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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Suicidology during the Pandemic (US)
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(and a quick lesson in visualization)
Suicide rates decreased significantly when the pandemic started, and remained lower than 2019 for the remainder of the year. This is the monthly breakdown.
This is the best way to visualize yearly changes, and media types/communication types, please take note. This graph contains all of the necessary information to put a yearly change into context.
This graph is my invention, called the "GETH"
Why is it the best, you ask? /2
FIRST: it standardizes each month and year to "per 100,000 per year". Populations change over time and months have 28-31 days. This variation matters and without controlling, introduces error. /3
This is one of the true issues of COVID when it comes to preventing transmission/reducing spread, and protecting children. Eggheads & doofuses will focus on how "rare" it is for kids to die (tho its a leading cause of death in kids), but so many children have suffered d/t COVID.
Doofus: "0.00x% of kids die" - there are other issues with COVID spreading through a community that severely harm children
Egghead: "masks stop kids from reading facial expressions, and being out of school could cause problems" - how about losing a parent to preventable disease
Every human who can be vaccinated should be vaccinated, and we should be doing everything we can to prevent the preventable deaths and illnesses that occur due to COVID. This has *always* been the answer to "how can we help our kids the most?"
A Very Grim Milestone:
As of today, 1:1500 people **worldwide** have died due to COVID-19.
This ranks COVID-19 between #4-6 in cause of death in the world, over the past 22 months.
/1
Of course, the world is a big place.
COVID stats:
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Peru: 1 in 167 dead
Brazil: 1 in 350 dead
USA: 1 in 418 dead
UK: 1 in 475 dead
Sweden: 1 in 675 dead
Germany: 1 in 846 dead
Canada: 1 in 1,295 dead
Australia: 1 in 13,369 dead
New Zealand: 1 in 128,205 dead
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Remember, this isn't infection mortality (the chance of dying if you get COVID), this is POPULATION mortality. 0.067% of the population doesn't sound like a lot, but its far higher than suicide worldwide (#10 cause of death, 0.019% Population Fatality Rate in 22 months).
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Suicide rates in 2020 in the US are now available via @CDCgov BY AGE.
No significant change in youth groups, decreased in older ages past expected levels.
/1
By racial categories, for men there was variation but the trend of "white and Asian down, Black, Hispanic, and Indigenous" was present. Due to size of the groups the Indigenous men increase is within variance.
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In female suicides all groups saw a decrease, but only white women had a drop outside variance.
Women fared better than men for suicide in absolute terms (men outnumber women 4:1 this year), but also relatively (women down 8.3%, men down (2.2%)
While the "serotonin hypothesis" of depression is no longer taught, #SSRIs delay the reuptake of serotonin @ neurotransmitters. We also now know they have a host of other effects (σ1, BDNF, CREB, cytokines, on top of a slew of differences on the various subtypes of serotonin)
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The key difference, is that today, we know that the brain changes seen in depression are impairing, and we know that SSRIs work. Instead of drawing a straight line between "serotonin regulation" and efficacy, the honest psychiatrist doesn't understand the current mechanism.
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We now suspect that there are a host of effects, second, third, & even tertiary effects, and the complex way in which the brain is interconnected plays a role.
But yes, SSRIs DO block the reuptake of serotonin. It's why we have to be careful about withdrawal and tolerance.
/3
Thank you so much everyone for sharing your experiences. I have to mute notifications now due to virality but I've done my best to read and hear all of you. I'm glad my message resonated with so many. and pretty much 90% of disagreement/exception was respectful.
Honestly I'm touched, sometimes i feel this place is all about fights but most got what I was saying and shared so much about the *why* I've said it. If you ever want to see a "reaffirming ratio" look at that thread.
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I understand why parents feel scared and worried about the world and why it seems like intruding on their privacy is safe, but please read the responses and all of the hardship, hurt, and fractured relationships that were caused by such behavior.
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