[V]ermonters are dying by suicide at a rate more than 35 percent higher than the national average, continuing a years-long trend in spite of widespread prevention and education efforts.
Breaking down the state’s statistics produces similar results: People in Vermont are more likely to take their own lives with a gun, for example, and the state’s suicide rates are higher than national averages in nearly every age group — especially between the ages of 70 and 74.
Experts say there are many overlapping factors behind the numbers, and there are no easy solutions. But they’re hoping use the latest, most detailed statistics to bolster and refine their anti-suicide efforts.
“It’s complicated, and every suicide death is its own story,” said Thomas Delaney, an assistant professor at the University of Vermont’s Larner College of Medicine. “But I think there’s an opportunity to use data like these to maybe think about programming.”
That approach makes sense to JoEllen Tarallo, director of the Vermont Suicide Prevention Center. She said the state’s advocates have focused on doing suicide-prevention work “across the lifespan.”
“That said, we know that different age groups have different risk factors associated with them for suicide, and it’s becoming clear that we need to do more age-specific targeted interventions,” Tarallo said.
Vermont is not alone in grappling with a growing suicide problem. The issue has moved to the fore of the nation’s consciousness, at least momentarily, with the high-profile deaths of chef storyteller Anthony Bourdain and fashion designer Kate Spade in the past week.
A new report from the U.S. Centers for Disease Control and Prevention says suicide rates “increased significantly” in 44 states between 1999 and 2016. There were increases of more than 30 percent in 25 states, including Vermont.
“From 1999 to 2015, suicide rates increased among both sexes, all racial/ethnic groups and all urbanization levels,” the report says. “Suicide rates have also increased among persons in all age groups (less than) 75 years, with adults aged 45–64 having the largest absolute rate increase.”
In total, nearly 45,000 people died by suicide in the U.S. in 2016, the latest year for which federal data is available.
“Not that many years ago, we were talking about 30,000 deaths,” Delaney said. “It’s really becoming more and more of a problem.”
Delaney was speaking in Stowe at a Vermont Suicide Prevention Symposium that, coincidentally, occurred a few days before the CDC issued its state-by-state statistical breakdown.
He told symposium attendees that, even though Vermont’s national ranking has improved — the state’s suicide rate is 19th in the nation — that shouldn’t be seen as good news.
“Actually, our rates have also gone up,” Delaney said. “It’s just that other states are going up even faster. So it’s tragic. It’s not an improvement.”
Delaney also made the case that, by many measurements, Vermont’s suicide problem is far worse than national averages:
• Suicide is the eighth-leading cause of death in Vermont. It’s the 10th-leading cause nationally.
• Guns are used in approximately 59 percent of Vermont’s suicide deaths – higher than the 51 percent rate nationally.
• Vermont’s suicide rate was 18.9 per 100,000 people in 2016. That’s significantly higher than the U.S. rate of 13.9 per 100,000.
• Males are four times more likely than females to die by suicide in Vermont. That’s a worse ratio than in the U.S. as a whole, where men are three times more likely to take their own lives.
• In the 10-14 age group, Vermont’s suicide rate is lower than the nation’s. But “Vermont is higher … than the U.S. for almost every (other) age category,” Delaney said.
• He pointed out a particularly large disparity among older adults: From 2012-2016, the suicide rate for Vermonters aged 70 to 74 was 25 per 100,000 people; the national rate for that age group was 15 per 100,000.
• Within Vermont, there’s also a big disparity among counties. For the years 2012-14, “Lamoille County’s suicide death rate is almost five times higher than the county with the lowest suicide death rate, which is Grand Isle,” Delaney said.
While the statistics are clear, the reasons behind them are not. Those who study suicide warn against attributing causation to any one issue; the CDC says “suicide is rarely caused by any single factor, but rather, is determined by multiple factors.”
One common factor — mental health issues — may not be as reliable of a measurement as commonly thought. The CDC study says that, among 27 states surveyed in 2015, more than half of those who died by suicide “did not have a known mental health condition.”
Delaney – who stressed that he was speaking for himself, and not for UVM – said there may be several “correlates” behind Vermont’s higher suicide numbers.
Those include Vermont’s higher rates of binge drinking and firearm ownership, as well as the fact that it’s a rural state. That latter factor includes correlations with higher rates of poverty, and financial issues are one contributing circumstance in suicides.
Additionally, the state’s racial makeup is overwhelmingly white, and “white people are disproportionately represented among suicide deaths,” Delaney said.
Also, Vermont has one of the oldest populations in the country. Risk factors for suicide among older adults can include depression, poverty, medical problems and isolation — particularly in Vermont, where a lack of widespread public transit is a big obstacle for those who can’t drive.
Given the diversity of factors behind suicide rates, Vermont has a wide-ranging package of suicide-prevention tools. Much of this work happens via the Vermont Suicide Prevention Center — a public-private partnership that receives funding from the state Department of Mental Health — and a larger prevention coalition.
There are initiatives like UMatter, which includes programs for youth, schools and communities; the Zero Suicide program; and the Vermont Gun Shop Project, a collaboration that includes state officials, suicide-prevention advocates and gun-ownership groups.
Advocates also are looking to expand their tool kit and their reach with help from detailed data about who is most prone to suicide.
For instance, “we need to really work on addressing bullying and dealing with the issues around cyber-bullying” among youth and adolescents, Tarallo said.
She also noted that a recent survey of middle school and high school students found a higher rate of suicide plans and attempts among lesbian, gay, bisexual and transgender youth. Tarallo wants to encourage such students’ participation in UMatter programs, and she also wants to focus on decreasing stigma, increasing family supports and “creating safe environments in school.”
For young people transitioning into adulthood, substance abuse prevention is key because “50 percent of our suicides have some associated substance-misuse factor,” Tarallo said.
“If they are under the influence of substances, they are not able to cultivate the skills to cope effectively,” she added.
In addition to advocating for new prevention efforts, Delaney said the state should try to improve its surveillance of suicide attempts. Younger people, he said, “are making about 25 attempts for every death.”
“These have to be taken very seriously,” Delaney said. “They’re very common. They’re probably more common than we realize. And there might be opportunities to learn more about young peoples’ suicide attempts.”
He also wants Vermont advocates to learn more about what other states are doing, particularly rural states. “I think that there’s probably a lot of innovative stuff happening that we just don’t know about,” Delaney said.
That’s partly because – despite the attention given to high-profile suicides like Bourdain and Spade – suicide receives “less attention than similar health care and mental health issues,” Delaney said.
“There’s simply stigma about talking about suicide,” Delaney said. “I think people just don’t know about it.”
