4 Suicide

Suicide has become a devastating health outcome in the United States, with many feeling its impacts regardless of gender, race, ethnicity, or age. The rate of suicide has steadily increased from 2000 to 2020 by 30% (Centers for Disease Control and Prevention [CDC], 2022). In 2020, the Centers for Disease Control and Prevention (CDC) estimated that over 12.2 million American adults contemplated suicide, 3.2 million planned to commit suicide, and 1.2 million attempted suicide (CDC, 2022). The term “suicide” covers the death of an individual caused by injuring oneself with the intent to die (CDC, 2022). However, this is different to a suicide attempt. A “suicide attempt” is when someone harms themselves with an intent to end their life, but they do not die because of their action (CDC, 2022). The difference of definitions is shown in statistics of gender preferences in suicide.

“This work” by Heather Plew, is licensed under Pixabay

Suicide is a complex health result influenced by social, environmental, and physical factors. The risk factor list is split into personal, interpersonal, communal, and societal. The personal risks are individuals with a history of mental illness, working in stressful environments, being male, or abusing drugs (Frey, 2022). Interpersonal issues are history of child abuse, recent loss of a loved one, unemployment or money issues, and isolated from others. Communal conditions that are related to suicide are homelessness, lack of access to healthcare and local epidemics of suicide. Lastly, societal risks of suicide are guns, social stigmas related to asking for help, and media glamorization of suicides. All factors above increase the likelihood of suicide and can impact multiple parts of a person’s life. Therefore, having a single prevention or treatment is impossible.

While suicide is a leading cause of death in the United States, the outcome continues to affect the male population more than the female. Men die from suicide four to five times more often than females (Freeman et al., 2017). Plus, when looking at the intent of suicide, males more often commit suicide, while females have a higher rate of suicide attempts (Freeman et al., 2017). Also, many developed countries have failed to start suicide prevention programs for the male population (Struszczyk et al., 2019). Popular suicide prevention programs in the US are gender neutral, which can lower costs and expand access. But these programs may not fix issues that the male population needs. Also, its incorrect to assume that the male population in the US is affected similarly by suicide. Within the male population certain subgroups or divisions are presented with a greater risk of committing suicide. Specifically, different ages and races increase one’s risk of experiencing suicide.

How Could Age and Race Effect Male Suicide Rates?

Life Stage

The sharpest increase in the number of suicide deaths occurs from early adolescence through young adult. In the United States, suicide is a top three leading cause of death for youth and young adults ages 10 to 25 years old (CDC, 2022). There is no evident difference between sex in suicide attempt or completion until age 11. Boys are more susceptible to suicide attempts once they turn 11 (Cha et al., 2017). Researchers have not given a reason why age 11 shows an increase in suicide attempts. However, one can speculate. Answers could be that boys go through puberty then or they are exposed to more bullying as they get older . As to why the sharpest jump occurs for adolescents and young adults, there are multiple answers. From my perspective, individuals at that age could be experiencing bullying, battling with mental health issues, and struggling with their sexual orientation.

While looking more at the older age groups within the United States, the males suicide rates are extremely concerning. Despite a steady decline in elderly suicide since 2009, males aged 65 and older still have the highest suicide rates in the US (Perry et al., 2022). Reasons for elderly male suicide rates could be because of less family connections, decreasing feeling on purpose or importance and long-term struggles with mental illness (Perry et al., 2022). Although there is evidence on why the rates of older men are high, complete answers are limited. This may be because protecting the youth from suicide could be a bigger focus.

As for middle-aged men (35-64 years old), the rates of suicide are not as overwhelming compared to young or older males. Overall, suicide is the ninth leading cause of death in the United States for this age group (CDC, 2022). Compared to other age groups, middle-aged men are more likely to be employed or married. In fact, a study shows that being single increases one’s risk of suicide by 6.06 times and the greatest possibility of suicide for these individuals occurring 30 days after a separation (Næss et al., 2021). Therefore, middle aged men may have protective factors that reduce their risks of suicide.

Race

Only recently has the suicide rates for different race and ethnicities within the male population become a major public health issue. Recent data shows that for suicide deaths, White individuals experience 17.6 per 100,000 deaths, American Indian or Alaska Native individuals experience 22.2 per 100,000 deaths, Hispanic Americans experience 7.3 per 100,000 deaths, Black individuals experience 7.4 per 100,000 deaths, and Pacific islanders or Asian individuals at 7.3 per 100,000 deaths (Ramchand et al., 2021). It is concerning to see the American Indian and Alaskan Natives experience such a large suicide death rate with such a small population. When looking at current race and ethnic suicide rates, it is important to look at how these rates have changed over time. The age-adjusted rates for, suicide rates for White and American Indian or Alaska Natives decreased from 2014 to 2019 (Ramchand et al., 2021). However, from 2014 to 2019, suicide rates increased by 30% for Black and 16% for Asian or Pacific Islander Americans (Ramchand et al., 2021). Despite these troubling numbers, most long-term data available only contains the White population. In fact, a study found that over 20% of research on suicide attempts did not report race and over 50% did not report ethnicity (e.g., Latinx/Hispanic) (Carter et al., 2021). In future suicide research, there needs to be an anonymous survey including participant’s race and ethnicity.

