Please Note: This transcript is not edited and may contain errors.

Moderator – 00:31

Thank you all for joining us today as we release a new CDC vital signs report. We are joined by Dr. Debra Houry, CDC, Deputy Director for Programming Science and Chief Medical Officer and Dr. Alison Cammack, lead author and Health Scientist on CDC Suicide Prevention Team. Following opening remarks, we will be joined by Dr. Deborah Stone, CDC, Lead Behavioral Scientist for Suicide Prevention to take your questions. Please note that this briefing is embargoed until 1pm Eastern, when our vital signs is live on the CDC website. I will now turn the call over to Dr. Houry.

Dr. Debra Houry 01:11

Hello and thank you for joining us today. This issue of CDC vital signs focuses on suicide rates in the US with an in depth look at how three community factors can influence a person’s risk of suicide. Today’s release is particularly timely, as September is Suicide Prevention Month, and today is World Suicide Prevention Day, a day where we raise awareness and attention to this issue, emphasizing the message that suicide is preventable. Often, suicide prevention focuses on helping people who are in crisis, while this is critically important, CDC approach to suicide prevention is to increase factors that promote resilience and to reduce factors that increase suicide risk, to keep people from ever getting to a crisis. This new report is an example of CDC work and suicide prevention as it explores community factors that can be improved to help protect people from suicide. Our vital signs study found that health insurance coverage, broadband Internet access, and higher income levels may impact suicide risk. CDC’s comprehensive suicide prevention program which invests in 28 sites across the US specifically works to improve the conditions where people are born, grow, work, live and age to reduce suicide risk. CDC also funds and supports organizations working with tribes, veterans and others to prevent suicide. Let’s look at this heartbreaking issue a bit more. Suicide rates have increased over the last 20 years and remain high. More than 49,000 people died by suicide in 2022 and provisional data indicate a similar number of people died by suicide in 2023. Suicide and suicide attempts also have serious emotional, physical and economic impacts on people and the communities they live in. We all likely know someone who has struggled with suicidal thoughts, I lost two medical school classmates to suicide, and know how this crisis can truly impact anyone and everyone. Some groups have higher suicide rates than others. For example, males have higher suicide rates than women. Rural communities have higher rates of suicide than urban communities, and the highest suicide rates are among non Hispanic, American Indian, Alaska Native people, followed by non Hispanic white people. So bottom line, today’s vital signs report shows an association between health insurance coverage, broadband Internet access and household income and counties with suicide rates. I’ll now pass it over to Dr Alison Cammack, the study’s lead author, to go over the specific findings of this report.

Dr. Alison Cammack 04:14

Thank you, Dr Houry. Today’s vital signs describes how county level factors are related to 2022 suicide rates in the United States. This new report found that suicide rates were lowest in counties with higher levels of health insurance coverage, broadband Internet access and household income. More specifically, suicide rates were 26% lower in counties where the most people have health insurance coverage compared to counties that have the least health insurance coverage. In counties where the most households have broadband Internet access, suicide rates were 44% lower than in counties that have the least accessed and finally, suicide rates were 13% lower in counties with the most household income compared. Counties with the lowest household income levels, these factors were more strongly associated with suicide rates in some groups of people, including American Indian and Alaska Native people. Suicide rates for American Indian and Alaska Native people in counties with the highest percentages of these three factors were half the rate of counties with the lowest percentage of these three factors. There may be many reasons why counties have lower suicide rates when they have higher levels of health insurance coverage, broadband Internet access and income. We know that these three factors are linked with protective factors that have been shown to help reduce the risk of suicide. Health insurance coverage can help people access mental health and primary care services and treatment. High Speed Internet access connects people to prevention resources, job opportunities, telehealth services and friends and family. Household financial resources such as income and economic supports put in place by local, state and federal governments can help families secure food, housing, healthcare and other basic needs. This report also found that certain groups of people continue to have higher rates of suicide, including males, rural residents, American Indian Alaska, native people and white people. It is important to note that many barriers challenge a person’s ability to access health insurance, broadband internet and higher income. For example, tribal and rural communities may lack the infrastructure to obtain internet access. It’s imperative that our nation works towards a comprehensive suicide prevention approach focused on programs, practices and policies designed to prevent suicide crises before they happen. And now I’ll turn it back over to Dr. Houry to discuss how we can work together on a comprehensive approach to suicide prevention.

