GESTIÓN EN SALUD PÚBLICA: BioEdge: Suicide rate rises steeply in US

domingo, 10 de junio de 2018

BioEdge: Suicide rate rises steeply in US

BioEdge: Suicide rate rises steeply in US

Bioedge

Suicide rate rises steeply in US

by Michael Cook | 9 Jun 2018 |

Two American celebrities committed suicide during the week: Kate Spade, a 55-year-old fashion designer, and Anthony Bourdain, a 61-year-old chef and TV host. Their deaths underscored dire news from the Centers for Disease Control about a steep increase in suicides in the US over the past two decades.

Nearly 45,000 lives were lost to suicide in 2016 – a 30% rise in half of states since 1999. Rates increased significantly among males in 34 states and females in 43 states. Men accounted for three-quarters of the deaths. The figures were highest among non-Hispanic whites and among those aged 45 to 65 years old.

Suicide is now the tenth leading cause of death for Americans. Suicide, Alzheimer’s disease and overdoses are the only causes of death which are increasing. Among people aged 15 to 34, suicide is the second leading cause of death.

CDC researchers did not single out one issue responsible for the rise. A number of factors are involved. Suicide is often attributed to mental health problems but many who die in this way did not have a diagnosed condition. However, “the reason most suicide decedents don’t have a known mental disorder is that they were never diagnosed, not that they didn’t have one,” said Dr David Brent, a psychiatrist at the University of Pittsburgh, told the New York Times.

There are other factors as well: relationship setbacks, substance use, poor physical health, and job, money, legal, or housing stress.

Firearms were the leading method, accounting for about half of suicides. The rates varied widely from state to state: 6.9 per 100,000 residents a year in the District of Columbia to 29.2 per 100,000 in Montana.

The statistics are puzzling. According to the Times:

Suicide rates have waxed and waned over the country’s history and tend to reach highs in hard times. In 1932, during the Great Depression, the rate was 22 per 100,000, among the highest in modern history. The rate in the new C.D.C. data was 15.4 per 100,000. The past three decades have presented a morbid puzzle. Rates have risen steadily in most age and ethnic groups, even as rates of psychiatric treatment and diagnosis have also greatly increased.

“At what point is it a crisis?” Nadine Kaslow, a past president of the American Psychological Association, asked the Washington Post. “Suicide is a public health crisis when you look at the numbers, and they keep going up. It’s up everywhere. And we know that the rates are actually higher than what’s reported. But homicides still get more attention.”

Sunday, June 10, 2018

The deaths this week of fashion designer Kate Spade and celebrity chef Anthony Bourdain (see below) focused the media once again on explanations for America’s rising suicide rates. The short answer is: nobody knows. The more nuanced long answer is: nobody knows for sure. But something is driving it. Here are a few paragraphs from the New York Times which suggest that suicide is becoming culturally more acceptable:

The rise of suicide turns a dark mirror on modern American society: its racing, fractured culture; its flimsy mental health system; and the desperation of so many individual souls, hidden behind the waves of smiling social media photos and cute emoticons.

Some experts fear that suicide is simply becoming more acceptable. “It’s a hard idea to test, but it’s possible that a cultural script may be developing among some segments of our population,” said Julie Phillips, a sociologist at Rutgers.

Prohibitions are apparently loosening in some quarters, she said. Particularly among younger people, Dr. Phillips said, “We are seeing somewhat more tolerant attitudes toward suicide.”

In surveys, younger respondents are more likely than older ones “to believe we have the right to die under certain circumstances, like incurable disease, bankruptcy, or being tired of living,” she said.

If this is the case, why, O why, is there a movement for assisted suicide? Yes, it’s hard to prove, but it makes sense: if assisted suicide is a triumph of compassion and autonomy, how can unassisted suicide possibly be a tragedy?