A reason why research sees a larger number of male suicides could be because of the idea of masculinity. Specifically, the traditional, hegemonic masculine norms that are idealized within Western culture. There is an increasing pressure within Western culture for young boys to be a strong, dominant man in order to be “masculine” (Struszczyk et al., 2019). If unable, they could begin to feel isolated from society. Certain circumstances, like mental health issues or unemployment, can contribute to the pressure because of its vulnerable, weak image. Also, traditional masculine norms may affect how males view seeking help in combatting suicide. The social stigma of asking family members, friends, and health care professionals for help, perpetuates the vulnerable, weak male image (Struszczyk et al., 2019). The masculinity stress placed on different racial or ethnic groups could contribute to higher suicide rates (Ramchand et al., 2021). Beginning to reconstruct the traditional masculine norms that society views as “correct” could allow males to feel less isolated and find value within. However, while society catches up to the changing of masculinity, males can work themselves. Healthy coping strategies for males are avoiding alcohol and drugs, logging off from social media, and engaging in wellness (e.g., yoga or meditation). These examples can help lessen the amount of pressure on males while society continues to modernize.

Current Actions and Recommendations

Current suicide prevention programs use popular strategies like public awareness campaigns, gate-keeper training programs, and survivor support groups (Cramer et al., 2017).

My recommendations to reduce male suicide rates in the US are on the societal and community level. For the societal level, firearm access and improper gun storage allows individuals to use the weapon for suicide attempts. Compared to females, males are 8 times more likely to use a gun for lethal suicide attempts (The Educational Fund to End Gun Violence, 2022). Firearm deaths affect all male age groups, but older adults have the highest firearm suicide usage (The Educational Fund to End Gun Violence, 2022). Plus, American Indian and Alaska Natives adolescence and young adult males have the highest firearm suicide rate (The Educational Fund to End Gun Violence, 2022). The American Foundation for Suicide Prevention recommends gun laws or regulation for storage along with public awareness. Intervening with stricter laws on guns and their storage could lower the number of male suicides. Along with this, communities need to have free crisis support lines and free mental health screening through community mental health centers. This is because 7% of men with a history of depression will die by suicide (Perry et al., 2022). It is vital to have access to affordable and culturally appropriate mental health screening within communities of American Indian and Alaska Native males. This is due to their high risk of suicide. And so, action in both the societal and community levels are necessary to attack the public health issue of male suicide.

Chapter Summary:

References

Carter, S. P., Campbell, S. B., Wee, J. Y., Law, K. C., Lehavot, K., Simpson, T., & Reger, M. A. (2021). Suicide Attempts Among Racial and Ethnic Groups in a Nationally Representative Sample. Springer Science and Business Media LLC. 10.1007/s40615-021-01115-3

Centers for Disease Control and Prevention. (2022). Facts About Suicide. https://www.cdc.gov/suicide/facts/index.html

Centers for Disease Control and Prevention. (2017). The Social-Ecological Model: A Framework for Prevention. Retrieved from. https://www.cdc.gov/ violenceprevention/overview/socialecologicalmodel.html (Accessed January 13, 2017).

Cha, C. B., Franz, P. J., M. Guzmán, E., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2017). Annual Research Review: Suicide among youth – epidemiology, (potential) etiology, and treatment. Wiley. 10.1111/jcpp.12831

Cramer, R. J., & Kapusta, N. D. (2017). A Social-Ecological Framework of Theory, Assessment, and Prevention of Suicide. Frontiers Media SA. 10.3389/fpsyg.2017.01756

Freeman, A., Mergl, R., Kohls, E., Székely, A., Gusmao, R., Arensman, E., Koburger, N., Hegerl, U., & Rummel-Kluge, C. (2017). A cross-national study on gender differences in suicide intent. Springer Science and Business Media LLC. 10.1186/s12888-017-1398-8

Frey, R. J. (2022). Suicide prevention. In Gale Health and Wellness Online Collection. Gale. https://link.gale.com/apps/doc/QQEBSC058843025/HWRC?u=clemsonu_main&sid=bookmark-HWRC&xid=e2afde90

Næss, E. O., Mehlum, L., & Qin, P. (2021). Marital status and suicide risk: Temporal effect of marital breakdown and contextual difference by socioeconomic status. SSM – Population Health, 15, 100853. 10.1016/j.ssmph.2021.100853

Perry, S. W., Rainey, J. C., Allison, S., Bastiampillai, T., Wong, M., Licinio, J., Sharfstein, S. S., & Wilcox, H. C. (2022). Achieving health equity in US suicides: a narrative review and commentary. Springer Science and Business Media LLC. 10.1186/s12889-022-13596-w

Ramchand, R., Gordon, J. A., & Pearson, J. L. (2021). Trends in Suicide Rates by Race and Ethnicity in the United States. American Medical Association (AMA). 10.1001/jamanetworkopen.2021.11563

Struszczyk, S., Galdas, P. M., & Tiffin, P. A. (2019). Men and suicide prevention: a scoping review. Journal of Mental Health (Abingdon, England); J Ment Health, 28(1), 80-88. 10.1080/09638237.2017.1370638

The Educational Fund to Stop Gun Violence. (2021, March 2). Prevent Firearm Suicide – Statistics. Prevent Firearm Suicide. Retrieved from https://preventfirearmsuicide.efsgv.org/about-firearm-suicide/statistics/