Suicide increase linked to economic downturns

Everyone is familiar with stories of businessmen jumping to their deaths from window ledges during the Great Depression. New data from the Centers for Disease Control and Prevention indicate that those stories, sometimes viewed as apocryphal, have a strong basis in fact: The rate of suicides rises during times of economic hardship and declines in periods of prosperity.

The association, however, holds strongly only for adults of working age, those between 25 and 54 years old, the authors reported Wednesday in the online version of the American Journal of Public Health.

And overall, suicides are only a small proportion of deaths, even at times when rates peak. “The rates were higher during the Great Depression, but not incredibly high,” said Dr. Alexander E. Crosby, a medical epidemiologist in the CDC’s Division of Violence Prevention and a coauthor of the paper. “But suicide is still a relatively rare event when you talk about all the events that cause deaths.”

Earlier studies examining links between economic conditions and suicide have covered only relatively short periods and small groups, and have produced conflicting results, with studies in some countries showing a link and research in other countries showing none. The CDC study is by far the most expansive, covering a period of 80 years and eight distinct age groups.

Overall, the study — which did not distinguish between men and women — found that the suicide rate was 18 per 100,000 adults in 1928, the earliest year for which data were available, and climbed to 22.1 per 100,000 in 1932, the last full year of the Great Depression. That 22.8% jump over a four-year period is the largest in history.

Since then, the suicide rate has been dropping, with much smaller increases at the end of Franklin D. Roosevelt’s New Deal (1937-38), the oil crisis (1973-75) and the Double-Dip Recession (1980-82). By 2007, the rate had dropped to 11.2 per 100,000 people and suicide was the 11^th leading cause of death in the United States, accounting for 34,598 deaths.

The authors’ interest in the subject was initially triggered by concerns about what effect the most recent recession might have on the suicide rate, but not enough data were available for that period yet, Crosby said.

The greatest decline in suicide rates over the eight decades of the study was observed in older Americans. The 65 and older group had the highest suicide rates during the Great Depression (53 per 100,000 for Americans ages 65 to 74), but rates have been falling steadily since then, have shown little deviation due to economic stress, and are now at the same level as other groups. That decline is probably because of much better medical care, which has reduced feelings of hopelessness among the elderly.

It is probably not surprising that the group at the prime working age is most susceptible to economic variations, the authors wrote. Those individuals are responsible for mortgage payments, health insurance, children’s educations and a variety of other expenses.

Moreover, people are vulnerable to suicide for a variety of complicated reasons, including psychological factors, substance and alcohol abuse, family dysfunction, relationship problems and other stressful life events, Crosby said. Economic setbacks can then be a “precipitating factor” that pushes them over the edge.

A lesson from this study is that communities need to focus their prevention efforts on certain groups, particularly working adults ages 25 to 54, the authors said. In communities affected by plant closings and other economic hardships, they added, special care needs to be taken to provide resources for this group so they know “where to turn, who to turn to, and don’t feel like they are isolated and have no hope, nowhere to go,” Crosby said.

For those who don’t know where to turn, there is a national crisis hotline, 1-800-273-TALK, for those who are contemplating suicide or for family and friends who are concerned about someone. That number will connect them to the closest certified crisis center.

thomas.maugh@latimes.com