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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The core trick: he treats prescription prevalence as self-evidently bad. But high rates only signal a problem if the meds don't work, are given to people who don't need them, or cause net harm. He establishes none of this. He just gestures at numbers.
/2
The same rhetorical structure would indict insulin prescribing, or asthma inhalers. Prevalence is not pathology. The question is whether treatment matches need — and whether the alternative (untreated illness) is better or worse.
/3
It makes no sense the way we treat our people with disabilities in Canada. Canada has the full apparatus to implement adjusted payments, yet we typically support disabled people WELL under the poverty line.
/1
Canada has an official poverty line: the Market Basket Measure. It's regionally calibrated, methodologically sound, and updated by StatCan.
A single person on BC PWD receives ~$18.4k/year. The Vancouver MBM is ~$29k.
That's not a rounding error. It's a structural choice.
PWD recipients in Vancouver sit at roughly 47% of the poverty line and below the Deep Income Poverty threshold (75% of MBM), which is the level StatCan uses to flag the worst material deprivation in the country.
/3
To be clear, my first answer is "well we know they are supposed to block serotonin reuptake, but it's not that simple and we don't really know."
But, if you want the best 2026 science...
/1
For a few particularly science-interested patients, I walk them through what we currently have for the 'best evidence' even though we're still not sure.
This is the "best story" I can tell about SSRI's right now.
(nb, this is NOT locked in, this is MY best synthesis)
/2
1) SSRIs BLOCK the Serotonin Transporter
The protein that pulls serotonin back into the neuron after its released is blocked. Serotonin lingers longer in the synapse, the gap where neurons signal each other.
This is very well established, & how SSRIs were designed.
The Ihben story is making the rounds. "Judge forced 18 vaccines, child got autism." It's being treated as a smoking gun. It is not a smoking gun. It is barely a story.
Sourcing: one father, one advocacy org (CHD), one GiveSendGo. Records sealed. No filings. No named physicians. Every outlet repeating it cites the same Defender article. This is a closed loop, not corroboration.
/2
"18 vaccines in one day" is not a thing. That number counts antigens as doses to make the headline scream. Real catch-up schedules don't work this way and you can verify that in five minutes on the CDC site.
/3
Ask any person who has been even suggested to have BPD; they will uniformly tell you that they have been told to try DBT (Dialectical Behavioural Therapy). Reflexively recommended. "Gold standard."
This is not science-supported.
/1
Quick history: Marsha Linehan developed DBT in the late 1980s, published the foundational manual in 1993. She drew on CBT, Zen Buddhism, and dialectical philosophy. Brilliant clinician, brilliant marketer. Her institute has trained tens of thousands of therapists worldwide.
/2
That marketing machine is the reason DBT is "the BPD treatment." It is not the reason DBT works better than alternatives, because it does not.
The faint superiority signals in older trials evaporate once you adjust for allegiance bias (DBT researchers studying DBT).
/3
The McCullough Foundation's @NicHulscher — who posts garbage medical misinformation — styles himself an "independent epidemiologist."
His entire career has been spent publishing with, and working for, McCullough.
No academic post, no health agency, no clinical role, no pre-Foundation experience. Hired straight out of his 2024 MPH by the senior author on nearly every paper bearing his name.
/2
He publishes almost exclusively with McCullough, overwhelmingly in predatory or fringe journals, and has already been retracted twice — plus an Expression of Concern — in a career that's barely two years old.
/3