61.2 An Epidemic of Inequity: Understanding Social Drivers of Intersectional Suicide Deaths in the United States

Jonathan Platt; John R. Pamplin; Katherine Keyes

doi:10.1016/j.jaac.2023.07.427

Suicide is the leading cause of violent death in the United States, accounting for 2.6% of all mortality. Suicide deaths have increased to historically high rates in the 21st century overall, although differing trends suggest complex social patterns with the greatest increases occurring in historically marginalized groups. Despite congressional calls to address these concerning trends, research focusing on social inequities and suicide is limited. To fill this critical gap, this project employs a structural intersectionality approach to answer the following key questions: 1) What are the key indicators of structural systems of inequity, and how do they vary across time and place?; and 2) How do these structures differentially shape suicide outcomes across the US population? Methods Using a complete census of suicide deaths from all US counties from 2005 to 2020, we will: 1) estimate trends in the distribution of suicide deaths across intersecting race/ethnicity, sex, geography, and education levels; 2) assemble a novel dataset of indicators of structural social inequities; and 3) estimate associations between those inequities and suicide deaths. The results will inform effective interventions to reduce suicide disparities. Results We anticipate several results based on preliminary data. First, we hypothesize that suicide death rates among individuals with greater levels of social disadvantage will have increased relative to those with high levels of social advantage. Second, social inequity will be significantly associated with suicide rates and group differences, such that rates among groups with greater social disadvantage will be elevated in areas with greater levels of structural social inequities. Work is ongoing to test these hypotheses, to be completed by July 1, 2023. Conclusions We expect to have described the complex social distribution of suicide deaths and identified emerging high-risk groups. We also will have defined a set of social inequities that are important drivers of suicide deaths and disparities. By investigating population heterogeneity in the context of social power, oppression, discrimination, and privilege, we seek to identify the distribution and determinants of emerging social inequities in suicide deaths.

61.2 An Epidemic of Inequity: Understanding Social Drivers of Intersectional Suicide Deaths in the United States

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