Profiles of Violent Death

There were 65,000 violent deaths in the United States in 2016, according to the CDC. The 62 percent majority were suicides, followed by homicides (25 percent), deaths of undetermined intent (11 percent),  legal intervention (1 percent), and unintentional firearm deaths (fewer than 1 percent). The legal intervention category is defined as "deaths caused by law enforcement and other persons with legal authority to use deadly force in the line of duty, excluding legal executions."

The CDC analyzed the circumstances surrounding the violent deaths that occurred in 32 states in 2016. In those states, there were 23,630 suicides, 10,336 homicides, 515 legal interventions, and 295 unintentional firearm deaths. The CDC examined the demographics of the victims  (age, sex, race), the method of death (firearm, sharp instrument, drowning, etc.), the location of death (house/apartment, street, etc.), and precipitating circumstances (depression, intimate partner problem, job problem, crime in progress, and so on).

Looking at the most likely scenario for each type of violent death, here are their profiles...

Suicide: A non-Hispanic White (83 percent) man (77 percent) aged 35 to 64 (52 percent) shot (49 percent) or hung (28 percent) himself in his house/apartment (74 percent) because he was depressed (74 percent). He did not leave a suicide note (66 percent), nor did he disclose to others his suicide intent (76.5 percent).

Homicide: A Black (56 percent) man (79 percent) aged 20 to 34 (46 percent) was shot (74 percent) in his house/apartment (47 percent) by an acquaintance/friend (27 percent) during an argument (32 percent).

Legal intervention death: A non-Hispanic White (50 percent) man (96 percent) aged 25 to 44 (59 percent) was shot (96 percent) in a house/apartment (38 percent) or on the street (28 percent). He had a drug problem (26 percent) or mental illness (21 percent). He had a weapon (73 percent).

Unintentional firearm death: A non-Hispanic White (59 percent) man (86 percent) aged 15 to 24 (35 percent) was in his house/apartment (74 percent), playing (35 percent) with a handgun (63 percent) when he unintentionally pulled the trigger (23.5 percent).

Source: CDC, Surveillance for Violent Deaths—National Violent Death Reporting System, 32 States, 2016

Suicide Rate Continues to Rise

The suicide rate in the United States continues to rise. A recent study by the National Center for Health Statistics examines the increase by sex, age, race, and Hispanic origin. The results are disturbing and a sign that something is very wrong.

The age-adjusted suicide rate climbed 33 percent between 1999 and 2017— from 10.5 to 14.0 deaths per 100,000 standard population. (To compare deaths over time, statisticians age-adjust the rates so that results are not affected by changes in the age structure of the population.) The 33 percent increase is bad, but it is dwarfed by even larger increases in some age groups...

• The age-adjusted male suicide rate rose 26 percent between 1999 and 2017. The rate increased significantly in all but the oldest age group (75-plus). The biggest increases in the rate occurred among 10-to-14-year-olds (up 74 percent) and 45-to-64-year-olds (up 45 percent). 
• The age-adjusted female suicide rate grew by 53 percent between 1999 and 2017, although females remain far less likely than males to commit suicide. In 2017, the age-adjusted female suicide rate was 6.1 deaths per 100,000 population versus the 22.4 deaths for males. The suicide rate among females increased significantly in all but the oldest age group (75-plus). Between 1999 and 2017, the biggest increases in the female suicide rate occurred in the 10-to-14 (up 240 percent) and 15-to-24 (up 93 percent) age groups.

Suicide is the 10th leading cause of death in the United States and the 8th leading cause of death among males. By race and Hispanic origin, the suicide rate for both males and females is highest among American Indians and non-Hispanic Whites.

Source: National Center for Health Statistics, Suicide Rates for Females and Males by Race and Ethnicity: United States, 1999 and 2017

Suicide Rate by Occupation

The suicide rate among the working-age population (aged 16 to 64) is rising, reports the CDC. To try to "inform suicide prevention efforts," the CDC is tracking suicide rates by occupation because "the workplace is an important but underutilized location for suicide prevention."

Among men, those working in construction and extraction have the highest suicide rate, at 53.2 suicides per 100,000 population in 2015. Among women, those working in arts, design, entertainment, sports, and media have the highest rate—15.6 suicides per 100,000 population. Here are men's suicide rates by occupation, ranked from highest to lowest...

