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- Title
Social Vulnerability and Risk of Suicide in US Adults, 2016-2020.
- Authors
Liu, Shuhan; Morin, Samuel B.; Bourand, Natalie M.; DeClue, Isabella L.; Delgado, Gustavo E.; Fan, Jiahe; Foster, Sabrina K.; Imam, Maaz S.; Johnston, Coulter B.; Joseph, Franklin B.; Lu, Yihao; Sehrawat, Ujjwal; Su, Li Chun; Tavan, Ketaki; Zhang, Kelly L.; Zhang, Xingruo; Saulsberry, Loren; Gibbons, Robert D.
- Abstract
Key Points: Question: Is social vulnerability associated with suicide rates for US adults? Findings: In this cohort study including 222 018 suicides in 3141 US counties, high scores on both the US Centers for Disease Control and Prevention's Social Vulnerability Index and the new Social Vulnerability Metric were associated with higher adult suicide rates at the county level. Comparing the lowest 10% and highest 10% in the indices showed a 56% higher suicide rate for the Social Vulnerability Index and 82% higher for the Social Vulnerability Metric. Meaning: These results suggest a possible quantitative approach to reduce suicide rates through targeted interventions of social vulnerability. This cohort study using county-level US Census data examines the association of social vulnerability with suicide rates using 2 indices from the US Centers for Disease Control and Prevention. Importance: There were over 45 000 suicides in the US in 2020, making suicide the 12th leading cause of death. If social vulnerability is associated with suicide rates, targeted interventions for at-risk segments of the population may reduce US suicide rates. Objective: To determine the association between social vulnerability and suicide in adults. Design, Setting, and Participants: This cohort study analyzed 2 county-level social vulnerability measures (the Social Vulnerability Index [SVI] and the Social Vulnerability Metric [SVM]) and US Centers for Disease Control and Prevention–reported county-level suicides from 2016 to 2020. Data were analyzed November and December 2022. Exposures: County-level variability in social vulnerability. Main Outcomes and Measures: The primary outcome measure was number of county-level adult suicides from 2016 to 2020, offset by county adult population during those years. The association between social vulnerability (measured using the SVI and the newly created SVM for 2018) and suicide was modeled using a bayesian-censored Poisson regression model to account for the CDC's suppression of county-level suicide counts of less than 10, adjusted for age, racial and ethnic minority, and urban-rural county characteristics. Results: From 2016 to 2020, there were a total of 222 018 suicides in 3141 counties. Comparing the least socially vulnerable (0% to 10%) to the most socially vulnerable (90% to 100%) counties, there was a 56% increase in suicide rate (17.3 per 100 000 persons to 27.0 per 100 000 persons) as measured by the SVI (incidence rate ratio, 1.56; 95% credible interval, 1.51-1.60) and an 82% increase in suicide rate (13.8 per 100 000 persons to 25.1 per 100 000 persons) as measured by the SVM (incidence rate ratio, 1.82; 95% credible interval, 1.72-1.92). Conclusions and Relevance: This cohort study found that social vulnerability had a direct association with risk for adult suicide. Reducing social vulnerability may lead to life-saving reduction in the rate of suicide.
- Subjects
UNITED States; SUICIDE risk factors; PSYCHOLOGICAL vulnerability; AGE distribution; RURAL conditions; REGRESSION analysis; RACE; SUICIDAL behavior; SOCIOECONOMIC factors; RISK assessment; DESCRIPTIVE statistics; METROPOLITAN areas; LONGITUDINAL method; ADULTS
- Publication
JAMA Network Open, 2023, Vol 6, Issue 4, pe239995
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.9995