Rising suicide among adults aged 40-64 years: the role of job and financial circumstances.

INTRODUCTION: Suicide rates among middle-aged men and women in the U.S. have been increasing since 1999, with a sharp escalation since 2007.
PURPOSE: To examine whether suicides with circumstances related to economic crises increased disproportionately among the middle-aged between 2005 and 2010.
METHODS: This study used the National Violent Death Reporting System (NVDRS) in 2014 to explore trends and patterns in circumstance and method among adults aged 40-64 years.
RESULTS: Suicide circumstances varied considerably by age, with those related to job, financial, and legal problems most common among individuals aged 40-64 years. Between 2005 and 2010, the proportion of suicides where these circumstances were present increased among this age group, from 32.9% to 37.5% of completed suicides (p<0.05). Further, suffocation is a method more likely to be used in suicides related to job, economic, or legal factors, and its use increased disproportionately among the middle-aged. The number of suicides using suffocation increased 59.5% among those aged 40-64 years between 2005 and 2010, compared with 18.0% for those aged 15-39 years and 27.2% for those aged >65 years (p<0.05).
CONCLUSIONS: The growth in the importance of external circumstances and increased use of suffocation jointly pose a challenge for prevention efforts designed for middle-aged adults. Suffocation is a suicide method that is highly lethal, requires relatively little planning, and is readily available. Efforts that target employers and workplaces as important stakeholders in the prevention of suicide and link the unemployed to mental health resources are warranted.