summary: Social determinants of health are associated with suicide risk, with suicide rates nearly doubling between the least and most vulnerable counties.
This study shows how targeting social vulnerabilities in communities, such as improving access to mental health services and quality healthcare, and building stronger social networks, can reduce suicide rates. It proposes some public health and economic policies.
Key Point:
- Social vulnerability is closely associated with increased suicide risk, with suicide rates nearly doubling between the most vulnerable and least vulnerable counties.
- To address the social determinants of health that contribute to suicide risk, this study suggests improving access to mental health services, medical care and building stronger social networks. .
- The study highlights the importance of targeted interventions for communities at higher risk and the need to address social and economic disparities to prevent unnecessary deaths. .
sauce: University of Chicago
More than 45,000 Americans will die by suicide in 2020, 30% more than in 2000 and 12th.th leading cause of death in the United States
Research shows that social and environmental factors where people live, such as exposure to violence and crime, access to quality health care, food insecurity, job opportunities and air pollution, are linked to suicide rates. I’m here.
A new research study from the University of Chicago now provides more statistical evidence that social determinants of health are closely associated with suicide risk.
Research published in JAMA network open, Designed to address health and economic disparities in these regions, showing nearly double suicide rates between the least and most vulnerable counties It clearly shows that the program designed to prevent unnecessary deaths.
“A big contributor to suicide rates in the United States is the social vulnerability of the community you live in,” said Bloom Reise, professor of medicine and public health sciences at the University of Chicago and senior author of the study. Dr. Gibbons said. .
“The doubling of suicide rates is an earthquake. , it is very important.”
This research began as a class project for a course Gibbons teaches about statistical applications for graduate and undergraduate students. In a previous class, we looked at the association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States. was announced in JAMA Psychiatry 2018.
A new project built on recent research published in health services research Dr. Lauren Salisbury, Assistant Professor of Public Health Sciences, Diane Lauderdale, Professor and Chair of Public Health Sciences, Gibbons, et al. developed a metric.
The SVM draws on over 200 variables from 17 publicly available nationally representative databases, focusing on demographics such as age, education, employment status, housing and transportation, and health insurance coverage. pull out.
The resulting model produces a score that summarizes an individual’s vulnerability due to social risk factors and provides a measure of their ability to survive various events or cope with long-term challenges.
The SVM was highly correlated with mortality at the county level and tracked zip code-level outcomes such as COVID-19 mortality and vaccination rates and asthma emergency room visits.
Gibbons students used public data on suicide deaths provided by the Centers for Disease Control (CDC) from 2016 to 2020 to see how SVM was associated with suicide rates. Divided the statistical work. With a PhD in statistics from the University of Chicago and a recent PhD in statistics at Northwestern University, he led the analytical work, while Samuel Morin, his senior at the University of Chicago, led his CDC. I spearheaded the task of extracting data from sources.
The team calculated the SVM scores for counties in the United States and divided them into 10 categories, from least vulnerable counties to most vulnerable counties. There was an 82% increase in suicide rates from lowest stratum to highest stratum, as measured by SVM.
The team also evaluated another CDC-developed tool called the Social Vulnerability Index (SVI) that measures the impact of social determinants of health. This measure showed a 56% increase in suicide rates from the lowest to highest suicide risk group.
Gibbons said this points to an undeniable link between the influence of these factors and suicide.
“In our analysis of the data, we did not intend to assume that the relationship between the social vulnerability index and suicide was a simple linear function, but we found that higher SVMs were associated with higher suicide rates.”
By targeting social vulnerabilities in communities, the research team improved access to mental health services by opening more clinics and changing insurance coverage and the cost of these services. , proposes some common-sense public health and economic policies that could reduce suicide rates.
Social isolation is another factor that contributes to vulnerability, and community programs, shared public spaces, and volunteer services can build stronger social networks.
Increasing access to quality health care generally, especially in rural areas, by expanding Medicaid coverage and increasing the number of health care workers in underserved areas can also make a difference. prize. Here is a list of solutions to address many social and health disparities, given enough support.
“These are all major contributors to the social vulnerability index, which can be improved by improving quality and access to mental and general health care,” Gibbons said. These are flexible social traits: we don’t have to wait for a social revolution to bring about change.”
About this mental health research news
author: matt wood
sauce: University of Chicago
contact: Matt Wood – University of Chicago
image: Image credited to Neuroscience News
Original research: open access.
“Social Vulnerability and Suicide Risk Among US Adults, 2016-2020” by Robert Gibbons et al. JAMA network open
overview
Social Vulnerability and Suicide Risk Among US Adults, 2016-2020
Importance
There will be more than 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 could reduce suicide rates in the United States.
the purpose
To identify the association between social vulnerability and suicide in adults.
design, setting, participants
This cohort study analyzed two county-level Social Vulnerability Indexes. [SVI] and social vulnerability indicators [SVM]) and county-level suicides from 2016 to 2020 reported by the U.S. Centers for Disease Control and Prevention. The data were analyzed he November 2022 and he December 2022.
exposure
County-level variation in social vulnerability.
Main achievements and countermeasures
The primary endpoint was the number of county-level adult suicides from 2016 to 2020, offset by the county’s adult population during that time. The association between social vulnerability (measured using the SVI and the newly created SVM in 2018) and suicide was modeled using a Bayesian-censored Poisson regression model, and the CDC estimated suicide at the county level. I explained that I had constrained the number to less than 10 and adjusted for age. , racial and ethnic minorities, and urban and rural county characteristics.
result
From 2016 to 2020, there were a total of 222,018 suicides in 3141 counties. A 56% increase in suicide rates (17.3 per 100,000 to 27.0 per 100,000). SVI (incidence rate ratio, 1.56; 95% confidence interval, 1.51-1.60) and SVM (incidence rate ratio, 1.82; 95% confidence interval, 1.72-1.92).
Conclusion and relevance
This cohort study found that social vulnerability is directly associated with adult suicide risk. Reducing social vulnerability can lead to a reduction in life-saving suicide rates.
