however, has been increasing. While the rates in African American adolescents has increased through the 1990s, the rates appear to have leveled off.

  • The differences in suicide rates among ethnic groups in the United States, among immigrant populations, and among countries throughout the world point to the influence of social and cultural factors. Risk factors vary in their importance for different groups. Youth suicide is more highly associated with impulsiveness than for other age groups. On the other hand, older persons are at greater risk for completing suicide because of the seriousness of the intent and social isolation.

Studies of the differences in the risk of suicide among populations can enhance our understanding of the impact of risk and protective factors. This is best accomplished by collection of specific data from well defined and characterized populations whose community level social descriptions are well known, which would allow the integration of population-based approaches with studies of individual characteristics.

  • Suicide rates vary across geographic region. Rates are lower in more densely populated areas around the world. When rates within the United States are analyzed county by county, striking variations in some adjacent counties are revealed. This approach bridges traditional sociological and anthropological studies that use ecological data and case controlled approaches that examine individual risk factors for suicide.

Future studies could identify social factors that differ between two communities that are adjacent, or otherwise similar, but have dramatically different suicide rates. This approach could provide more precise assessments of the roles of social factors in suicide including public health issues such as access to and the quality of health care.

  • Costs to Society: The annual cost of lost productivity due to suicide deaths was calculated to be $11.8 billion (in 1998 dollars). This does not include medical care costs, or costs incurred by loss of productivity of either those suffering from suicidality or the close family and friends of a suicide victim.

REFERENCES

Agerbo E, Mortensen PB, Eriksson T, Qin P, Westergaard-Nielsen N. 2001. Risk of suicide in relation to income level in people admitted to hospital with mental illness: Nested case-control study. British Medical Journal, 322(7282): 334-335.

Anderson RN. 2001. United States Life Tables, 1998. National Vital Statistics Report, 48(18): 1-40.



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