Men's suicide rate per 100,000 population by occupation, 2015
Construction and extraction: 53.2
Arts, design, entertainment, sports, and media: 39.7
Installation, maintenance, and repair: 39.1
Transportation and material moving: 30.9
Production: 30.5
Protective service: 28.2
Building and grounds cleaning and maintenance: 26.8
Health care practitioners and technical: 25.6
Faming, fishing, and forestry: 22.8
Sales and related: 21.5
Food preparation and serving: 20.9
Health care support: 19.5
Architecture and engineering: 19.4
Legal: 18.7
Management: 17.8
Personal care and service: 16.5
Computer and mathematical: 16.1
Office and administrative support: 15.8
Life, physical and social science: 15.0
Community and social service: 14.6
Business and financial operations: 13.0
Education, training, and library: 10.9

Between 2012 and 2015, men's suicide rate increased the most in arts, design, entertainment, sports, and media occupations—up 47 percent. The second largest increase (43 percent) was among those working in food preparation and serving. Among women, the biggest increase in the suicide rate occurred among those in food preparation and serving (54 percent), followed by art, design, entertainment, sports and media (34 percent).

Source: CDC, Morbidity and Mortality Weekly Report, Suicide Rates by Major Occupational Group—17 States, 2012 and 2015

CDC Investigates Rise in Suicides

The CDC's report on the rising number of suicides in the United States was released on June 8,  just days after Kate Spade committed suicide and the same day Anthony Bourdain took his own life. The government's in-depth analysis of suicide's potential causal factors sheds light on just how difficult it will be to stem the rising tide.

In 2016, nearly 45,000 Americans killed themselves, making suicide the 10th leading cause of death. The annual number of suicides has grown by almost 30 percent since 1999, the CDC reports. The suicide rate has increased in every age group under age 75 and has grown in most states. Confronted with these facts, this timely CDC report examines 2015 data from the National Violent Death Reporting System, in which 27 states participated. Information from friends and family, reported to law enforcement at the time of death, are part of the database. The findings are not encouraging...

• Among those who committed suicide in the 27 reporting states, the 54 percent majority did not have a known mental health condition. 
• Among those without a mental health condition, only 22.4 percent had disclosed their intention to commit suicide. Even among those with a known mental health condition, only 23.5 percent had disclosed their intention to commit suicide. 
• Only 28 percent of those who committed suicide had problematic substance abuse problems—a possible indicator of suicide risk.
• Among suicide victims with known mental health problems, more than half were in treatment at the time of death.

What can be done to save lives? In an attempt to answer that question, the CDC examined the problems of suicide victims, with information provided by friends and family about troubles in the victim's life. The most commonly reported issues were intimate partner problems (27 percent), physical health problems (22 percent), school problems (20 percent), and job/financial problems (16 percent). These troubles are not unique to suicide victims, of course, which is why one of the CDC's recommendations is the suggestion that we teach better "coping and problem-solving skills to manage everyday stressors and prevent future relationship problems, especially early in life."

Most of the family and friends of suicide victims may never know why their loved one chose to take his or her own life. Only one-third of suicide victims leave a note, the CDC reports.

Source: CDC, Vital Signs: Trends in State Suicide Rates—United States, 1999–2016 and Circumstances Contributing to Suicide—27 States, 2015

Suicide Rate Highest in Nonmetro/Rural Areas

Yet another study has found a widening health gap between rural and urban areas. In an analysis of suicide rates by urban status over the past decade, the CDC finds much higher suicide rates in nonmetropolitan and rural areas than in metropolitan areas. To make matters worse, suicide rates are rising faster in the hinterlands than in the rest of the U.S.

In 2013–15, the suicide rate in nonmetro/rural areas (19.74 suicides per 100,000 population aged 10 or older) was 18 percent higher than the rate in medium/small metro areas (16.77), 32 percent higher than the national average (14.98), and 55 percent higher than the rate in large metropolitan areas (12.72). Since 2001–03, the suicide rate has climbed across the nation, but nowhere more so than in nonmetropolitan/rural areas. Between 2001–03 and 2013–15, the suicide rate climbed 14 percent in the largest metros, 19 percent nationally, 25 percent in medium/small metro areas, and 27 percent in nonmetro/rural areas.

The pattern in the suicide rate is the same for both males and females, in every age group, and for every race and Hispanic origin group except Blacks—whose relatively low suicide rate has not increased much and is highest in medium/small metros.

Suicide rates are "consistently higher in rural communities," concludes the CDC. "Findings from this study underscore the need to identify protective factors as part of comprehensive suicide prevention efforts, particularly in rural areas."

Source: CDC, Suicide Trends among and within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death—United States, 2001–2015