The second consecutive year of declining suicide rates in the United States is encouraging and is consistent with other high-income and upper-middle-income countries that experienced either unchanged or declining suicide rates during the early months of the COVID-19 pandemic. From 2019 to 2020, the U.S. suicide rate decreased by 3%, with significant declines among both females and males. Overall suicide rates declined in large metropolitan areas and in seven states and remained stable in other county urbanization levels and states. Rates of suicide by fall, poisoning, and suffocation declined significantly. Although, rates among non-Hispanic White females and males declined from 2019 to 2020, the suicide rate among Hispanic males and non-Hispanic multiracial females increased. Although many age groups experienced a decline in rates, rates increased among persons aged 25–34 years; rates were highest among persons aged ≥85 years, followed by those aged 75–84 and 25–34 years. Moreover, whereas rates were stable among most racial/ethnic groups, and in most states and county urbanization levels, some subgroups experienced increases, underscoring that persistent health disparities remain. Provisional data indicate similar case counts in the first half of 2021 compared with the first half of 2020.
As the nation continues to respond to the COVID-19 pandemic and its long-term effects on isolation, stress, economic insecurity, and worsening substance use, mental health, and well-being, prevention is critical. Existing data suggest that suicide rates might be stable or decline during a disaster, only to rise afterwards as the longer-term sequelae unfold in persons, families, and communities, as was the case in New Orleans 2 years after Hurricane Katrina.
Suicide is preventable. A comprehensive approach to suicide prevention is urgently needed in all states to continue to build on the progress that began in 2019. A comprehensive approach relies on the use of data to drive decision-making and robust implementation and evaluation of prevention strategies that address the range of factors associated with suicide, especially among disproportionately affected populations.** Such strategies, as laid out in CDC's Suicide Prevention Technical Package are especially relevant during the COVID-19 pandemic and should include community partners, such as public health, education, health care, and employers, coming together to enhance resilience and improve well-being by strengthening economic supports (e.g., unemployment benefits), expanding access to and delivery of care (e.g., telehealth), promoting social connectedness, creating protective environments (e.g., safely securing medications and firearms), teaching coping and problem-solving skills, identifying and supporting persons at risk, and lessening harms and preventing future risk (e.g., safe media reporting on suicide).
The findings in this report are subject to at least two limitations. First, caution should be used when interpreting rate decreases from one year to the next because rates might be unstable, especially in smaller segments of the population. Second, suicides might be undercounted on death certificates for a variety of reasons, including the higher burden of proof to classify a death as a suicide (versus that needed to classify other manners of death), stigma, misclassification, and lack of autopsies or thorough investigations.
CDC's Suicide Prevention Technical Package and its Comprehensive Suicide Prevention Program,†† which currently funds 10 states and one university, are helping states and communities prioritize prevention strategies with the best available evidence to save lives. Expansion and adoption of these resources are critical to realizing further declines in suicide and reaching the national goal of reducing the suicide rate by 20% by 2025 set by the American Foundation for Suicide Prevention and the National Action Alliance for Suicide Prevention.
Morbidity and Mortality Weekly Report. 2022;71(8):306-312. © 2022 Centers for Disease Control and Prevention (CDC)