Suicide, Substance Use Causing Increased Mortality Rates Among White, Middle-aged Men

Suicide rates are increasing and locally the number of suicides were either highest among those 20-44 or 45-74, as detailed in a recent Drawing Detroit blog post. According to a recent New York Times article, suicide is a cause of death that is not only growing in Southeastern Michigan, but nationally. Throughout the state of Michigan, according to the Michigan Department of Health and Human Services, suicide was the fourth leading cause of death for white males between the ages of 35 and 49 (244 suicides total).

The article details recent research conducted by Princeton Economists Angus Deaton and Anne Case, which concludes that the rising death rates among middle-aged white men are being caused by suicides and issues related to substance use. According to the article, the mortality rate for white Americans between the ages of 45 and 54 with no more than a high school education increased by 134 deaths per 100,000 people. While the Michigan Department of Health and Human Services does not detail mortality rates by race, age and education level explicitly on its website, it does show that the mortality rate from white males between the ages of 45 and 54 increased from 469.7 to 494.4 between 2000 and 2013. Just as the death rate for white American males is increasing nationally, Michigan is also experiencing the plight.

While suicide rates have contributed to the growing mortality rate for this segment of the population, Deaton and Case found that suicide coupled with deaths caused by drug use and alcohol poisoning are what explained the increased mortality rate.

No direct explanations were discovered for the increase in suicide deaths and deaths caused by drug and alcohol use, however, Deaton found that increases in mortality rates for middle aged white men were parallel with the same population’s reports on distress, pain and poor health. This correlation, he said, could be used a rationale for the increase in the type of deaths.

 

For more on this article click here.

To learn more about suicide rates in Southeastern Michigan click here.

Southeastern Michigan’s Firearm Deaths Ruled Suicide Surpass those Ruled Homicide, Accidental

In Detroit, homicides by firearm far outpace suicide, according to the Michigan Department of Health and Human Services 2013 data. Outside Detroit in each of the seven counties in the region, the reverse holds. Suicide by firearm far exceeds homicide by firearm. Accidental deaths by firearm in Southeastern Michigan in 2013 were far lower than either other category. Wayne County, excluding the city of Detroit, had the largest difference between firearm deaths ruled suicide and firearm deaths ruled homicide; there were 50 more firearm deaths ruled homicide. Macomb County had the second largest difference at 42 and Oakland County’s difference was 39.

In Detroit there were 214 more firearm deaths ruled homicide than suicide.

Firearm deaths ruled accidental was the category with the lowest numbers across the region. Wayne County had the highest number of accidental deaths at three while Livingston, Oakland and Washtenaw counties, along with the city of Detroit, had zero.

When looking at the rate of suicide and homicide deaths by firearm per 100,000 residents we see that suicide had a higher rate in all counties but Wayne in 2013. However, when the number of Detroit suicide and homicide deaths are removed from Wayne County it was in line with its peers in that its rate of suicide death by firearm was higher than its rate of homicide by firearm. At the county level, Macomb County had the highest rate of suicide by firearm at 7.6 and Livingston County had the lowest at 2.7. When not including the Wayne County rate of homicide by firearm with Detroit numbers included, Oakland County had the highest rate of homicide by firearm per 100,000 residents in 2013 at 2.5.

Detroit’s rate of homicide by firearm per 100,000 residents was higher than its suicide rate by firearm though in 2013; the rate of homicide by firearm was 13.6 while the suicide rate by firearm was 4.7.





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Southeastern Michigan Firearm Deaths

Rate of Suicide by Forearm

2013 Firearm Homicides

In Detroit, homicides by firearm far outpace suicide, according to the Michigan Department of Health and Human Services 2013 data. Outside Detroit in each of the seven counties in the region, the reverse holds. Suicide by firearm far exceeds homicide by firearm. Accidental deaths by firearm in Southeastern Michigan in 2013 were far lower than either other category. Wayne County, excluding the city of Detroit, had the largest difference between firearm deaths ruled suicide and firearm deaths ruled homicide; there were 50 more firearm deaths ruled homicide. Macomb County had the second largest difference at 42 and Oakland County’s difference was 39.

In Detroit there were 214 more firearm deaths ruled homicide than suicide.

Firearm deaths ruled accidental was the category with the lowest numbers across the region. Wayne County had the highest number of accidental deaths at three while Livingston, Oakland and Washtenaw counties, along with the city of Detroit, had zero.

When looking at the rate of suicide and homicide deaths by firearm per 100,000 residents we see that suicide had a higher rate in all counties but Wayne in 2013. However, when the number of Detroit suicide and homicide deaths are removed from Wayne County it was in line with its peers in that its rate of suicide death by firearm was higher than its rate of homicide by firearm. At the county level, Macomb County had the highest rate of suicide by firearm at 7.6 and Livingston County had the lowest at 2.7. When not including the Wayne County rate of homicide by firearm with Detroit numbers included, Oakland County had the highest rate of homicide by firearm per 100,000 residents in 2013 at 2.5.

Detroit’s rate of homicide by firearm per 100,000 residents was higher than its suicide rate by firearm though in 2013; the rate of homicide by firearm was 13.6 while the suicide rate by firearm was 4.7.

