Tyler Black, MD Profile picture
Dec 3, 2021 16 tweets 5 min read Read on X
Full Subgroup Analysis, US Suicides 2020
-=-=-= LONG = THREAD =-=-==-

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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More from @tylerblack32

Jul 31
How to fail at parenting
🧵 by a child psychiatrist

There is value to play, learning & development, however there are many ways for kids to do this.

tag
baking
reading

This kid is receiving a message:
"I don't like the you that you are. Let's fix that. Be more like them"

/1
First off, what is "alone"?

Coplan et al separated three kinds of preschool solitude: reticence (hovering, wanting in), solitary-active (solo play near others), solitary-passive (quiet constructive or exploratory play).

/2
They were not associated with each other. And only reticence was associated with anxiety now and later for the child.

The kid reading a book is solitary-passive, and that's a benign form of solitude (not always, but mostly).

/3
Read 21 tweets
Jul 9
A warning about Dr Jessica Taylor, the "Sexy But Psycho" author whose anti-psychiatry content keeps crossing my feed. She has real credentials and a PhD in forensic psychology. What she doesn't have is any clinical qualification.

/1
Her own bio lists her credentials: PhD, BPS Chartered Psychologist, AFBPsS. What it has never listed: "clinical psychologist" / "practitioner psychologist". the HCPC-regulated, legally protected titles required to practice clinically in the UK.

No regulatory body to complain to
Yet her businesses offer "expert witness services," trauma "assessments," "therapies" and a sound bath studio using quartz bowls to "recalibrate the nervous system."

Oof.

No Ouija? Seances?

/3
Read 9 tweets
Jul 2
Since Trump took office:

* Elon net worth is $980B (+$500B)
* Donald Trump's family ~$10B, up about $7B
* Top 15 billionaires: up 33%

And USAID was cut 6 billion, resulting in hundreds of thousands of or the poorest people needlessly dying and suffering.

/1
Since Trump was elected:

* $5-700M on white house renovations
* $132B for the war in Iran
* $930M for the refurbishment of the "gifted Qatari jet"
* $102M for Trump's golf trips every weekend (at his properties, which profit)
* $40M for a military parade

/2
Since Trump was elected:

* $500B in lost IRS revenue
* $135B in benefits obligations and costs due to DOGE retirements

/3
Read 4 tweets
May 13
OK @joannamoncrieff ,lets do this.

POINT BY POINT
🔽🔽

/2 Image
Point 1: "Disease-targeting" is an invented criterion

1a. You demand drugs show "disease-targeting effects" or be presumed harmful. This is never necessary. The actual claim: reliable symptom change across replicated RCTs.

/2
Point 1: "Disease-targeting" is an invented criterion

1b. Cardiology doesn't know the molecular lesion driving most post-MI mortality benefit from beta-blockers. We use them anyway because they work. "No known mechanism, therefore presume harm" would gut most of medicine.

/3
Read 14 tweets
May 5
RFK is no better at psychiatric medications than he is about vaccines.

RFK's "overmedicalization crisis" thread is a master class in using true-ish numbers to imply a false conclusion. Let's go through it. 🧵

/1
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
Read 20 tweets
May 4
Disabled people should not live in poverty.

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 Image
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.

/2www150.statcan.gc.ca/t1/tbl1/en/tv.…
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
Read 10 tweets

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