County-level suicide rates in the United States had a strong positive relationship with county poverty rates, while no relationships were found between county measures of unemployment or foreclosures when poverty rates were controlled, according to a new study from the Alcohol Research Group (ARG), a program of the Public Health Institute, in collaboration with the UCLA Luskin School of Public Affairs, Oregon Health and Science University, Prevention Research Center and the Centre for Addiction and Mental Health in Toronto.
The study, published in the American Journal of Preventive Medicine, analyzed data over a six-year period from 2005 to 2011 that includes the major U.S. economic downturn from 2007 to 2009. The study also found that for men 45 to 64 years old, the proportion of alcohol-related suicides and poverty rates were positively associated. This working-age group was a key demographic in rising suicide rates during the recession.
This is the first study to try to unravel how different features of such a downturn affect suicide rates and alcohol-related suicides in particular. It is also the first study to suggest that unemployment's role may not be as significant as poverty.
"Our finding suggests that the consequences of unemployment were more important than being unemployed during this period," said ARG senior scientist and lead author William C. Kerr. "These results are consistent with what we see in countries that have strong unemployment support systems—where being out of a job doesn't increase your risk for suicide."
Poverty was also found to mediate unemployment's effect on suicide rates, which suggests that policies should focus directly on reducing poverty as well as on supporting people who are unemployed.
"The analysis also draws attention to the importance of targeting suicide prevention efforts in economically disadvantaged communities and incorporating alcohol control policies, abuse prevention and treatment for alcohol misuse into such efforts," said Mark S. Kaplan, co-author and professor in UCLA Luskin's Department of Social Welfare.
"County-level poverty rates reflect what's happening at an individual and family level as well as across the entire area," Kerr added. "It speaks to a lack of resources for people who are struggling. It's possible that some people were already at a breaking point when the recession hit—it's difficult to know for sure. But the results do tell us that we need better mechanisms in place to help the people who need it the most."
The study analyzed data from 16 states included in the National Violent Death Reporting System during the study period. This system links data from coroner/medical examiner records, police reports, death certificates and crime laboratories.
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William C. Kerr et al. Economic Recession, Alcohol, and Suicide Rates: Comparative Effects of Poverty, Foreclosure, and Job Loss, American Journal of Preventive Medicine (2016). DOI: 10.1016/j.amepre.2016.09.021