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Reducing Suicide: A National Imperative
non-Hispanic, Asian/Pacific Islander non-Hispanic, and Hispanic of any race. Next, we estimated the present value of future earnings by discounting and summing the stream of expected annual earnings. Race- and sex-adjusted life expectancy at the mid-point of each age interval was taken from the 1998 U.S. Life Tables (Anderson, 2001). This method of estimating future earnings is based on a cross-sectional perspective, rather than a longitudinal birth cohort perspective. For example, the 1998 earnings of a 60 year old black man are used to estimate the annual earnings of a 50 year old black man 10 years later. Future earnings were discounted at an annual rate of 3 percent to yield their present values. This is based on the real value of the short-term United States T-bill, in an effort to approximate the risk-free time-value of money.
To estimate the total lost earnings due to suicide, we multiplied the number of suicides in each age/sex/race group (data from the National Center of Disease Control’s WISQARS™, Web-based Injury Statistics Query and Reporting System) in 1998 by age-, sex-, race-specific estimated future earnings and summed across groups. As described above, the cost of lost earnings from suicide in just the one year (1998) was calculated to be $11.8 billion.
A similar analysis was done for suicides in New Brunswick, Canada, during 1996 (Clayton and Barcelo, 1999). The direct costs (health care services, autopsies, funerals, and police investigations) for the 94 reported suicides came to $535,158. Indirect costs, which include the lost productivity, came to $79,353,354 for a mean total cost per suicide death in 1996 of $849,878. For 30,000 deaths each year, this totals about 25 billion dollars.
Although the issue can be raised that any premature death (e.g., from smoking) can save society money (Viscusi, 1995), the Committee decided not to even broach this argument, considering it contrary to the goals of public health and morally unacceptable.
Suicide rates vary widely across demographic groups. African Americans have had significantly lower rates historically than whites despite higher incidence of major risk factors. The rates of completed suicide are particularly low among African American women. In contrast, the suicide rates among Native Americans have been and continue to be extremely high. Older white males have the highest rate in the United States. Males have higher rates across the globe except in rural China where women complete suicide at a higher rate.
The suicide rate in the United States has remained relatively unchanged for the last 50 years. The rate for youth in the United States,