Suicide during the COVID-19 pandemic: Uncovering demographic and regional variation in the United States and associations with unemployment and depression

Abstract

The COVID-19 pandemic heightened risk factors for suicide globally. Using prominent sociocultural theories of suicide, we investigated whether the COVID-19 pandemic affected suicide rates differently across demographic groups and regions in the United States of America. In Study 1, we found that after 2020 suicide rates increased especially among young Black and Alaskan Native populations. Conditional process analyses were conducted to shed light on racial disparities in the temporal impact of unemployment on suicide from 2018 to 2021. The results showed that suicides among younger Asians and Blacks were affected by the surge in unemployment, whereas Whites, especially the older population, benefitted from the increased unemployment. In Study 2, we explored the regional variation in the temporal associations between suicide, unemployment, and depression across the 50 U.S. states from 2019 to 2021 taking into account pre-pandemic between-state conditions. Multilevel regression analyses showed that urbanism (characterized by low firearm proportion, high income, high cultural looseness, and high population density) but not social integration (characterized by low social capital, high collectivism, and high southerness), partially explained the regional variation in the temporal pattern of suicide rates. We also found that in states with already high depression levels, the temporal increase in depression predicted increases in suicide from 2019 to 2021, whereas it had minimal impact in states with low average depression. We emphasize the need for future theories to consider longitudinal designs and highlight two key takeaways: (1) the pandemic reshaped racial disparities in suicide, and (2) the temporal effects brought by the national crisis on suicide patterns depended on existing between-state differences.