The Public's Health: Guns and Suicide | Public Health Post

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Suicide is one of the very few causes of death that have remained stubbornly steady over nearly the past century. A recent CDC report showed that suicide rates have risen about 30% in the United States since 1999. This report revealed an increase among all sexes, racial/ethnic groups, and all ages; in 2016 there were nearly 45,000 suicides in the US. With the recent increase adding fuel to our concern, suicide is now the tenth leading cause of death in the country.  
Suicidologists have long noted that there is no single cause of suicide. Although those with medical illness are at higher risk of suicide, as are those with a substance use history, fully half of all suicide deaths have no known history of a mental health diagnosis. Reflecting this, the National Strategy for Suicide Prevention calls for a broad range of approaches at the individual, family, and community level. 
We have no doubt the National Strategy’s prevention goals, which move in many directions at once and require resources and new services, would make a difference over time. What if, as a first step we focused on something quite specific? What if we focused on limiting the means to commit suicide?
We can learn here something from South Korea where suicide rates have long been higher than other high-income countries. Suicide by pesticides accounted for more than a fifth of all suicides in the country in the 2006–2010 time period. Korea banned the sale of paraquat—the leading pesticide—in 2012, and this was followed by an immediate decline in suicide rates across all groups.   
The success of such an effort rests on a simple observation—maybe close to half of all suicides are acts of impulse, decided within the hour, if not a few minutes, before the suicide itself. This means that having access to lethal means matters enormously. And lethality varies between means. Thelikelihood of a successful suicide by drug overdose is less than 10 percent; the likelihood of successful suicide by gun is more than 90 percent. That means that the impulse to suicide is much more likely to succeed with guns around. 
It is then not surprising, given how many guns we have in the country, that guns account for about half of all suicides—more than 22,000 deaths in 2016—in the latest CDC report, far more likely than the next nearest cause.
There are plenty of reasons for gun safety measures in the United States. Surely as we discuss suicide, measures to limit the role of guns should be part of the national conversation.

Michael Stein & Sandro Galea