and ethnic minority teams in the US: implications for interventions. Am J Neighborhood Psychol 2021;68:486–512. PMID:33811676
Rehkopf DH, Buka SL. The affiliation between suicide and the socio-economic traits of geographical spaces: a scientific evaluate. Psychol Med 2006;36:145–57. PMID:16420711
Arias E, Heron M, Hakes J; Nationwide Heart for Well being Statistics. The validity of race and Hispanic-origin reporting on dying certificate in the US: an replace. Important Well being Stat 2 2016;2:1–21. PMID:28436642
Arias E, Xu J, Curtin S, Bastian B, Tejada-Vera B. Mortality profile of the non-Hispanic American Indian or Alaska Local inhabitants, 2019. Natl Important Stat Rep 2021;70:1–27. PMID:34842523

TABLE 1. Suicide charges by way of race and ethnicity, intercourse, age staff, and urbanicity — Nationwide Important Statistics Gadget, United States, 2022

Demographic staff
Suicide deaths
Fee*

Total†
49,476
14.2

Race and ethnicity†,§

AI/AN
650
27.1

Asian and NH/PI
1,554
7.1

Black or African American
3,826
8.9

White
37,481
17.6

Hispanic or Latino
5,122
8.1

Multiracial
682
10.5

Intercourse†

Feminine
10,203
5.9

Male
39,273
23.0

Age staff, yrs¶,**,††

10–24
6,533
10.0

25–44
16,848
18.9

45–64
15,645
19.0

≥65
10,438
18.1

Urbanicity§§,¶¶

City
40,096
13.4

Rural
9,359
20.0

Abbreviations: AI/AN = American Indian or Alaska Local; NH/PI = Local Hawaiian or Pacific Islander.
* Suicide deaths in keeping with 100,000 inhabitants.
†Age-adjusted charges, as described by way of Hispanic or Latino (Hispanic) decedents may well be of any race; all different racial and ethnic teams had been non-Hispanic.
§ Race or ethnicity lacking for 161 deaths.
¶ Crude charges.
** Age lacking for 3 deaths.
†† Suppression of individuals elderly <10 years because of low dying counts.
§§ Age-adjusted charges (calculated by way of direct means, the use of 2000 U.S. same old inhabitants) used 10 age staff classes for age-adjustment: 0–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years. Nationwide Important Statistics Gadget information was once used for all states excluding Connecticut, the place state essential data had been used (information equipped for 377 of 398 suicide deaths amongst Connecticut citizens).
¶¶ Rural-City Continuum Codes 1–3 had been coded as city, and Codes 4–9 had been coded as rural.
FIGURE 1. Suicide charges,* by way of tertiles of decided on county-level elements†,§,¶,** — Nationwide Important Statistics Gadget,†† United States, 2022

Abbreviation: FIPS = Federal Knowledge Processing Same old.
* Age-adjusted charges (calculated by way of direct means, the use of 2000 U.S. same old inhabitants) used 10 classes for age adjustment: 0–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years.
† Share of individuals with medical health insurance protection. Connecticut and Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. Information was once no longer to be had for Kalawao County, Hawaii. Information for 2021 are to be had at
§ Share of families with a broadband Web subscription. Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. 5-year estimates (2018–2022) are to be had at
¶ Share of individuals dwelling in a family with revenue >100% of the federal poverty point. Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. Information was once no longer to be had for Kalawao County, Hawaii. Information for 2022 are to be had at
** The county tertile cutoffs for the proportion of citizens or families with a given issue had been as follows: medical health insurance protection: 53.7%–87.0%, 87.1%–91.7% and 91.7%–97.6%; broadband Web get admission to: 36.0%–80.6%, 80.6%–86.0%, and 86.0%–100%; and revenue >100% of the federal poverty point: 57.6%–83.9%, 84.0%–88.3%, and 88.4%–96.9%. Percentages had been rounded to at least one decimal position for clarity, however teams don’t overlap; statistical rating was once used to separate counties into tertile teams earlier than rounding.
†† Information from state essential data had been used for 377 of 398 suicide deaths amongst Connecticut citizens.

