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Suicidality and Death by Suicide Among Middle-Aged Adults in the United States

October 5, 2017

AUTHORS: Kathryn Downey Piscopo, Ph.D.


Suicide is a national public health concern. According to the U.S. Department of Health and Human Services (HHS) National Center for Health Statistics (NCHS), suicide was the 10th leading cause of death in the United States in 2013.1 Recent research indicates that suicide is at a 30-year high.2 In addition, other reports conclude that the suicide rate is rising sharply for males aged 45 to 64 (from 20.8 to 29.7 deaths per 100,000 between 1999 and 2014) and females aged 45 to 64 also had the second-largest percentage increase in suicide deaths (from 6.0 to 9.8 deaths per 100,000 between 1999 and 2014) compared with other age groups. 3,4  

To present a complete picture of suicidal behavior and outcomes, this issue of The CBHSQ Report uses data from two federal sources: the National Survey on Drug Use and Health (NSDUH) from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Vital Statistics System (NVSS) Mortality data file from NCHS. This report focuses on adults aged 45 to 64 because of the increase in the suicide death rates for this age group. 

The Center for Behavioral Health Statistics and Quality (CBHSQ) within SAMHSA collects, analyzes, and disseminates NSDUH data on mental health and substance use. NSDUH is a nationally representative household survey of the U.S. civilian, noninstitutionalized population aged 12 or older. In 2009 to 2014, the number of completed interviews was 410,000, with 280,100 of those completed interviews from people aged 18 or older. NSDUH respondents aged 18 or older were asked if at any time during the past 12 months they had thought seriously about trying to kill themselves. Those who had serious thoughts of suicide were then asked whether they made a plan to kill themselves or tried to kill themselves in the past 12 months.

NCHS maintains the NVSS Mortality data file, which includes state-level information about the demographics of all deaths in the nation and the cause of the death based on death certificates filed in the 50 states and the District of Columbia. The Mortality data file contains information related to "intentional self-harm (suicide)," which is defined as International Classification of Diseases, Tenth Revision (ICD-10) codes *U03, X60–X84 and Y87.0 as the underlying cause of death.5

This report examines NSDUH and NVSS mortality data using the same time frame (2009 to 2014) as a recent NCHS publication (NCHS's Data Brief No. 241).4 To improve statistical power for trend analysis, 2-year annual averages were used for both data files. The NVSS data were analyzed using the online Web-based Injury Statistics Query and Reporting System (WISQARS).

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