Suicide Rose in 2021 After Curious Decline in 2020

Suicide rates inched up slightly from 2020 to 2021, driven primarily by a higher rate of male suicides, according to provisional data from the CDC’s National Center for Health Statistics.

The 4% increase reflected 45,979 deaths by suicide in 2020 compared with 47,646 in 2021, for age-adjusted rates of 13.5 and 14.0 per 100,000, respectively, according to researchers led by Sally Curtin, statistician at the CDC’s National Center for Health Statistics.

The age-adjusted rate of increase was 3% among males (from 22.0 to 22.7 per 100,000) and 2% for females (from 5.5 to 5.6 per 100,000), although not statistically significant among females after age adjustment.

Males age 15-24 sustained the largest statistically significant percentage increase, at 8%, the National Vital Statistics System Vital Statistics Rapid Release report showed.

Suicide is the second leading cause of death among individuals 10-34 in the U.S., and rates of suicide among youth have been increasing since about 2007, noted Curtin.

While it was “encouraging” to see a 2-year decline in the rate of suicides from 2018 to 2020, now the trend has begun to reverse and “we’re almost back up to where we were” in 2018, she told MedPage Today. (Suicides in 2021 were 1% lower than the peak suicide count in 2018 of 48,344.)

Suicide rates rose 35% from 1999 through 2018 before falling 5% through 2020, according to the report.

She called it “surprising” to see suicide rates decline in the first year of the pandemic, when risk factors for suicide had increased dramatically and suicide hotlines were “ringing off the hook.”

Looking more closely at the age of the deceased, suicide rates rose among males 15-44, and 65-74. No significant declines were seen across any male age groups from 2020 to 2021.

The broader picture, Curtain said, citing her group’s prior report on suicide mortality from 2000 to 2020, shows that “throughout the whole period, the youth [suicides] have continued to increase, even though there was an overall decline.”

For example, that report found that while female suicide rates were “consistently lowest” among girls ages 10-14, rates more than tripled from 2000 to 2020, from 0.6 to 2.0 per 100,000. And while suicide rates among older males declined from 2018 to 2020, suicide rates in boys ages 10-14 increased from 1.2 to 3.6 per 100,000 from 2007 to 2020.

The provisional suicide count for males in 2021 was almost four times more than for females, at 38,025 versus 9,621, as has been reported previously in the U.S.

Breaking down the data by month, the largest percentage increase of 11% was seen in October 2021, whereas the peak typically comes in summer and the low usually occurs in late fall or winter, Curtin noted.

The first year of the pandemic, 2020, did not follow this pattern. For instance, the final suicide count in April 2020 was “way down,” she said. In 2021, counts returned to more typical month-to-month trends.

Male suicide counts were also lower in 2021 than in 2020 for the entire first quarter of the year and in July, but higher in all other months. Among females, suicides were lower in 2021 than in 2020 for 6 months of the year and higher in the remaining months.

Study Details

The study was based on death certificate data, using 99% of 2021 death records collected and processed by the National Center for Health Statistics as of May 15, 2022. Provisional suicide rates are estimated using death data following a 6-month lag after the date of death.

Another limitation is that most suicides, particularly those involving drug overdoses and where a suicide note has not been found, are investigated; and since drug poisoning makes up a larger proportion of suicides among females, provisional suicide counts among females usually lag behind those of males.

A particular challenge in studying female suicides is that the numbers are underpowered. For example, the largest increase of any age group from 2020 to 2021 was the 15% increase in suicides among girls ages 10-14 but was based on relatively few deaths, and so the change was not statistically significant.

Curtin said her group plans to release additional data related to race in the coming months.

If you or someone you know is having thoughts of suicide, please call the National Suicide Prevention Lifeline at 988.