Full Subgroup Analysis, US Suicides 2020
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2020's effect on suicide can now be analysed thanks to @CDCgov at the yearly level. Very shortly I'll be able to look monthly as well.
This is the whole US population, but we can now do subgroups. /1
The big headline: Children 10-14 did NOT have a significant increase in suicides. It was well within expected rate variability. Error bars shown.
Because of small #'s, the rate changes can be drastic.
The 2020 increase was less than '00, '04, '07, '09, '13, '14, '17 and '18 /2
In other words, no evidence that the "lockdown" phase of the pandemic caused more child suicides, and no evidence that 2020 was associated with a significant increase in child suicides. /3
For men, 2020 saw a decrease (-2.2%), continuing the decrease seen in 2019. /4
For women, 2020 saw a much larger decrease (-8.3%). /5
It's the 2nd largest change in female suicide rates in the US in 50 years! /6
Hey remember when all those American outlets picked up the news that suicides "increased for women in Japan?" Thousands of stories. This data about women in the US has been out a month, how many stories have you seen? Yay, media. /7
I'll now break things down by race, and for comparison's sake I am keeping the Y axis the same (0 to 30 suicides per 100,000), so you can also compare racial rates to each other. /8
(Non-Hispanic) White Americans had a very large decrease in suicide rates, the largest seen in 21 years. White women had a much larger decrease (-10%) than the men (-3%). /9
Indigenous (CDC Alaska Native or American Indian) people had a small increase in suicide rates in 2020, and the gender difference here was significant. The diff b/w white (-4.6%) & Indigenous (+6%) is quite large, and I feel represents a significant difference as well. /10
It should be noted that Indigenous suicide counts may be underestimated due to procedural issues with death coding, so this rate might be even higher.
The gender difference between Indigenous men (+5%) and women (-4%) was large. /11
(Non-Hispanic) Black Americans had an increase in the suicide rate in 2020, again separating strongly (9% difference) from white Americans. The rate increase was not as high as in many years.
Black women had a small decrease (-3%) while Black men had an increase (+8%) /12
Asian Americans (CDC: "Asian American or Pacific Islander) had a decrease of about 10%, and there was no significant gender differences. /13
I cannot reconcile a discrepancy in the CDC Rapid release for 2020 (which has Asian American 2019 deaths at 1342, and CDC wonder at 1548.) Because I trust CDC Wonder more, and know how to use it, I used this number, but it might have exaggerated the drop in 2020. /14
Hispanic Americans had a slight increase in suicide rates in 2020, and there was a large gender discrepancy, with men having an increase (+5%) and women having a decrease (-7%). This is the largest gender divide, by race. /15
The top line is reassuring for a "large pandemic effect", but there is evidence (and in a month I will be able to dive deeper) that there were significant racial differences between white and Asian (decreased) and Black, Indigenous, and Hispanic Americans (increased).
Fin. /16
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Talking to kids when they're struggling🧵
For parents (or anyone who cares for kids!)
It can be really scary to notice something in your kid & be worried suicidality/self-harm.
How do you approach kids?
I've had this conversation >10000 times so I have some tips!
Be CALM
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CALM is a memory-trick to remember the key concepts of communicating to a struggling kid but also to remind you to be in control of your own emotions. If you are prepared, you will defeat your initial instinct, which will be to FREAK THE BLEEP OUT!
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First, COOPERATE!
You & your kid are a team, and you have a common goal: their present & future wellbeing. Don't set yourself up as the security guard, jailor, punisher, or antagonist. Don't push. Don't pull. Be alongside them, tell them you're willing to walk with them.
A recent study looking at >2M Americans presenting to ERs with MH concern shows the difficulty of "predicting suicide" - we can't predict suicide to help guide important clinical decisions.
The problem: Sensitivity vs PPV
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They used machine learning EMR-coded variables (outpatient visits, medications, previous appointments, age, etc etc) - you can see the entire dictionary used to "predict" here (word doc):
They had 2,069,170 ER visits and 899 suicides within 90 days.
After running the model and letting machine learning do its thing, the best fit had the following predictive properties at the 95% percentile cutoff of risk:
Debunking Antivaxxer Tropes:
"Antivaxxer is a slur" 🧵
Many many many accuse me of using a "slur" when I say "antivaxxer". It is a twitter shorthand for sure, but it is not a "slur", and I use it without regret or remorse.
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I certainly believe that if one is an "anti-vaxxer", they are not using science, reason, or reality to understand vaccines.
& I note a distrubing trend in antivax and some concerning other beliefs.
That being said, when I say antivax, I only mean "antivaccine belief holder"
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Check out my "antivax misinfo" threads. Someday take a look at the "hidden replies" & note that the antivax profiles are quite.. well.. recognizable.
Note: Do not assume every "Antivaxxer" is, I just notice the trend. As do many of my colleagues here space fighting misinfo.
Debunking Antivaxxer Myths
"🇪🇺 Vaxxed Countries have higher mortality"
No, they don't.
This is COMPLEX:
a) countries had different PRE-VACCINE infection (offers more dangerous protection than vax but indeed protection). Obv, vaccination NOT correlated with pre-vax death.
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b) The FIRST VACCINATION SERIES against OG COVID was phenomenally effective at preventing infection, transmission, illness, hospitalization, and death (VE >80-90% in all).
This is clearly evident by one of the most striking correlations you'll see!
COVID deaths vs Vax:
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And because COVID was the primary driver of excess mortality in 2021, excess ALL CAUSE mortality was almost identical to COVID MORTALITY.
He presents data to scare people into believing that vaccines have caused harm, & he continuously is on the bandwagon that C19 vaccines cause cancer. This is contrary to the damage.
Here, he's using a report using 1998-2019 data.
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In fact, there was such a DROP in incidence (assumed to be due to lack of access to health care) in 2020, that they had to amputate the model at 1998-2019 so that it wouldn't project a decrease! (a reasonable thing to do!)
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In their report, they clearly show that their trending is based off of models that ONLY end at 2019. ZERO PERCENT of this report is suggesting, implying, or reporting that vaccines have led to an increase in cancers.
He will have a huge platform & can say what ever he wants as long as there is right wing grift.
He is a licensed professional being held standard.
/1
It is against his license to publicly suggest to die by suicide.
It is against his license to publicly & intentionally call physicians 'criminals,' people "not beautiful" or "appalling self-righteous moralizing things."
His license prohibits misgender people intentionally.
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The standards of his college are publicly available; including social media. By being licensed, he represents his college and the profession, and that college/profession gets to have a say in how they are represented.