Social Vulnerability and Risk of Suicide in US Adults, 2016-2020

Liu, Shuhan; Morin, Samuel; Bourand, Natalie; deClue, Isabella; Delgado, Gustavo E; Fan, Jiahe; Foster, Sabrina K; Imam, Maaz S; Johnston, Coulter B; Joseph, Franklin B; Lu, Yihao; Sehrawat, Ujjwal; Su, Li Chun; Tavan, Ketaki; Zhang, Kelly L; Zhang, Xingruo; Saulsberry, Loren; Gibbons, Robert D.

doi:10.1001/jamanetworkopen.2023.9995

Cited by 11 publications

(8 citation statements)

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“…For example, a 2017 study from Korea showed that people with lower household income were at a higher risk of suicide, and that this rate increased across income deciles, so that people in the lowest income decile had more than three times the suicide risk of people in the highest income decile [57]. A 2023 study from the United States found that higher county-level social vulnerability (measured by the Social Vulnerability Metric which incorporates socioeconomic factors such as county-level average unemployment, education, insurance, and housing) was associated with a higher suicide rate [58].…”

Section: Discussionmentioning

confidence: 99%

Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research

Grobman,

Mansur,

Babalola

et al. 2023

JCM

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Cancer is a major public health concern associated with an increased risk of psychosocial distress and suicide. The reasons for this increased risk are still being characterized. The purpose of this study is to highlight existing observational studies on cancer-related suicides in the United States and identify gaps for future research. This work helps inform clinical and policy decision-making on suicide prevention interventions and ongoing research on the detection and quantification of suicide risk among cancer patients. We identified 73 peer-reviewed studies (2010–2022) that examined the intersection of cancer and suicide using searches of PubMed and Embase. Overall, the reviewed studies showed that cancer patients have an elevated risk of suicide when compared to the general population. In general, the risk was higher among White, male, and older cancer patients, as well as among patients living in rural areas and with lower socioeconomic status. Future studies should further investigate the psychosocial aspects of receiving a diagnosis of cancer on patients’ mental health as well as the impact of new treatments and their availability on suicide risk and disparities among cancer patients to better inform policies.

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Section: Discussionmentioning

confidence: 99%

Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research

Grobman,

Mansur,

Babalola

et al. 2023

JCM

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“…Our primary independent variable was zip code level estimates of the SVM . The SVM builds on existing SV measures by weighting the set of included neighborhood characteristics using multi-dimensional item response theory, which leverages item difficulty and item-test correlations.…”

Section: Methodsmentioning

confidence: 99%

“…Our study investigates associations between the Social Vulnerability Metric (SVM), a new measure of SV that expands on previous measures through the use of item-level weighting, with MH and SUD prevalence and treatment use. Our primary research objective was to determine the ability of the SVM to reflect the prevalence of local MH and SUD as assessed by MH clinicians using a structured clinical interview and to identify unmet service needs for specific behavioral health indications.…”

Section: Introductionmentioning

confidence: 99%

Social Vulnerability and Prevalence and Treatment for Mental Health and Substance Use Disorders

