Altitude, Gun Ownership, Rural Areas, and Suicide

Abstract

Objective The authors recently observed a correlation between state altitude and suicide rate in the United States, which could be explained by higher rates of gun ownership and lower population density in the intermountain West. The present study evaluated the relationship between mean county and state altitude in the United States and total age-adjusted suicide rates, firearm-related suicide rates, and non-firearm-related suicide rates. The authors hypothesized that altitude would be significantly associated with suicide rate. Method Elevation data were calculated with an approximate spatial resolution of 0.5 km, using zonal statistics on data sets compiled from the National Geospatial-Intelligence Agency and the National Aeronautics and Space Administration. Suicide and population density data were obtained through the Centers for Disease Control and Prevention (CDC) WONDER database. Gun ownership data were obtained through the CDC’s Behavioral Risk Factor Surveillance System. Results A significant positive correlation was observed between age-adjusted suicide rate and county elevation (r=0.51). Firearm (r=0.41) and non-firearm suicide rates (r=0.32) were also positively correlated with mean county elevation. Conclusions When altitude, gun ownership, and population density are considered as predictor variables for suicide rates on a state basis, altitude appears to be a significant independent risk factor. This association may be related to the effects of metabolic stress associated with mild hypoxia in individuals with mood disorders.

Elevated incidence of suicide in people living at altitude, smokers and patients with chronic obstructive pulmonary disease and asthma: possible role of hypoxia causing decreased serotonin synthesis

“…They found highly significant correlations between suicide rates and both the highest elevation in each state and the elevation of the state capital. Kim and colleagues 12 followed up this observation with a more detailed study that used a greater spatial resolution (3108 counties) and looked at a number of other variables. They performed a multiple regression analysis using elevation and 2 other factors known to be associated with suicide (population density and gun ownership) as independent factors.…”

“…Taken together, all these results provide good preliminary evidence that an association might exist between altitude and suicide. Kim and colleagues 12 suggested that the mediating mechanism might be metabolic stress associated with mild hypoxia.…”

Hypobaric Hypoxia Induces Depression-like Behavior in Female Sprague-Dawley Rats, but not in Males

“…National mental health surveys indicate that rates of depression and suicide, the most negative outcome of depression, are highest in the intermountain states (Mark, 2007). Recent studies suggest that altitude of residence may contribute to the increased suicide rates, independent of other risk factors such as age, gender, race, psychiatric disorders, and sociocultural factors Haws et al, 2009;Kim et al, 2011). Regional variation in suicide rates in the United States correlate directly with state peak elevation (Haws et al, 2009) and county elevation , despite the decrease in overall mortality rates with altitude .…”

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“…Altitude has been reported to influence suicide rates Kim et al, 2011). In the United States of America (USA), it has been found to be an independent risk factor for suicide even when controlling for age, sex, race, median household income, gun ownership, and population density Kim et al, 2011).…”

“…In the United States of America (USA), it has been found to be an independent risk factor for suicide even when controlling for age, sex, race, median household income, gun ownership, and population density Kim et al, 2011). It was speculated that in higher altitude regions, metabolic stress with mild hypoxia might lead to a worsening of mood disorder symptoms and thus to higher suicide rates Kim et al, 2011).…”