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Suicide, ‘a major contributor to premature death’ in U.S., rises by 4% for 2021

Article

Figures strengthen resolve but don’t offer context for complex issue, American Foundation for Suicide Prevention says.

Suicide, ‘a major contributor to premature death’ in U.S., rises by 4% for 2021

The U.S. suicide rate rose 4% to 47,646 deaths in 2021, up from 45,979 in 2020.

The figures were published this month in the report “Provisional Numbers and Rates of Suicide by Month and Demographic Characteristics: United States, 2021,” by the National Vital Statistics System (NVSS) in the U.S. Centers for Disease Control and Prevention (CDC). The numbers were based on 99% of the 2021 death records processed by the National Center for Health Statistics as of May 15, 2022.

The report notes “suicide is a major contributor to premature death in the United States, especially among people aged 10-34, for whom it is the second leading cause of death.”

In the United States, suicide rates increased 35% from 1999 to 2018, then declined 5% through 2020. Although the 2021 result was up year-on-year, the American Foundation for Suicide Prevention (AFSP) noted it remained below the 2018 rate.

“At AFSP we understand how devastating and painful it is to lose a loved one to suicide,” the foundation’s statement said. “This CDC provisional suicide data invigorates our resolve to continue fighting so that we can see a day when suicide does not exist. Despite the data indicating an increase in suicide deaths in 2021, we remain hopeful that our public education and advocacy efforts are making a difference.”

Combing through the data, AFSP noted “it’s important to remember that suicide is complex, and we are still understanding through research how societal factors and historical context impact suicide at an individual level.”

The results

Among the findings:

  • Suicide numbers were 2% higher for females from 2020 (9,428) to 2021 (9,621).
  • The number of suicides for males was 38,025 in 2021, 4% higher than 36,551 in 2020.
  • By month, suicides were lower in January, February, and July 2021, than in the same months in 2020.
  • October 2021 had the single largest monthly increase, up 11% over 2020.
  • August 2021 had the highest number of suicides at 4,328, while February 2021 had the lowest at 3,552.

Foundation response

The data does not explain contributing factors to suicide deaths, such as isolation, depression, anxiety, economic stress, suicidal ideation, and access to lethal means, according to AFSP.

The foundation predicted the COVID-19 pandemic’s effects are far from over, at least for mental health.

“Research has shown that people tend to come together during traumatic events initially and this can serve as a protective factor against suicide, though this societal cohesion may not persist as time passes,” the AFSP statement said. “This is why sustained prevention education efforts and advocacy are needed.”

AFSP noted suicide did not increase at the same rate for every age group. Rates remained relatively stable for females of all age groups and males aged 55 to 64 years but increased for males in other age groups. The largest increase in the suicide rate 8% -- occurred among males aged 15 to 24 years.

“Because the teen years are a time when we see the onset of mental health concerns as well as more suicide attempts, this makes early detection and prevention efforts for youth critical,” the AFSP statement said.

Future actions

AFSP called for more accessible and affordable mental health care on a regular, ongoing basis. Assessment and treatment must be accessible, culturally appropriate, and effective. People also should have insurance coverage for mental health equal to physical health, known as “mental health parity.”

AFSP’s Project 2025 will continue with the goal to reduce the annual suicide rate by 20%.

September is National Suicide Prevention Awareness Month and National Physician Suicide Awareness Day was Sept. 17, 2022. If you are in crisis, please call the National Suicide Prevention Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

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Michael J. Barry, MD