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Tyler Black, MD

22 Feb, 11 tweets, 4 min read

Suicidology 2020:
Subgroup analysis (youth, sex, race)

I was able to access a data set from a Cook County, Illinois. Cook County is home to 5.2M people and includes Chicago.

It's the 2nd largest county in the US
/cont

1/ In total, there were 438 suicides in 2020 in Cook County, compared to an average of about 480 in the past 3 years. During the pandemic spikes, suicides decreased.

All in all, it was a below-average year for suicide deaths.

2/ Black residents died by suicide at a much higher rate (42% increase). This increase was occurring before the pandemic as well. During the first wave of the pandemic, it worsened, second wave it lessened.

A much higher year for Black suicides: 97 vs. an average of 68 in 5y.

3/ .
4 subgroups are available:

Black <18y (within variance, high side)
Black 18-24y (within variance, high side)
Black Female (51% increase vs 5y avg)
Black Male (40% increase vs 5y avg)

4/ This means, of course, that race was a confounder for suicide. Systemic racism is a known contributor to A NUMBER of mortality outcomes.

With the knowledge that Cook County Illinois' rates overall decreased, and for Black residents they increased, we know what this means.

5/ White residents had a decrease. White Cook County residents had an overall 16% fewer suicides. A clear "pandemic decrease" is seen in the first wave.

6/ 4 subgroups are available:

White<18y (average)
White 18-24y (average)
White Female (30% decrease vs 5y avg)
White Male (12% decrease vs 5y avg)

7/ For youth, this is the first complete data set I've had available to me that is not embargoed, but it is consistent with the other datasets from other jurisdictions that I have seen (but are embargoed). Overall, 2020 ended up being an average year for kids.

8/ For race, there have been 3 states (IL, MD, CT) showing racial breakdowns, and all 3 have shown a similar pattern: White suicides decrease, Black suicides increase.

9/ Unfortunately, I could not analyze Hispanic suicides. From the data that I have, they were average in 2020 however I am led to believe that racial coding for Hispanic residents in Cook county is very poor.

10/ Data set:

datacatalog.cookcountyil.gov/Public-Safety/…

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More from @tylerblack32

Tyler Black, MD

@tylerblack32

20 Feb

Friday Update for Suicidology Data/News regarding 2020:

We have new data on Oregon has layers of detail. Suicides overall in 2020 were down 10.6%, from 910 in 2019 to 820.

(recommend you assume Nov goes up a slight amount, dec a little bit more, and Jan significantly)

/1

Importantly, more evidence to the pile that the reporting on suicide presentations to the ER are MISQUOTED and MISATTRIBUTED. It is generally not true that presentations are up (both nationally and at state level data).

/2

Here, suicide presentations to the ER dropped off and overall were lower than 2019, but not as severely as visits for other reasons, making the *proportion of visits higher*. So it is not true in Oregon that "presentations for suicide were up".

/3

Read 16 tweets

Tyler Black, MD

@tylerblack32

19 Feb

@CDCgov

I am glad so many are seriously considering suicides in school-aged children as more than just about "mental health."

Recognizing that school may be a factor in youth suicide is very important.

Here's 1999-2019 in America, prior to COVID.

Source: @CDCgov

Let's make sure we don't pretend that we will solve the problem of youth suicide by "getting back to normal."

We will all need to continue to focus, on a national level, to our children's wellbeing and work to remove stresses, barriers, stigmas, and structural inequalities.

As any person who works with kids in an emergency department, mental health centre, crisis call centre, or psychology/psychiatry department will tell you, school and its surrounding stressors are a MAJOR CAUSE of youth distress.

Read 4 tweets

Tyler Black, MD

@tylerblack32

17 Feb

Update: USA Suicidology 2020

3 new jurisdictions are in:
* NJ (decreased 16.5%)
* HI (decreased 26.8% April-Dec)
* Franklin County, OH (decreased 6.1% Jan-Sep)

/1

@CDCgov

Due to lag, the "-11%" number is probably more like -4%. Interesting to note, this matches very well with the @CDCgov Jan-July report, which shows that suicides are about 4.6% fewer in 2020.

/2

What these data are not:
NOT A PREDICTION:
* other states or counties
* 2021
* other parts of the world

What these data are:
A REPORT:
* the counties and states reported
* everything that has been reported
* for the time ranges reported!

/3

Read 13 tweets

Tyler Black, MD

@tylerblack32

17 Feb

Using a quick example of how sensational numbers in headlines can paint an incomplete picture. In Franklin County, Ohio, Suicides are overall down in 2020, but the article portrays something different for youth:

dispatch.com/story/news/loc…

/1

Of course, the headline is not incorrect, but there is a larger context to provide. Using the data provided, I'm plotting the youth (8y-25y) suicide rate next to the adult+ suicide rate.

/2

As the headline states, there is an increase in 2020 vs 2019. However, 2019 also saw a substantial decrease, and just 4 years prior, 2017 saw an even greater increase from the previous year.

/3

Read 8 tweets

Tyler Black, MD

@tylerblack32

17 Feb

"Frequently Asked Questions" about the data I post regarding suicides in 2020 not changing overall from 2019. Due to the number of requests/questions I get, I will stop answering them personally if they are listed here.

FAQ 1:

What about "attempts?"

* numbers of attempts are not necessarily related to deaths numbers of death suicide (by far, most who attempt do not end up dying by suicide); overall, attempts are down in emergency departments (But the proportion of presentations is up)

FAQ 2:
What about "Deaths of Despair"

I hate the term.

"Despair" (what this ugly lumping calls "worsening socioeconomics") affects ALL DEATHS. It's honestly NOT OK and IGNORANT about social effects on health to use this term to separate suicide, overdose, and alcoholism.

Read 9 tweets

Tyler Black, MD

@tylerblack32

16 Feb

In Japan, preliminary data released showed suicides increased sharply amongst children in 2020.

Elementary: 6 (2019) --> 14
Junior HS: 96 (2019) --> 136
High School: 237 (2019) --> 329

/1

2) Obviously, this is quite an increase. 41% in a year is significant and concerning. It is in very different from North America, which have so far have not shown a youth increase. (Similarly, suicides in Japanese women skyrocketed whereas no change in North America/Europe)

/2

It's important to note that this number has been increasing sharply for a while, this is definitely amplified however.

Japanese Student Suicides
=-=-=-=-=-=-=-=-=-=-=
2016: 244
2017: 250
2018: 332
2019: 339
2020: 479

/3

Read 8 tweets

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