Longtime readers know that Microkhan has a curious obsession with suicide. (We blame Ozzy Osbourne and Randy Rhoads.) So we couldn’t help but notice the fact that Montana has by far the highest suicide rate in the U.S., at 22 cases per 100,000 residents. That leaves even Nevada and its legions of busted, coked-out gamblers in the dust.
Yet here’s the rub: While Montanans appear to be killing themselves at an alarming rate, they’re quite reluctant to turn their pain or fury outward. The state has the nation’s second lowest homicide rate, behind only New Hampshire. What gives?
The standard explanation is that residents of Montana’s rural areas are ashamed of depression, and so don’t seek treatment until it’s too late. On top of that, rural dwellers are often more prone to suicide than their urban counterparts, though the reasons for this are not entirely clear. (Poverty is often said to play a role, but that’s probably less of an issue in Montana than in the hinterlands of, say, China or Bangladesh.)
Gun ownership has to be a factor, since it’s far easier to kill one’s self with a firearm rather than pills, carbon monoxide, or the noose. Montana has the third highest rate of gun ownership in the U.S., behind only Wyoming and Alaska (two other states with disturbingly high rates of suicide).
But Microkhan thinks the overlooked factor here is proximity to emergency medical care. Keep in mind that for every suicide in the U.S., there are nearly 19 unsuccessful attempts. What keeps the failure rate so high—and has slowly decreased the American suicide rate over the past 60 years—is more effective ER treatment. But that requires getting to the hospital quickly, and that’s just not possible in more rural areas.
Unfortunately, there’s doesn’t seem to be a quick fix to this problem, seeing as how there probably isn’t much cash available to build new ERs around Wolf Point. Perhaps the state government should just distribute Mormon literature and Prozac.
Gramsci // Apr 9, 2009 at 9:41 am
Given your interests, you should read The House of Wittgenstein, which just came out.
Brendan I. Koerner // Apr 9, 2009 at 10:13 am
Yeah, I just read the review of this in the NYer. It’s on the to-do list, though I’ll have to read it when the weather’s a bit nicer. Wittgensteins plus Seasonal Affective Disorder may equal disaster.
Jay // Apr 9, 2009 at 10:58 am
I was suprised and disappointed by the glib and somewhat uncaring tone of the post.
Brendan I. Koerner // Apr 9, 2009 at 11:11 am
@Jay: Fair point. It’s a sensitive subject, to be certain. Sorry you didn’t like this post, but hope you’ll check out Microkhan’s other takes on suicide. And hope you’ll keep reading the blog.
Captured Shadow // Apr 9, 2009 at 3:04 pm
It might be possible (and interesting) to do some comparisons in demographics that might, at least generate some ideas on risk factors. Those top suicide states might also have high Native American populations, high poverty rates, but maybe Montana also has an older and more male population. Higher levels of education in Montana might also correlate.
Brendan I. Koerner // Apr 10, 2009 at 7:49 am
@Captured Shadow: Excellent suggestion. Strange that no federal agency has this data on hand; I’ll need to compile myself.
I don’t know about Montana’s age demographics offhand, but you’re right about the correlation between advancing years and suicide rates. Rates typically peak between 18-25, then dip down for a few decades. But they steadily climb past c. 65.
I’ll definitely be posting on this topic again soon, so please keep an eye peeled.
Yangshao // Apr 14, 2009 at 5:16 pm
most of the time, the highest suicide rate is in alaska (e.g. 23 per 100k in 2007). this rate is much, much higher in bush alaska, where it is considered epidemic among rural youth, particularly in the north.
Brendan I. Koerner // Apr 15, 2009 at 10:02 am
Yeah, that would make sense, esp. among native communities in the rural north. Per CDC, suicide rate among all Native Americans is 1.5 times higher than population at large. I wonder what the comparison is for Alaska Natives versus other Alaskans? Fodder for another post, I’m sure.
The Stability of Suicide // Apr 28, 2009 at 9:09 am
[…] This historical data also raises the question of whether suicide attempts have remained stable over the years. Our hunch is that the number of annual attempts has markedly increased since 1950, which would explain why suicide rates have remained steady despite huge advances in emergency medicine. (Average distance from ERs may play a big role in Montana’s sky-high suicide rate.) […]