America is facing a suicide crisis.
A new survey on mortality and life expectancy in the United States, released by the Centers for Disease Control and Prevention (CDC), found that 47,000 Americans took their own lives in 2017—2,000 more than recorded in 2016. The national suicide rate has increased 33 percent between 1999 and 2017, according to the CDC's National Vital Statistics System data. What's worse, a broader Associated Press analysis of government records indicates that American suicides are now at their highest point in 50 years. It's now the second-leading cause of death for Americans under the age of 35.
And the rate of suicides has only accelerated in recent years. According to the CDC, suicide rates among both men and women increased around 1 percent a year between 1999 and 2006; between 2006 and 2017, however, rates jumped to a 2 percent annual increase. The suicide crisis isn't evenly distributed, though: CDC research indicates that the suicide rate jumped more dramatically in rural areas (13.1 per 100,000 in 1999, vs. 20 per 100,000 in 2017) compared to urban metros (9.6 per 100,000 in 1999, vs. 11.1 per 100,000 in 2017).
That finding gels, broadly speaking, with a growing body of research that indicates it's primarily white, rural Americans who are killing themselves. In 2015, a Proceedings of the Natural Sciences (PNAS) study indicated that middle-aged, white Americans were dying at a greater rate than ever before. Even as mortality rates declined in almost every major developed nation (with the exception of Russia), they rose steadily for the U.S., thanks to the uptick in suicides:
The following year, a National Center for Health Statistics study indicated that the rising suicide rate was particularly pronounced among middle-aged Americans between the ages of 45 and 64. More specifically, the suicide rates for middle-aged men rose 43 percent, while the suicide rate for women grew by a staggering 64 percent.
White, middle-aged, and primarily rural: Together, these three studies appear to uncover the contours of the so-called "death of despair" that PNAS authors Angus Deaton and Anne Case describe in their research back in 2015.
Suicide has been considered a disturbing indicator of underlying social problems ever since Émile Durkheim's seminal 1897 book, Suicide. Applied here, might the rise in suicide among white Americans signal anxieties tied to the issues of the economy and demography?
It's a persuasive argument (especially given the 2016 presidential election), but it doesn't fully explain why Americans kill themselves at a higher rate than those in other advanced countries, plenty of which experienced the same global economic turmoil of the Great Recession.
To that end, it's important to look not just at why people kill themselves, but also how they do it. As Pacific Standard reported back in 2014, most suicides "are 'impulsive'—a gun to the head, a jump from a bridge—and were there not, say, loaded firearms around or bridges without suicide guards, tens of thousands of lives could be saved."
But that last figure might not be as relevant anymore. Yes, the 2016 NCHS data indicated that, between 1999 and 2014, guns and poisoning were at play in the majority of American suicides, likely attributable to the also-increasing rate of opioid overdoses and the ubiquity of firearms. But, according to the CDC data, guns and poisoning both declined as the preferred methods of suicide among men and women. For women, suffocation (which here means hanging) jumped from 16.3 percent between 1999 and 2006, to 26.2 percent between 2006 and 2017; for men, there was a jump from 19.1 percent to 26.8 percent during those same time periods.
This indicates a changing character of American suicide. As the relative social and economic pressures on white, middle-aged, rural Americans have gone up, so has the acceptability of suicide. Once considered a dark cloud over society, suicide—in whatever form is takes—is becoming more commonplace in America.