Midlife suicides are on the rise

A dark underside of middle-age has surfaced in the past decade. Although this phase of life is one psychologists have long considered a time of general stability and emotional well-being, white men and women ages 40 to 64 accounted for the bulk of a recent increase in the U.S. suicide rate, a new study finds.

Data gleaned from U.S. death certificates show that the overall suicide rate rose 0.7 percent annually between 1999 and 2005, reversing a downward trend in the rate that had begun in 1986. This increase primarily reflected a 2.7 percent annual rise in the suicide rate among middle-aged white men and a corresponding 3.9 percent annual rise among middle-aged white women, say epidemiologist Susan Baker of Johns Hopkins Bloomberg School of Public Health in Baltimore and her colleagues.

Over the same time period, self-inflicted deaths among blacks declined by 1.1 percent annually. Suicide rates held steady among Asians and Native Americans, although the rate for Native Americans was 3 percent higher than for whites in 2004.

From 1999 to 2005, the suicide rate for whites aged 65 or older declined by 1.2 percent annually, Baker’s team reports online and in the December American Journal of Preventive Medicine.

Suicide prevention programs have historically targeted elderly men as well as teenagers and young adults of both sexes. Mid-life suicide has not been extensively studied.

“Our results underscore a change in the epidemiology of suicide, with middle-aged whites emerging as a new high-risk group,” Baker says.

In 2005, evidence of a disproportionate number of annual deaths among middle-aged people in the United States raised suspicion that an escalating percentage of the deaths were suicides, remarks sociologist Robert Bossarte of the University of Rochester Medical Center in Rochester, N.Y. “The big unanswered question is why middle-aged adults killed themselves at an increased rate in the years covered by this new study,” Bossarte says.

Possible contributors to this trend include mounting numbers of military veterans reaching middle age and rising difficulties for middle-aged individuals in trying to secure medical insurance, he suggests.

Suicide prevention efforts may need to tailor services to middle-aged individuals, such as setting up programs in the workplace, Bossarte adds. Middle-aged white men may be especially reticent to seek mental-health assistance for depression and thoughts of suicide, in his view.

Baker and her coworkers also charted changes in the methods by which people killed themselves. Men displayed annual increases of 6.3 percent for suicide by hanging or suffocation and 2.3 percent for poisoning. Women showed annual increases of 2.8 percent for suicide by hanging or suffocation and a whopping 19.3 percent for poisoning.

Hanging and suffocation accounted for 22 percent of all suicides by 2005. Another 18 percent of suicides resulted from poisoning.

Still, suicide by firearm continued to dominate, constituting 52 percent of all suicides in 2005. At the same time, the firearm suicide rate declined 1.1 percent annually during the study’s seven-year span.

Baker’s team analyzed data from the Web-based Injury Statistics Query and Reporting System, or WISQARS. This resource uses death certificates from throughout the country to provide numbers and rates of deaths due to various types of injuries. WISQARS mortality figures run from 1981 through 2005 and are based on data files updated annually and held at the Centers for Disease Control and Prevention in Atlanta.