TABLE 2. Suicide charges by way of tertiles of decided on county-level elements by way of demographic traits — Nationwide Important Statistics Gadget,* United States, 2022

Function
Tertile†

Lowest
Intermediate
Easiest

Deaths
Fee§
Deaths
Fee§
Deaths
Fee§

Medical health insurance protection¶,**,††,§§

Race and ethnicity¶¶

AI/AN
377
35.0
188
24.5***
85
15.4***

Asian and NH/PI
243
8.0
444
6.8***
851
7.0

Black or African American
1,151
9.0
1,393
8.7
1,246
9.2

White
9,855
22.2
11,809
18.6***
15,513
15.1***

Hispanic or Latino
1,979
9.0
1,777
7.7***
1,325
7.5***

Multiracial
139
10.2
191
9.8
348
11.2

Intercourse¶¶

Feminine
2,782
6.7
3,189
5.8***
4,135
5.6***

Male
10,984
26.5
12,667
23.3***
15,316
20.9***

Age staff, yrs†††,§§§

10–24
1,874
11.6
2,172
10.2***
2,446
9.1***

25–44
4,768
22.1
5,537
19.0***
6,409
17.1***

45–64
4,211
21.2
4,883
18.8***
6,408
17.9***

≥65
2,911
20.6
3,260
18.5***
4,185
16.5***

Urbanicity¶¶,¶¶¶

City
10,396
15.3
12,947
13.5***
16,403
12.4***

Rural
3,370
21.1
2,909
20.1
3,048
18.8***

Broadband Web get admission to**,****

Race and ethnicity¶¶

AI/AN
261
41.0
138
29.7***
251
19.3***

Asian and NH/PI
17
8.2
100
7.3
1,435
7.0

Black or African American
267
8.3
843
9.7***
2,711
8.8

White
3,371
22.7
8,009
19.8***
26,086
16.5***

Hispanic or Latino
296
9.5
824
8.9
3,999
7.9***

Multiracial
40
13.5
84
9.9
558
10.6

Intercourse¶¶

Feminine
758
7.2
1,905
6.3***
7,536
5.7***

Male
3,503
31.4
8,125
27.0***
27,623
21.3***

Age staff, yrs†††,§§§

10–24
582
13.5
1,219
10.6***
4,725
9.6***

25–44
1,482
28.4
3,510
23.5***
11,846
17.2***

45–64
1,259
22.8
3,107
21.2***
11,273
18.1***

≥65
937
21.5
2,191
19.8***
7,310
17.3***

Urbanicity¶¶,¶¶¶

City
1,080
16.7
6,012
14.8***
33,001
13.0***

Rural
3,181
20.3
4,018
19.9
2,158
19.7

Source of revenue**,§§,††††

Race and ethnicity¶¶

AI/AN
343
37.9
159
22.6***
148
18.5***

Asian and NH/PI
174
6.9
499
7.3
879
7.0

Black or African American
1,216
9.1
1,359
9.1
1,246
8.7

White
7,036
20.0
13,196
19.1***
17,234
15.8***

Hispanic or Latino
1,082
8.2
2,085
8.1
1,952
8.1

Multiracial
95
9.4
212
9.6
375
11.4

Intercourse¶¶

Feminine
1,949
5.9
3,544
6.0
4,706
5.8

Male
8,026
25.1
14,027
23.9***
17,198
21.4***

Age staff, yrs†††,§§§

10–24
1,398
10.4
2,227
10.0
2,901
9.8

25–44
3,648
21.3
6,092
19.8***
7,098
17.2***

45–64
2,905
19.2
5,533
19.7
7,201
18.3***

≥65
2,020
18.6
3,716
18.7
4,702
17.4***

Urbanicity¶¶,¶¶¶

City
6,271
13.3
14,020
13.8***
19,802
13.1

Rural
3,704
20.5
3,551
20.1
2,102
18.9***

Abbreviations: AI/AN = American Indian or Alaska Local; FIPS = Federal Knowledge Processing Same old; NH/PI = Local Hawaiian or Pacific Islander.
* Information from state essential data had been used for 377 of 398 suicide deaths amongst Connecticut citizens.
† The county tertile cutoffs for the proportion of citizens or families with a given issue had been as follows: medical health insurance protection: 53.7%–87.0%, 87.1%–91.7% and 91.7%–97.6%; broadband Web get admission to: 36.0%–80.6%, 80.6%–86.0% and 86.0%–100%; and revenue >100% of the federal poverty point: 57.6%–83.9%, 84.0%–88.3% and 88.4%–96.9%. Percentages had been rounded to at least one decimal position for clarity, however teams don’t overlap; statistical rating was once used to separate counties into tertile teams earlier than rounding.
§ Suicide deaths in keeping with 100,000 inhabitants.
¶ Share of individuals with medical health insurance protection. Information for 2021 are to be had at
** Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded.
†† Connecticut was once excluded.
§§ Information no longer to be had for Kalawao County, Hawaii.
