Suicide rates in the US are highest among elderly men, and most involve guns, CDC report says

(CNN) — The suicide rate in the United States spiked in 2021, reversing two years of decline, and rates among older men were especially high, a new report says.

There were about 30 suicide deaths for every 100,000 men ages 55 and older in 2021, according to a report published Wednesday by the US Centers for Disease Control and Prevention – more than double the overall age-adjusted rate of about 14 suicide deaths for every 100,000 people that year.

Men 85 and older were the most at risk, with nearly 56 suicide deaths for every 100,000 people in that group, higher than any other age group.

Suicide is complex, said Dr. Yeates Conwell, a psychiatry professor at the University of Rochester who was not involved in the new report. Five major factors can contribute to suicide risk – depression, disease, disability, disconnection and deadly means – and the combination of these risk factors can be “relatively more salient for older adults,” he said.

“Imagine a Venn diagram with these five circles, each representing one of those ‘Ds’ that overlap. The more of the intersecting circles one is in, the greater the risk,” said Conwell, who previously led a geriatric psychiatry program and co-directed a center for the study and prevention of suicide.

There’s more physical illness and disability later in life, more social isolation and more loss, which all compound to make older adults more vulnerable, he said.

The suicide rate among older women has increased over the past two decades but remains far below the rate among older men. There were about 6 suicide deaths for every 100,000 women 55 and older in 2021, according to the new report.

Firearms are one key factor contributing to this difference, experts say.

In the US overall, more than half of firearm-related deaths are suicides, and more than half of suicides involve guns. But firearms are an even more common method among older men, involved in at least three-quarters of suicides among men 65 and older in 2021, according to the report.

Among older women, rates of firearm-related and poisoning-related suicide were similar.

Men are more likely than women to own a gun, and seniors are more likely than others to have a gun in the household, according to a 2017 survey from Pew Research Center. And nearly all suicide attempts using guns are fatal, making them the most lethal of the deadly means – one of the five risk factors that Conwell identified.

Men have a “greater comfort with and access to firearms,” Conwell said, in part because they’re more likely to have military training or hunting experience. And many senior men in the US are Vietnam War veterans.

In addition to greater access to the most lethal of the deadly means, men are more vulnerable to another key risk factor: disconnectedness, Conwell said.

“Older men in our society tend not to have the skills in developing and maintaining close relationships with as many other people as do women in our culture,” he said. “There’s too much identity tied up in one’s work, so that is lost [after retirement]. And then there’s the cultural script of what maleness means in in our culture, so men just won’t admit or won’t receive care for depression because of that sense that it’s somehow not what a man does.”

While older adults tend to have higher rates of suicide, they represent a small share of the total number of suicides in the US overall.

Still, it’s important that this group not be forgotten when addressing suicide in the US, Conwell said.

“There’s this construct in actuarial science called ‘years of potential life lost.’ It represents the cumulative number of years that would have been lived out had a person not taken their life,” he said.

“If you’re not careful about how that kind of statistic is used, it devalues life after a certain point. And what it’s devaluing is experience, wisdom, knowledge, things that we know contribute to the richness of a social tapestry. There’s another term that I use, which is years of experience in life lost.”

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