The News Story: Are Suicides Really Preventable?

In the wake of the suicides of Anthony Bourdain and Kate Spade last, multiple media outlets focused on the tragedy of suicide in the U.S. and what might be done to alleviate such suffering.

The answer, according to the Chicago Tribune: “Predicting if someone will attempt to take his or her own life is only slightly better than chance and has not significantly improved during the last five decades.” That is, it is almost impossible to predict whether someone will attempt suicide—oft-cited characteristics such as depression or mental illness are not really that good as indicators, experts say. The elusiveness of determining if someone is likely to attempt suicide makes prevention difficult, although there are some promising research trends.

But something this story only touches on bears further examination. Nadine Kaslow, professor at Emory University School of Medicine, tells the Tribune, “We do know that strong social support protects people from attempting suicide or dying by suicide.” And other new research indicates that such “strong social support”—particularly the family—actually goes a long way to protecting whole neighborhoods of people.

(Source: Gracie Bonds Staples, “Are Suicides Really Preventable? The Statistics Aren’t Encouraging,” Chicago Tribune, June 20, 2018)

The New Research: Preventing Suicide—Family Connections as Safety Net 

With suicide rates in the United States surging to their highest level in decades, public-health officials are looking with a keen sense of urgency for strategies to prevent such deaths. Unfortunately, in a nation where low marriage and fertility rates and high divorce rates are leaving unprecedented numbers of people without the support of spouse or family, their search may prove unavailing. Indeed, according to a study recently completed by researchers at Rice University, a person’s vulnerability to suicide depends first on whether that person lives with spouse or family and then on whether that person lives in a community filled with family households.

The Rice team began their new study cognizant of the scope of the problem in view. “As a leader of premature mortality in the U.S. and other developed nations, suicide is a social problem that arouses continued concern from researchers and policymakers alike,” they write. “In the U.S. alone, suicide accounts for nearly 40,000 deaths annually.”  

In framing their inquiry into this distressingly large tragedy, the researchers draw on the thinking of Emile Durkheim, the sociological pioneer who believed that “suicide was an inherently social act, one that is heavily influenced by broader social factors and thus could not be understood solely at the individual level.” Consequently, though the Rice scholars do look at individual characteristics in their investigation of suicide risk, they also examine the broader social context, especially as that context is defined by socioeconomic disadvantage and family living arrangements.

To gauge the impact of individual characteristics and social context on suicide risk, the authors of the new study examine data collected by the National Health Interview Survey from almost one million adults between 1986 and 1993, linking those data with 1990 and 2000 Census data, correlated with mortality numbers through 2006. The focus on adults, the researchers explain, reflects confidentiality concerns relevant for suicides under age 18.

Through statistical analysis, the researchers establish that both individual characteristics and social context affect suicide risk. Of course, individual characteristics actually point toward social context when those characteristics reflect marital status and family-living arrangement. And these marital and family-living characteristics matter for suicide risk: the Rice scholars conclude that divorced and separated individuals face a significantly higher suicide risk than do married peers (p < 0.01).  They also conclude that individuals face a significantly lower suicide risk if they live in a family comprised of four or more members rather than in a smaller household (p < 0.01).

Furthermore, when the researchers shift their focus from individual characteristics to community characteristics, Durkheim’s theoretical emphasis on social context looks fully justified. In these community-level analyses, the researchers compare Metropolitan Statistical Areas (MSAs) with relatively high numbers of family households with MSAs with relatively low numbers of such households. For these comparisons, the researchers define family households as those involving “married-couple families and other family types (male or female householder with no spouse but with children or other relatives).” Non-family households in these analyses were those involving individuals “living alone or with other nonrelatives.” These comparative analyses clearly establish that, “compared to MSAs with the highest proportion of residents living in family settings, persons in MSAs with the fewest family living residents have odds of suicide 2.4 times higher over the follow-up period.”

Even when the researchers repeat their community-level analyses using statistical models that adjust for the individual-level characteristics, they find that “regardless of their own marital status and family size, persons living in the lowest family-living type MSAs have odds of suicide that are twice as high as persons living in the highest family-living MSAs” (Odds Ratio of 2.03; p < 0.01).

What is more, in their most sophisticated statistical models the researchers find that “family living related powerfully to both men’s and women’s risk and both younger and older respondents’ [risk].” In contrast, socioeconomic disadvantage in an MSA was “significantly associated with an increased suicide risk only for men,” and not for women. 

In other words, regardless of their own personal household circumstances, living in a community largely composed of family households protects both men and women, both young and old, from the temptation to suicide.  

After reflecting on the policy implications of their findings, the Rice scholars hope their research can “contribute to reducing the risk of suicide by encouraging more investment in both individual and area level resources aimed at fostering social integration and connectedness and eliminating socioeconomic disadvantages.” “Reducing suicide mortality,” they assert, “can lengthen overall life expectancies and result in stronger, richer, more tightly knit communities.” 

Unfortunately, until wedding chapels start filling and divorce courts empty out, until more women are headed for maternity wards and fewer for abortion clinics, phrases such as “social integration and connectedness” will remain empty abstractions, and hopes for “more tightly knit communities” will prove vain. Only a genuine renewal of marriage and family life in America seems likely to end the nation’s alarming epidemic of suicide.  

(Source: Bryce J. Christensen and Nicole M. King, “New Research,” The Natural Family 30.4 [2016]. Study: Justin T. Denney et al., “Suicide in the City: Do Characteristics of Place Really Influence Risk?” Social Science Quarterly 96.2 [2015]: 313-29.) Republished from The Family In America with permission.