Suicide risk greater for people living at higher elevations

Twenty years of mortality data from counties across the United States led to the striking discovery that living at higher altitudes may be a risk factor for suicide, according to a provocative study published online ahead of print in High Altitude Medicine & Biology.

Barry Brenner, MD, PhD, and David Cheng, MD, University Hospitals Case Medical Center (Cleveland, OH), and coauthors Sunday Clark, MPH, ScD, University of Pittsburgh Medical Center (PA), and Carlos Camargo Jr., MD, DrPH, Massachusetts General Hospital (Boston), examined cause-of-death data from all 2,584 U.S. counties between 1979 and 1998 and found that, as a group, people living at higher elevations had a statistically significant higher rate of suicide. They report an apparent link between altitude of residence and suicide rate in the article "Positive Association between Altitude and Suicide in 2,584 U.S. Counties."

The positive correlation between elevation and suicide risk was present even when the authors controlled for known suicide risk factors, such as older age, male sex, white race, and low income. Interestingly, the authors determined that the increased suicide rates at higher altitudes are not part of a broader association between mortality from all causes and living at higher elevations. In fact, they report a significantly lower overall mortality rate at higher altitudes.

"This article describes a new, unexpected finding of a link between suicide rate and altitude of residence. The cause is obscure as yet," says John B. West, MD, PhD, Editor-in-Chief of High Altitude Medicine & Biology and Professor of Medicine at the University of California, San Diego School of Medicine.