Cross-level sociodemographic homogeneity alters individual risk for completed suicide

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 117; no. 42; pp. 26170 - 26175
• Main Authors: Pescosolido, Bernice A., Lee, Byungkyu, Kafadar, Karen
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences 20.10.2020
• Subjects: Adolescent; Adult; Cause of Death; Disabilities; Female; Geography; Homogeneity; Humans; Indigenous peoples; Individuality; Male; Marriage; Mental Disorders; Middle Aged; Native Americans; Population Surveillance; Risk; Similarity; Social conditions; Social Environment; Social Sciences; Sociodemographics; Suicide; Suicide, Completed - psychology; Suicide, Completed - statistics & numerical data; Suicides & suicide attempts; Unemployment; Uniqueness; United States; Violence; Young Adult; United States; United States > US; risk factors; networks; US suicide; multilevel; homogeneity
• ISSN: 0027-8424; 1091-6490
• DOI: 10.1073/pnas.2006333117

Among deaths of despair, the individual and community correlates of US suicides have been consistently identified and are well known. However, the suicide rate has been stubbornly unyielding to reduction efforts, promoting calls for novel research directions. Linking levels of influence has been proposed in theory but blocked by data limitations in the United States. Guided by theories on the importance of connectedness and responding to unique data challenges of low base rates, geographical dispersion, and appropriate comparison groups, we attempt a harmonization of the National Violent Death Reporting System (NVDRS) and the American Community Survey (ACS) to match individual and county–level risks. We theorize crosslevel sociodemographic homogeneity between individuals and communities, which we refer to as “social similarity” or “sameness,” focusing on whether having like-others in the community moderates individual suicide risks. While analyses from this new Multilevel Suicide Data for the United States (MSD-US) replicate several individual and contextual findings, considering sameness changes usual understandings of risk in two critical ways. First, high individual risk for suicide among those who are younger, not US born, widowed or married, unemployed, or have physical disabilities is cut substantially with greater sameness. Second, this moderating pattern flips for Native Americans, Alaska Natives, Asians, and Hispanics, as well as among native-born and unmarried individuals, where low individual suicide risk increases significantlywith greater social similarity. Results mark the joint influence of social structure and culture, deliver unique insights on the complexity of connectedness in suicide, and offer considerations for policy and practice.