Suicides among farmers in three southeastern states, 1990-1998.

Several studies have documented higher rates of suicide among farmers in comparison to other occupational groups, both in the U.S. and internationally. The purpose of this study is to describe the epidemiology of farmer suicides in three southeastern states (Kentucky, North Carolina, and South Carolina) during the nine-year period 1990-1998. Electronic death certificate data were obtained from the National Center for Health Statistics. Over the nine-year period, there were 590 deaths related to suicide (E-codes: 950-959) among farmers (occupation codes: 473, 474, 475, 477, and 479) in the states of Kentucky, North Carolina, and South Carolina. The results of this study confirm the increased rate of suicide mortality among white male farmers in comparison to the total white male population in these three southern states. The increased rate of suicide was significantly elevated among farmers age 25-34 years (RR: 2.07; 95% CI: 1.61-2.67) and among those age 75-84 (RR: 2.04; 95% CI: 1.70-2.45) and age 85 years and older (RR: 2.67; 95% CI: 2.02-3.54) in comparison to the total white male population.The use of a firearm was the primary mechanism of death for the majority (86%) of the cases. Farmer suicide mortality rates in the southeastern U.S. are higher than in Midwestern states. The elevated rate of white male farmer suicides in North Carolina over this time period (35% higher age-adjusted suicide rate in comparison to South Carolina) suggests a need for further investigation to assess the individual, social, and economic factors that may explain this elevated rate. Interventions for the prevention of suicide need to be directed to older male farmers who consistently have higher suicide rates than similar males in other occupations.