Gibbons,

Olfson,

Saulsberry

et al. 2024

JAMA Psychiatry

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ImportanceCommunity-level social vulnerability (SV) is associated with physical illness and premature mortality. Its association with mental health (MH) and substance use disorders (SUDs) needs further study.ObjectiveTo study associations of SV with clinical diagnoses of MH disorders, SUDs, and related treatments in the US noninstitutionalized population of adults aged 18 years and older.Design, Setting, and ParticipantsA survey of adults in a national sample of US households between October 2020 and October 2022. Participants drawn from a multistage, clustered, and stratified area probability sample of US households were included, excluding adults older than 65 years because of the difficulty of differentiating mental disorders from symptoms of dementia. The sample also included adults living in prisons, state psychiatric hospitals, and homeless shelters who were excluded from the sample of US households used in these analyses. Each sample household was sent a letter explaining the study and offering the option to complete the household roster online, by phone, or by email. Of the 12 906 adults selected for clinical interviewing in the household sample, 4674 completed clinical interviews.Main Outcomes and MeasuresMain outcomes were Structured Clinical Interview for DSM-5 past-year diagnoses of MH disorders and SUDs and responses to survey questions regarding treatment received. The Social Vulnerability Metric (SVM) and the Area Deprivation Index (ADI) were used to determine SV at the residential zip code level.ResultsThe analysis involved 4674 participants (2904 [62.13%] female and 1770 [37.87%] male; mean [SD] age, 41.51 [13.41] years). Controlling for measured confounders, the SVM was significantly associated with diagnoses of schizophrenia spectrum disorder (SSD; adjusted odds ratio [aOR], 17.22; 95% CI, 3.05-97.29), opioid use disorder (OUD; aOR, 9.47; 95% CI, 2.30-39.02), stimulant use disorder (aOR, 6.60; 95% CI, 2.01-21.67), bipolar I disorder (aOR, 2.39; 95% CI, 1.19-4.80), posttraumatic stress disorder (aOR, 1.63; 95% CI, 1.06-2.50), and any MH disorder (aOR, 1.44; 95% CI, 1.14-1.83), but not major depressive disorder (MDD), generalized anxiety disorder (GAD), or any SUD. Results were similar for the ADI but generally of lower magnitude (SSD aOR, 11.38; 95% CI, 1.61-80.58; OUD aOR, 2.05; 95% CI, 0.30-14.10; stimulant use disorder aOR, 2.18; 95% CI, 0.52-9.18). Among participants with SSDs, SV was associated with reduced MH treatment (aOR, 0.001; 95% CI, 0.00-0.18) and reduced SUD treatment in participants with OUD or stimulant use disorder (aOR, 0.24; 95% CI, 0.02-2.80).Conclusions and RelevanceIn contrast to previous studies using nonclinical symptom-based survey data, we found no association between SV and GAD or MDD. By contrast, there were associations of SV with prevalence of SSD, stimulant use disorder, and OUD with corresponding decreases in treatment. These results suggest that the SVM might assist in developing more comprehensive care models that integrate medical and social care for MH disorders and SUDs.

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“…In fact, research has consistently shown that increasing the minimum wage lowers suicide rates ( 31 ). Kaufman and colleagues estimated that in the US, raising the minimum wage by just USD $1.00 above the levels from 1990 to 2015 would have saved 27,550 suicide deaths ( 32 ) (see also, 33 ). Such findings are why the former United Nations Special Rapporteur, psychiatrist Dainius Puras, called for addressing the social determinants of health rather than simply “scaling up” the diagnosis and treatment of depression based on prevailing reductionist approaches ( 34 , 35 ).…”

Section: Foundations Of Wellbeingmentioning

confidence: 99%

Industry influence on mental health research: depression as a case example

Cosgrove,

Patterson,

Bursztajn

2024

Front. Med.

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Emotional distress has been rising since before the COVID-19 pandemic and the public is told that depression is a major public health problem. For example, in 2017 depressive disorders were ranked as the third leading cause of “years lost to disability” and the World Health Organization now ranks depression as the single largest contributor to global disability. Although critical appraisals of the epidemiological data raise questions about the accuracy of population-based depression estimates, the dominance of the medical model and the marketing of psychotropics as “magic bullets,” have contributed to a dramatic rise in the prescription of psychiatric drugs. Unfortunately, the pharmaceutical industry’s influence on psychiatric research and practice has resulted in over-estimates of the effectiveness of psychotropic medications and an under-reporting of harms. This is because the principles that govern commercial entities are incongruent with the principles that guide public health research and interventions. In order to conduct mental health research and develop interventions that are in the public’s best interest, we need non-reductionist epistemological and empirical approaches that incorporate a biopsychosocial perspective. Taking depression as a case example, we argue that the socio-political factors associated with emotional distress must be identified and addressed. We describe the harms of industry influence on mental health research and show how the emphasis on “scaling up” the diagnosis and treatment of depression is an insufficient response from a public health perspective. Solutions for reform are offered.

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Social Vulnerability and Risk of Suicide in US Adults, 2016-2020

Cited by 11 publications

References 11 publications

Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research

Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research

Social Vulnerability and Prevalence and Treatment for Mental Health and Substance Use Disorders

Industry influence on mental health research: depression as a case example

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