Further Exploring American Exceptionalism via the Global Burden of Disease Study (Suicide)

Yesterday I explored America’s violent exceptionalism by looking at homicide data for the 38 member nations of the Organisation for Economic Co-operation and Development (OECD) collected by the Institute for Health Metrics and Evaluation (IHME).

Today I want to see what these data tell us about the problem of suicide in the United States relative to our peer nations. Are we exceptional here, too?

As with my examination of homicide, this is admittedly a very simplistic analysis. But for my work, it is important to be able to say something about the big picture of negative outcomes with firearms in the United States as a starting point for more sophisticated analyses.

On a global scale, the United States ranks #49 out of 204 countries in the IHME GBD data in terms of suicide rate per 100,000 population. So, we are in the top quartile of countries, but not particularly exceptional in my judgment.

In fact, the different dynamics of homicide and suicide already begin to stand out in the table above. Notably, peaceful, gun-free havens like South Korea (#6) and Japan (#21) are well above the gun-saturated United States (having 1.97x and 1.4x the U.S. rate, respectively).

Restricting the data just to OECD nations, the United States comes in the high middle of the pack (#14 of 38), alongside the Czech Republic and Germany.

As with homicide, there is something more going on here than just firearms. Which, of course, does not mean that we shouldn’t consider the role that firearms play in negative outcomes like homicide, suicide, or accidental death.

These results do look quite different if we sort the data according to the rate of suicide by firearm cross-nationally. The table below shows the United States has the second-highest firearm suicide rate in the world, falling well short of Greenland but also being quite a bit higher than #3 Uruguay.

Of course, looking just at OECD nations, the U.S. has the highest firearm suicide rate, nearly 3x the second highest country Finland. So, if we were to eliminate firearm suicides in the U.S., our suicide rate would put us near the bottom of the OECD list.

Maybe.

Or maybe not.

This maybe would only be true IF those who did not commit suicide by firearm also did not commit suicide by some other means. The issue of “replacement” hangs over discussions of firearm suicide.

I am not an expert in this area, but I don’t think that reducing firearm suicides by VALUE X is likely to reduce total suicides by VALUE X. But, given the lethality of firearms, reducing firearm suicides by VALUE X would probably reduce total suicides by VALUE Y.

And, of course, this is a worthwhile goal.

I appreciate the work being done by so many individuals, groups, and organizations to address self-harm both immediately and in the long run (see paragraphs 55-58 of my online essay on “Understanding and Misunderstanding American Gun Culture and Violence”).

To take just one example, addressing the motivations for self-harm is important. This highlights the need to create safe spaces for gun owners to discuss their mental health without fear of losing their gun ownership rights, and to create cultural competency among mental health care providers to better understand guns and their owners. Walk the Talk America (https://walkthetalkamerica.org) was founded by gun industry veteran Michael Sodini for just this purpose.

Walk the Talk America (WTTA) Founder and President at 2019 SHOT Show. Photo by David Yamane

If you want to examine these data for yourself, you can reproduce the dataset I am using here by following this link to the IHME GBD VizHub.

If you appreciate this or some of the other 250+ posts on this blog, please consider supporting my research and writing on American gun culture by liking and sharing my work.

2 thoughts on “Further Exploring American Exceptionalism via the Global Burden of Disease Study (Suicide)

  1. Pingback: From Relative Risk to Absolute Risk of Negative Outcomes with Firearms – And Back | Gun Curious

  2. I’d have to go searching for the numbers, but the most touted evidence for means-based reduction in suicides, proffered as a rejection of “replacement” claims, is the precipitous drop in suicides by coal gas in the UK after its replacement by less lethal natural gas in the ’60s and ’70s. Those suicides do not seem to have been replaced (statistically) at all.

    What seems to be missed is that using coal gas for cooking, as opposed to heating and lighting, only really began to expand in the early 20th century, a few decades prior. What you see if you look at the suicide rates broken out by all causes is the baseline of “non-coal gas” suicides prior to its introduction remained relatively unchanged throughout and after its use.

    “Suicide by oven” increased as that method became more widely available, but there does not seem to be a decrease in other methods, that is, oven coal gas itself was not a “substitute” for hanging, leaping, or pills, but apparently something more of a “fad” or social contagion. After all, it created headlines and jokes.

    Much like claims of an absolute rise in violent crime, it is necessary to look at long term rate trends, and not arbitrarily start at the point where the data matches the hypothesis.

    Like

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