Health Disparities
Intersectional group differences in the spatiotemporal patterning of suicide deaths in the US Amanda Sursely* Amanda Sursely Jonathan Platt
Objective: To identify the spatial and temporal trends in suicide clusters across intersectional social identity groups in the US population from 2005-2020.
Methods: US Vital Statistics data were used to calculate county-level suicide rates from 2005-2020. Rates were calculated for sixteen intersectional groups, defined by unique combinations of racial identity, ethnicity, and gender. We identified spatiotemporal suicide clusters among these groups using the SaTScan space-time statistic to identify areas of lower- and higher-than-expected suicide rates (cold and hot clusters). We also calculated the average proportion of deaths by suicide contained within these clusters to quantify the relative importance of clusters among overall suicide rates.
Results: 275 clusters were identified, comprising 11.4% of total suicides. Patterns of clustering were geographically (see Figure 1) and temporally distinct among intersectional groups. The number of clusters varied across groups, ranging from one in non-Hispanic Black Women to 135 in non-Hispanic White men, comprising a respective 0.4% and 8% of those group suicide deaths. The number and magnitude of hot clusters increased among Hispanic White men and women over time, and the highest overall magnitude clusters were observed in non-Hispanic Native American women. No significant clusters were identified among Hispanic Black Men and Women, or non-Hispanic API Women. Hot clusters were identified in 25 states, particularly in the Western region. Colorado contained the most clusters of any state (31). In contrast, cold clusters were most prevalent in the Northeast.
Conclusions: Suicide rates and clusters have increased since 2005, requiring attention from policy makers, clinicians, and caretakers. Distinct patterns between intersectional groups highlight opportunities to tailor individual- and population-level prevention efforts to prevent suicide deaths in emerging high-risk groups.