Dr. Debra Houry 06:54

Thank you. Dr. Cammack. In suicide prevention, CDC brings unique and unparalleled data systems, scientific and technical expertise and strong collaboration and funding support. This helps fund programs in state, health departments, tribes and tribal organizations, territories, academic institutions and other local coalitions and organizations. For example, with this report, CDC, experts are providing these data to inform action. A better understanding of suicide risk and protective factors, particularly in groups most affected by suicide, can improve suicide prevention efforts and save more lives. We offer proven actions for communities and organizations and our Suicide Prevention Resource for action, which you can find on CDC website. Examples of these actions include promoting healthy connections through school based programs, as well as programs that improve household access to financial security. And we incorporate our work with the solid foundation for positive change that already exists, such as traditions, cultural identities and connections to people and organizations. CDC co led development of the 2024 national suicide prevention strategy, which seeks to prevent suicide risk in the first place by under by addressing underlying factors, such as those described in the vital signs identifying and supporting individuals at increased risk through treatment and crisis intervention, preventing reattempts, promoting long term recovery and providing support to survivors of suicide loss. It’s important for everyone to recognize the warning signs of increased suicide risk, including expressing hopelessness, being isolated, sleeping too little or too much and increased substance use. Help is available if you or someone you know is struggling with thoughts of self harm or suicide, you can contact the 988 lifeline or use their online lifeline crisis chat. Help is free, confidential and available 24/7. We want to help people in need before a crisis occurs. Suicide is preventable, and we know what works to stop it and to spare families and friends from losing loved ones. Thank you for your time. Today, I will now open it up for questions.

Moderator 09:21

Thank you. We’re ready for questions.

Operator 09:25

If you would like to ask a question over the phone, please press star followed by one. Please make sure that your phone is unmuted and record your name clearly when prompted. Please limit yourself to one question and one follow up. Please allow a moment for questions to come in. Thank you.

Operator 09:59

Applause. Our first question comes from Mike. Stobbie be with the Associated Press. Your line is open.

Mike Stobbe – Associated Press 10:16

Hi. Thanks for doing this call and for taking my question. I have two if I if I may. One is, could you say a little bit more about the 2023 provisional suicide data, like exactly how many suicide deaths were recorded, and were there any trends up or down that were notable regarding method or demographics or anything that differed from earlier years, and my second question was, about this report. Is it correct that the findings weren’t consistent through all demographic groups, like for women or among females or for black persons regarding health insurance coverage. Could you speak a little bit to the uniformity of the findings and why there were differences?

Dr. Alison Cammack 11:13

This is Dr. Cammack. Regarding the provisional data. So we get our provisional data and it’s updated on a weekly basis. And the last time I checked for 2023 it was at 49315, which as Dr. Houry stated, is pretty similar to the number that we saw last year. We haven’t really looked at it in detail by trends yet, so I don’t really want to comment on that. With regard to your second question about differences that we saw across demographic groups? Yes, we did see some differences. Most notably, we saw the associations between the various county level factors and suicide rates. They were most consistent and strongest among American Indian, Alaska Native persons, males, white persons and individuals between the ages of 25 and through 44 and there could be various different reasons for this. We don’t know the exact reason, but I will say that we do know from other studies that there seem to be stronger associations among males and American Indian Alaska Native persons. When you look at economic factors more broadly and in terms of the groups that we didn’t necessarily see strong associations again, we don’t know the exact reason, but it’s possible that there just might be other types of risk factors that are more salient in those groups.

Operator 12:32

Our next question comes from Kirsten Dorman with KJZZ, NPR, your line is open.

Kirsten Dorman – KJZZ, NPR

Hi. Thanks so much again for having us, and thanks for taking my question. I was wondering if there was any further insights you can offer regarding any kind of potential link observed between or any notable trends regarding broadband Internet access and suicide prevention.

Dr. Alison Cammack 13:05

This is Dr. Cammack. Can you clarify? Just you want to understand more about why we might see this association.

