Geographic Variation, Economic Activity, and Labor Market Characteristics in Trajectories of Suicide in the United States, 2008–2020

Katherine M. Keyes, Sasikiran Kandula, Gonzalo Martinez-Ales, Catherine Gimbrone, Victoria Joseph, Shannon Monnat, Caroline Rutherford, Mark Olfson, Madelyn Gould, Jeffrey Shaman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Suicide rates in the United States have increased over the past 15 years, with substantial geographic variation in these increases; yet there have been few attempts to cluster counties by the magnitude of suicide rate changes according to intercept and slope or to identify the economic precursors of increases. We used vital statistics data and growth mixture models to identify clusters of counties by their magnitude of suicide growth from 2008 to 2020 and examined associations with county economic and labor indices. Our models identified 5 clusters, each differentiated by intercept and slope magnitude, with the highest-rate cluster (4% of counties) being observed mainly in sparsely populated areas in the West and Alaska, starting the time series at 25.4 suicides per 100,000 population, and exhibiting the steepest increase in slope (0.69/100,000/year). There was no cluster for which the suicide rate was stable or declining. Counties in the highest-rate cluster were more likely to have agricultural and service economies and less likely to have urban professional economies. Given the increased burden of suicide, with no clusters of counties improving over time, additional policy and prevention efforts are needed, particularly targeted at rural areas in the West.

Original languageEnglish (US)
Pages (from-to)256-266
Number of pages11
JournalAmerican Journal of Epidemiology
Volume193
Issue number2
DOIs
StatePublished - Feb 1 2024
Externally publishedYes

Keywords

  • economic factors
  • epidemiologic methods
  • growth mixture modeling
  • suicide

ASJC Scopus subject areas

  • General Medicine

Fingerprint

Dive into the research topics of 'Geographic Variation, Economic Activity, and Labor Market Characteristics in Trajectories of Suicide in the United States, 2008–2020'. Together they form a unique fingerprint.

Cite this