Americans who visit rural western states face a greater risk of suicide

March 10, 2010

GAINESVILLE, Fla. — Suicide has geographical differences, with people in the rural mountains of the West more likely than those in the more urbanized East to take their own lives, a new University of Florida study shows.

The nationwide study spanning three decades found that location is also a factor in suicide whether people lived in, had left or were just visiting some of the mountain states.

“Suicide levels for visitors to the western states were actually a little higher than they were for people who lived there, which means that something about simply being in the region, even temporarily, predicts an elevated suicide risk,” said Ilan Shrira, a University of Florida psychologist. “For residents, suicides were high whether they were in their hometown or outside the region, suggesting that characteristics of the people were also partly responsible.”

The study, scheduled to be published this year in the journal Suicide and Life-Threatening Behavior, examines whether elevated suicide levels are the result of individuals’ characteristics or the geographic region they live in. The researchers studied suicide patterns of both nonresidents visiting other regions and residents traveling away from home to try to determine whether the heightened suicide risk was due to the people or the place.

“It turns out that both factors are important,” said Shrira, who worked with Nicholas Christenfeld, a psychologist at the University of California at San Diego.

The results also suggest that access to guns plays a role in the higher suicide incidence in western states, Shrira said. “Firearm suicides accounted for 63 percent of all suicides in the region, which is even higher than the proportion in the rest of the country,” he said.

However, guns do not entirely explain the region’s excessive suicides, Shrira said. Other contributing factors may include social isolation and fewer mental health facilities, he said.

“In sparsely populated areas, people tend to have weaker social support networks and feel less strongly connected to their community,” he said. “The resulting social isolation may leave people vulnerable to suicide and the lack of mental health facilities makes it more difficult for them to get help.”

Using data from United States death records between 1973 and 2004, which covered more than 66 million people, the study focused on states with the highest and lowest suicide rates. High suicide states, defined as those ranked in the top 15 spots every year, consisted of Arizona, Colorado, Montana, New Mexico, Nevada, Oregon and Wyoming. Low suicide states, which were taken from the bottom 15 spots, were Connecticut, Illinois, Massachusetts, New Jersey and New York.

“The most distinctive feature of these two regions is their population density,” he said. “They comprise some of the most and least densely populated states in the country. Higher population density generally means lower suicide rates.”

In the low suicide states, residents’ low suicide risk skyrocketed once they left the area, Shrira said. However, there was no protective benefit for people visiting the region, he said.

Besides population density, another striking difference between the two regions is the proportion of people who own guns, with the low suicide region holding some of the lowest gun ownership rates in the country, he said.

“The use of firearms, or rather the disuse of firearms, was likely a major factor in the region’s low suicide levels,” Shrira said. Only 38 percent of this region’s suicides were committed with guns, which was well below the national average of 58 percent, he said.

“The overall pattern suggests that the extreme suicide rates in each region are due to a combination of at least two factors,” Shrira said. “The first is the available means to carry out suicides – whether or not guns are readily accessible to people. The second factor involves the geographical setting – such as how many people are around and how socially isolated people feel. Together, the setting and the means to commit suicide contribute to the highest and lowest suicide rates in the country.”

The findings highlight the importance of designing treatment and prevention strategies that address the underlying risk factors of suicide in different regions, he said.

“This study is another clear demonstration that a major cause of suicide in the United States is the ready availability of firearms,” said Matthew Miller, a professor of health policy and injury prevention at Harvard School of Public Health who has done extensive research on suicide. “These findings are consistent with a large body of empirical research.”