Kirsten Dorman – KJZZ, NPR

Sure, yes, and why it’s brought up in regard to, you know, rural communities and these different kind of demographics,

Dr. Alison Cammack 13:19

So we brought up, you know, the relevance for different demographic groups, because we know, like rural communities and tribal communities, they have less access to broadband internet. So it might be particularly important to see these associations within these groups. And to reiterate my earlier point, we did find particularly for American Indian Alaska Native persons, we saw all three factors, including broadband internet, that having higher levels of broadband was associated with lower suicide rates, so it was particularly salient in that group.

Operator 13:53

Thank you. Thank you. Our next question comes from Eden Brown with Fox News, your line is open.

Eden Brown – Fox News 14:02

I thank you for taking the call today. My question for whoever would like to answer is, what would the action items be on these data findings. What would you expect policy makers to do? There have been a number of initiatives to wire up rural America for high speed internet to do so on Native American territories, to provide subsidized internet service in urban, rural air, excuse me, in urban, lower income areas. So there seems to be a lot of both the federal and even many state level initiatives to address that disparity, and I guess, services, but you’re kind of putting another call it a dimension to it, to say that this could be saving lives, or perhaps you’re saying it’s the lack of the service is putting lives at risk. I’m not quite sure. But what would you want to you know, a. Legislature, either at a state level or the Congress, to do with your data here.

Dr. Debra Houry 15:05

Thanks. This is Dr Houry and a really important question. I would say, really developing programs and policies that improve housing stability, economic security, connection to community, Internet access and healthcare access and delivery are what this vital signs, and a lot of our other work has shown these are community level conditions with policies that can save lives.

Moderator 15:34

Missy, we have time for a couple more.

Operator 15:36

Next question comes from Eve Bender with Medscape, medical news, your line is open.

Eve Bender – Medscape 15:43

Hi, thank you for taking my question. I’m wondering if the CDC has a stamp on universal suicide screening.

Dr. Debra Houry 15:57

We don’t have a policy on that. But what I would say is in general, you know, this is why we focus on community level interventions, because any life lost is too many. Our work really focuses on those that are at risk for suicide, so that we can support those to get services and really raising awareness, which is one of the reasons why we have this vital signs, and why I also think it’s important when media report to really report on things to look for and how to get care, and 988 because I think just as important about having identification of those at risk for suicide is that we report on how we can respond to suicide, so that we aren’t having clusters or I would say, you know, making it more newsy than we want it to be. We really want suicide deaths to be viewed seriously as something that’s preventable, something that can be done, and that people know that it is preventable and that there is hope and help. So that is really our focus is on really community level interventions and focusing on those at risk.

Moderator 17:09

Our last question please,

Operator 17:10

Thank you. Our last question comes from Eduardo Cuevas with the USA Today your line is open.

Eduardo Cuevas – USA Today 17:18

Hi. Thank you for having us. Really appreciate the study. I wanted to ask, you know, looking at these three factors, health insurance, broadband internet, household income, how I was curious, how you view this study? Looking at, I guess, how does it look at maybe, individual factors around someone in Crisis or someone with mental health illness versus societal factors that contribute to suicide deaths. Thank you.

Dr. Alison Cammack 17:54

Hi. This is Dr. Cammack, so in this study, we didn’t focus on any individual factors, and we actually didn’t look at that other than just looking at the different demographic groups. When we looked at the relationship between the three different county level factors and suicide rates, looking, you know, for differences in that relationship. But we didn’t look at individual factors by themselves.

Dr. Debra Houry 18:18

And this is Dr Houry. I think what I would just add, not necessarily in relation to that question, but just overall, is, you know, these numbers are staggering. One life lost is too many. And sometimes it might seem overwhelming like is there more we could be doing? And certainly, I think focusing on this issue is very important. But what we know what to do works, and some of the things that we’re highlighting in this vital signs today are what works, and I’m really proud of our CDC programs in the areas to where we have had funding. We’ve seen that our recipients that we’ve seen decreases in veteran suicide deaths by 6% when there was actually an increase in this population, and we saw a decrease in suicide among youth served by our suicide prevention sites when the national rate decreased by about half of that so by doing what works, we can have an impact, and I hope that that is what the take home message is, that we can all make a difference by implementing these community level prevention programs and identifying the warning signs, we can all save a life.

Moderator 19:23

We’d like to thank you all for joining us today. If you have follow up questions, please call this main press office at 404-639-3286 or you can email media@cdc.gov This will conclude our call. Thank you. Applause.