Brief report
Increase in Suicide by Hanging/Suffocation in the U.S., 2000–2010

https://doi.org/10.1016/j.amepre.2012.10.010Get rights and content

Background

Recently, suicide exceeded motor vehicle crashes as the leading cause of injury death in the U.S. However, details of this change in suicide methods and the relationship to individual demographics, such as age and societal influences, have not been reported.

Purpose

To determine the characteristics of the changes in suicide rates between 2000 and 2010.

Methods

Data came from CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS™). Line charts were plotted to reveal changes in suicide rates by firearm, poisoning, and hanging/suffocation (ICD-10 codes: X72–X74, X60–X69, and X70). The measure of change used is the percentage change in suicide rate between 2000 and 2010.

Results

The overall suicide rate increased from 10.4 to 12.1 per 100,000 population between 2000 and 2010, a 16% increase. The majority of the increase was attributable to suicide by hanging/suffocation (52%) and by poisoning (19%). Subgroup analysis showed: (1) suicide by hanging/suffocation increased by 104% among those aged 45–59 years and rose steadily in all age groups except those aged ≥70 years; (2) the largest increase in suicide by poisoning (85%) occurred among those aged 60–69 years; and (3) suicide by firearm decreased by 24% among those aged 15–24 years but increased by 22% among those aged 45–59 years. The case fatality rates for suicide by hanging/suffocation during 2000–2010 ranged from 69% to 84%, close to those for suicide by firearm. Analyses were conducted in 2012.

Conclusions

Substantial increases in suicide by hanging/suffocation and poisoning merit attention from policymakers and call for innovations and changes in suicide prevention approaches.

Introduction

Suicide was recently reported1 to exceed motor vehicle crashes as the leading cause of injury death among Americans. The increasing prevalence of suicide mortality poses a challenge to injury prevention efforts. Unreported are the changes in the epidemiologic characteristics of suicide, an understanding of which is critical to prevention. The current paper highlights changes in the methods of suicide in the U.S. between 2000 and 2010, particularly in relation to age and methods.

Section snippets

Methods

Data were extracted from the CDC's Web-based Injury Statistics Query and Reporting System (WISQARS™).2 The ICD-10 describes deaths coded as X70 as “intentional self-harm by hanging, strangulation, and suffocation.” In the current paper, the cause of these deaths is referred to as “hanging/suffocation,” given that suffocation means depriving access to air or oxygen, and a common means of accomplishing this in order to kill oneself is by suspension or hanging. The ICD-10 codes for suicide by

Results

In 2010, the 38,364 suicides in the U.S. reflected an overall rate increase of 16% since 2000, from 10.4 to 12.1 per 100,000 population (Table 1). Taken together, suicide by firearm, hanging/suffocation, and poisoning constituted 93% of suicide by all methods. Between 2000 and 2010, most of the increase in suicide was due to an increase in hanging/suffocation. The proportion of all suicide by hanging/suffocation increased from 19% to 26%, and that by poisoning increased from 16% to 17%. Suicide

Discussion

The current findings reveal that hanging/suffocation played a major role in the increase in suicide rates between 2000 and 2010. Similar increases through 2005 were reported among whites by Hu et al. in 2008,3 but few efforts have been made to respond to these changes. Recognition of the changes in suicide methods is important because of the need for preventive measures directed toward this growing problem.

The increase in suicide was evident beginning in 2001, prior to the economic downturn.

References (10)

  • G. Hu et al.

    Mid-life suicide: an increasing problem in U.S. whites, 1999-2005

    Am J Prev Med

    (2008)
  • I.R. Rockett et al.

    Leading causes of unintentional and intentional injury mortality: U.S. 2000-2009

    Am J Public Health

    (2012)
  • Web-based Injury Statistics Query and Reporting System (WISQARS)

  • C.J. Ruhm

    Are recessions good for your health?

    Q J Econ

    (2000)
  • T.J. Classen et al.

    The effect of job loss and unemployment duration on suicide risk in the U.S.: a new look using mass-layoffs and unemployment duration

    Health Econ

    (2012)
There are more references available in the full text version of this article.

Cited by (77)

  • Assessing Female Suicide From a Health Equity Viewpoint, U.S. 2004–2018

    2022, American Journal of Preventive Medicine
    Citation Excerpt :

    Understanding how people die by suicide or the mechanism used for suicide can help to inform how public health professionals and partners shape suicide prevention strategies. Literature suggests that the mechanisms used for suicide differ by sex,5,9,10 age,11,12 and urbanicity.5 Suicide rates by firearm in rural counties were almost 2 times the rates in metropolitan counties between 2001 and 2015.5

View all citing articles on Scopus
View full text