¶¶ Age-adjusted charges (calculated by way of direct means, the use of 2000 U.S. same old inhabitants) used 10 classes for age adjustment: 0–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years. Hispanic or Latino decedents may well be of any race; all different racial and ethnic teams had been non-Hispanic.
*** p<0.05 for distinction with counties within the lowest tertile of issue according to Z-test for >100 deaths. When deaths had been <100, variations in charges had been thought to be important if CIs according to a gamma distribution didn’t overlap.
††† Crude charges.
§§§ Suppression of individuals elderly <10 years because of low dying counts.
¶¶¶ Rural-City Continuum Codes 1–3 had been coded as city, and Codes 4–9 had been coded as rural.
**** Share of families with a broadband Web subscription. 5-year estimates (2018–2022) are to be had at
†††† Share of individuals dwelling in a family with revenue >100% of the federal poverty point. Information for 2022 are to be had at

FIGURE 2. Associations between decided on county-level elements*,†,§,¶ and suicide charges,** by way of demographic staff††,§§,¶¶ — Nationwide Important Statistics Gadget,*** United States, 2022†††

Abbreviations: AI/AN = American Indian or Alaska Local; FIPS = Federal Knowledge Processing Same old; NH/PI = Local Hawaiian or Pacific Islander.
* Share of individuals with medical health insurance protection. Connecticut and the Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. Information no longer to be had for Kalawao County, Hawaii. Information for 2021 are to be had at
† Share of families with a broadband Web subscription. Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. 5-year estimates (2018–2022) are to be had at
§ Share of individuals dwelling in a family with revenue >100% of the federal poverty point. Valdez-Cordova Census House, Alaska, and its up to date cut up FIPS codes (Chugach and Copper River Census Spaces, Alaska) had been excluded. Information for 2022 are to be had at
¶ The county tertile cutoffs for the proportion of citizens or families with a given issue had been as follows: medical health insurance protection: 53.7%–87.0%, 87.1%–91.7%, and 91.7%–97.6%; broadband Web get admission to: 36.0%–80.6%, 80.6%–86.0%, and 86.0%–100%; and revenue >100% of the federal poverty point: 57.6%–83.9%, 84.0%–88.3%, and 88.4%–96.9%. Percentages had been rounded to at least one decimal position for clarity, however teams don’t overlap; statistical rating was once used to separate counties into tertile teams earlier than rounding.
** Charges had been age-adjusted (calculated by way of direct means, the use of 2000 U.S. same old inhabitants) for race and ethnicity, intercourse, and urbanicity; used 10 classes for age adjustment: 0–4, 5–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, and ≥85 years. Crude charges had been used for age-stratified teams.
†† Hispanic or Latino (Hispanic) decedents may well be of any race; all different racial and ethnic teams had been non-Hispanic.
§§ Individuals elderly <10 years weren’t incorporated in age-stratified fee ratios as a result of low dying counts.
¶¶ Rural-City Continuum Codes 1–3 had been coded as city, and Codes 4–9 had been coded as rural.
*** Information from state essential data had been used for 377 of 398 suicide deaths amongst Connecticut citizens.
††† The x-axis is plotted at the log scale.

Urged quotation for this text: Cammack AL, Stevens MR, Naumann RB, et al. Important Indicators: Suicide Charges and Decided on County-Stage Components — United States, 2022. MMWR Morb Mortal Wkly Rep. ePub: 10 September 2024. DOI:

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