Changing patterns in suicide mortality 1999–2019 in the USA: age–period–cohort analyses including gender and race

Background

Despite a global decline in suicide rates, the USA has witnessed a concerning rise in suicide mortality over the past two decades.

Aims

This study aims to elucidate the changing patterns of suicide mortality in the USA from 1999 to 2019, with a particular focus on gender and racial differences.

Method

We utilised national mortality data for causes of suicide (X60–X84, Y87.0) from the Centers for Disease Control and Prevention for 1999–2019. The age–period–cohort analysis was conducted to explore the effects of age, period and birth cohort effects on suicide mortality by gender and race.

Results

Between 1999 and 2019, the suicide rate and the number of suicides in the USA increased 33% and 62%, respectively. We discerned an emerging peak of suicide among young adult populations even as increases affected nearly all groups. Females have shown increasing period risk, which has exceeded that of males since 2011. Their cohort risk, which slowly increased and exceeded males in post-1959 cohorts, exhibited a steep J-shaped pattern, especially among those born after 1977. Although Americans of all races have experienced increased period risk since 2011, it was highest among American Indians and Alaska Natives by the end of the 20-year span. With the mortality risk increasing rapidly in all post-1959 cohorts, the risk showed an obvious cliff-shaped pattern among the Asian/Pacific Islander population born after 1989.

Conclusions

The shifting burden of suicide mortality towards younger populations, transcending gender and racial boundaries, underscores the need for the implementation of tailored public health strategies.