There were four counties with an increase in the percentage of firearm deaths ruled suicide between 2008 and 2013. Monroe County had the largest increase at 1,000 percent, which is representative of an increase of 10 firearm deaths ruled suicide. In 2008 there was one suicide in Monroe County and in 2013 there were 11. The other three counties were Washtenaw, Oakland and Macomb. In terms of sheer numbers, Oakland County had the largest increase of firearm deaths ruled suicide between 2008 and 2013 at 27.

Livingston County had the largest percentage decrease of firearm deaths ruled suicide between 2008 and 2013 at 55 percent. In 2008 in Livingston County there were 11 firearm deaths ruled suicide and in 2013 there were 5.

Change of Gun deaths

Livingston, Macomb, St. Clair Counties’ Suicide Rates Top Those Of State, Nation

Nationally, the suicide rate was 12.1 suicides per 100,000 residents in 2013, according to the Centers for Disease Control, and statewide it was 12. 9 per 100,000 people, according to the Michigan Department of Health and Human Services. However, in Southeastern Michigan we had three counties—Livingston, Macomb and St. Clair—that exceeded this rate. Livingston County had the highest rate in the region at 15.4 per 100,000 residents, with 28 suicides in the county in 2013. Macomb County had the second highest rate 14.8 (125) and St. Clair County had the third highest rate at 13.6 (22) in the region. In the seven counties throughout the region, and in the state overall, suicide was ranked as one of the top 10 causes of death in 2013.

While only certain cities throughout the region had suicide numbers available through the Michigan Department of Health and Human Services, we do know that Detroit had the largest overall number of suicides at 57 and Warren had the second highest number at 34; these are the first and third largest cities in the state, therefore when looking at total numbers (not the rate) it is not unexpected that they would also be the highest. The Detroit rate is below the state rate, however, at 12.3.

Southeastern Michigan Suicide Rate

Number of Suicides

Suicides by city

Nationally, the suicide rate was 12.1 suicides per 100,000 residents in

Suicide rates have been climbing at the state-level and in areas throughout the region. Michigan’s suicide rate is currently the highest it has been since at least 1980 (the first year this data is accessible online), according to the Michigan Department of Health and Human Services. From the 2004-2013, Macomb County had a suicide rate higher than that of the state for seven out of 10 years. In 2013, Macomb’s suicide rate was 14.8, an increase from 11.4 in 2004. Oakland County’s rate increased from 9.9 to 12.3 during that time frame (peaking at 13.9 in 2012), and Wayne County’s rate increased from 9.3 to 11.5 between 2013 and 2014.

In Oakland County, the rate peaked at 12.9 in 2012 and only slightly decreased to 12.3 in 2013. Director of Clinical Services for Health Management Systems of America Beth Combs cited the recession as one of the reasons for the national suicide rate climbed in the past 10 years, according to a 2013 Oakland Press article. She said the loss of a job, particularly for men between the ages of 35 and 55, can leave many feeling hopeless. However, a struggling economy does not solely cause one to take their own life, if at all. Suicide can be caused by mental health issues, feelings of hopelessness and/or loneliness, divorce, bullying, violence and several other issues, according to the Michigan Association for Suicide Prevention.

Annual rates for Livingston, Monroe, St. Clair and Washtenaw counties were not included in the below graph because the Michigan Department of Health and Human Services only had five year rolling averages for those counties.

Suicide rates over time

Suicide rates by age group

The suicide rate has nearly doubled for middle-aged Americans in the past decade, according to an Oakland Press article. Above we see that throughout Southeastern Michigan counties in 2013, the number of suicides were either highest among those 20-44 or 45-74 (this is how age categories are broken down by the Michigan Department of Health and Human Services). Livingston, Macomb and Wayne counties had the highest number of suicides in the 20-44 category while Monroe, Oakland, St. Clair and Washtenaw had the highest number in 45-74 category. At the national level, according to the Centers for Disease Control, the age group with the highest suicide rate (19.1) was those between the ages of 45 and 64.

According to the American Foundation of Suicide Prevention, adolescents consistently have lower suicide rates than other age groups.

 

In Michigan, while support groups for those suffering from suicidal thoughts and survivors of suicide do exist, mental health funding as a whole has been cut. In 2014, according to a Voice News article, Macomb County cut services to about 1,300 people and St. Clair County cut services to about to about 300. Overall, about $100 million was cut from the state’s mental health system in fiscal year 2014. In Macomb County, due to the state and Medicaid funding cuts, the county’s mental health authority cut its Survivors of Suicide (SOS) program and must rely on volunteers to staff its crisis center. Through general fund appropriations Macomb County has been able to re-establish the SOS program by contracting with an outside party. The Oakland County Community Mental Authority has taken a different route to promote suicide awareness prevention and support by a securing a five-year, $200,000 grant from the Substance Abuse and Mental Health Service Administration.

Despite monies being found outside of state funding to support suicide prevention, support and awareness programs we must be aware that rates are increasing locally and throughout the state as state funding for mental health services is declining.