Cross-level sociodemographic homogeneity alters individual risk for completed suicide

Abstract

Among deaths of despair, the individual and community correlates of US suicides have been consistently identified and are well known. However, the suicide rate has been stubbornly unyielding to reduction efforts, promoting calls for novel research directions. Linking levels of influence has been proposed in theory but blocked by data limitations in the United States. Guided by theories on the importance of connectedness and responding to unique data challenges of low base rates, geographical dispersion, and appropriate comparison groups, we attempt a harmonization of the National Violent Death Reporting System (NVDRS) and the American Community Survey (ACS) to match individual and county–level risks. We theorize cross-level sociodemographic homogeneity between individuals and communities, which we refer to as “social similarity” or “sameness,” focusing on whether having like-others in the community moderates individual suicide risks. While analyses from this new Multilevel Suicide Data for the United States (MSD-US) replicate several individual and contextual findings, considering sameness changes usual understandings of risk in two critical ways. First, high individual risk for suicide among those who are younger, not US born, widowed or married, unemployed, or have physical disabilities is cut substantially with greater sameness. Second, this moderating pattern flips for Native Americans, Alaska Natives, Asians, and Hispanics, as well as among native-born and unmarried individuals, where low individual suicide risk increases significantly with greater social similarity. Results mark the joint influence of social structure and culture, deliver unique insights on the complexity of connectedness in suicide, and offer considerations for policy and practice.

The role of context in shaping the relationship between physical health and suicide over the life course

“…For example, neighborhood socioeconomic characteristics affect health outcomes, both physical and mental, through a variety of mechanisms, including employment and education opportunities, exposure to crime or pollution, and access to healthy food and exercise ( Diez Roux, 2007 ). With respect to suicide, studies point to religious composition ( Van Tubergen et al, 2005 ), socioeconomic conditions ( Chang et al, 2013 ; Phillips & Nugent, 2014 ), availability of guns ( Anestis & Houtsma, 2018 ) and degree of “social sameness” ( Pescosolido et al, 2020 ) as key contextual features that can affect the risk for suicide, net of individual characteristics.…”

Analytic Advances in Social Networks and Health in the Twenty-First Century

“…This approach captures how overlapping patterns of relations entail rights and obligations with respect to others and how such informal roles emerge from interaction, allowing examination of the intertwining of social relations and identity (e.g., Mueller and Abrutyn 2016) and the emergence of communal norms (Molm, Collett, and Schaefer 2007). It is a growing area: Recent work connects the deaths of despair literature to social network considerations (Pescosolido, Lee, and Kafadar 2020) and advances Durkheimian theory (Mueller et al 2021). Although not tied explicitly to health, a growing share of this research emphasizes the overlap, or not, of value systems among various subpopulations (DellaPosta 2020; DellaPosta, Shi, and Macy 2015).…”

The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention

“…A recent study illustrates the power of this structural approach. Using novel US data connecting the social profile of individuals to the social profile of the communities where they live, the study draws from social network theory’s principles of selective attachment or homophily (i.e., the tendency of individuals to connect with similar others, sometimes called “assortative relating” in psychology) and differential association (i.e., individuals sometimes come to behave more like those with whom they interact) ( Pescosolido et al, 2020a ). Specifically, researchers examined whether the presence of more “like” or “similar-others” would affect individual suicide risk and found that community “sameness” generally reduces individual risk of suicide.…”

“…This multi-level examination of individuals’ embedded lives provides a glimpse into how “sameness” taps into structural ties, normative climates, and social diffusion processes. In fact, some of the most robust suicide research findings at the individual level are dramatically moderated by a consideration of their social environmental counterpart ( Muller et al, 2020 ; Pescosolido et al, 2020a ). Recent research further reaffirms the notion that current gaps in societal safety nets contribute to emotional distress and suicidality during the COVID-19 pandemic ( Fitzpatrick et al, 2020 ).…”

“…Where there are too few others at risk (e.g., the employed in an upper middle-class community), socially supportive ties may be unavailable but when others share the same fate, the sense of individual failure transforms into structural failure (e.g., unemployed in a rust-belt community), potentially reducing the psychological harm of the experience. But when that sense of despair or fatalism engulfs the community as a whole, the ability to see any future can be restricted in isolated and historically stigmatized communities ( Pescosolido et al, 2020a ). These studies illustrate how essential it is to consider the roles of social structure and culture in social interaction, as a core feature of theories of suicide; to not do so contradicts basic contributions to contemporary population health research ( Pescosolido, 1992 ; Hall and Lamont, 2009 ).…”