Despite global upheaval during the COVID-19 pandemic, suicide rates in the United States fell during 2020.
The downward trend in suicide rates mirrors what occurred in the Spanish Flu pandemic in 1918-1920. But researchers are warning that challenges still remain in addressing the impacts of COVID-19 among disadvantaged communities.
“Both during the Spanish flu pandemic more than a hundred years ago, and now during the COVID-19 pandemic, suicide rates have appeared to either be stable or decline. However marginalised and disadvantaged communities including black communities may be more vulnerable to COVID-19 impacts from both the direct infection, economic recession as well as disruption of employment and social connectivity,” Associate Professor Jeffrey Looi, co-author of the study and a Clinician and academic neuropsychiatrist at the Australian National University (ANU) Medical School told Theravive.
Data from the National Center for Health Statistics shows that though there was a 17.7% increase in overall mortality in the first stages of the COVID-19 pandemic, there was a 5.6% decline in the number of suicides in the United States compared with 2019.
In 2019, there were 47,511 suicides. In 2020 that number dropped to 44, 834.
The researchers were inspired to undertake their work to historically contextualise some of the trends seen in the COVID-19 pandemic. They hope this will then inform evidence based mental health policy during the pandemic.
“There were early signs that the COVID-19 pandemic may disproportionately impact suicide rates amongst black and vulnerable populations in United States, since there were more effected by health and socioeconomic effects of the pandemic. Also, there were significant racial differences in suicide mortality during the early stages of the pandemic for example, in Maryland in USA,” Looi said.
“To understand the historical context, we analysed the effects of the Spanish flu pandemic by racial group as classified in existing data. The Spanish flu pandemic killed 1-2.7% of the world’s population from 1918 to 1920. We found that US suicide rates reduced by 26% during the Spanish flu pandemic from 1918 to 1920 compared to the pre-pandemic period of 1910 to 1917 and increased by 10% in the post-pandemic period 1921 to 1928 compared to the pandemic period.”
The researchers found that prior to the Spanish flu pandemic, during and after it, suicide rates were lower among the non-white population than among the white population.
“Despite a long history of significant social, political, and economic disadvantage relating to discrimination and segregation non-whites consistently experienced less than half the suicide rate of the more advantaged white population since 1916,” Looi said.
The researchers say this may be due to the community coming together to support each other during the time of the Spanish flu.
“The overall reduction in suicide rate during the Spanish flu pandemic of 1918 to 1920 indicates that there was a possible pulling together effect of social cohesion that reduced suicide mortality and that this was more prominent in non-white communities including black people,” he said.
Whilst some of the evidence from the Spanish flu pandemic supports the idea that black communities may be more socially resilient, the authors caution the findings should be interpreted cautiously given concerns around the quality of data from the time of the Spanish flu.
But they say the idea of social cohesion may also be responsible for why suicide rates have remained stable or fallen in many parts of the world during the COVID-19 pandemic.
“The overall findings by other researchers analysed the impact of the COVID-19 pandemic on global suicide rates found that suicide rates in 21 countries have either been stable or reduced and that this pattern had persisted into late last year. The reasons why (despite loneliness and hardship) suicide rates dropped may relate to the social cohesion which we have previously mentioned, that may result from a pulling together effect of communities working together in adversity to survive during the pandemic,” Looi said.
“Historically the sociology researcher Emile Durkheim as well contemporary sociological research indicates that during major crises communities work together more cohesively, particularly if there is a major existential threat. This is thought likely to be a significant factor in promoting resilience of the population and thus a reduction in suicide rates.”