MMWR Morb Mortal Wkly Rep. 2024 Sep 19;73(37):810-818. doi: 10.15585/mmwr.mm7337e1.
Approximately 49,000 persons died by suicide in the United States in 2022, and provisional data indicate that a similar number died by suicide in 2023. A comprehensive approach that addresses upstream community risk and protective factors is an important component of suicide prevention. A better understanding of the role of these factors is needed, particularly among disproportionately affected populations.
Suicide deaths were identified in the 2022 National Vital Statistics System. County-level factors, identified from federal data sources, included health insurance coverage, household broadband Internet access, and household income. Rates and levels of factors categorized by tertiles were calculated and presented by race and ethnicity, sex, age, and urbanicity.
In 2022, the overall suicide rate was 14.2 per 100,000 population; rates were highest among non-Hispanic American Indian or Alaska Native (AI/AN) persons (27.1), males (23.0), and rural residents (20.0). On average, suicide rates were lowest in counties in the top one third of percentage of persons or households with health insurance coverage (13.0), access to broadband Internet (13.3), and income >100% of the federal poverty level (13.5). These factors were more strongly associated with lower suicide rates in some disproportionately affected populations; among AI/AN persons, suicide rates in counties in the highest tertile of these factors were approximately one half the rates of counties in the lowest tertile.
Higher levels of health insurance coverage, household broadband Internet access, and household income in communities might play a role in reducing suicide rates. Upstream programs, practices, and policies detailed in CDC's Suicide Prevention Resource for Action can be implemented by decision-makers, government agencies, and communities as they work together to address community-specific needs and save lives.
2022 年，美国约有 49000 人自杀身亡，临时数据显示，2023 年自杀人数相似。解决上游社区风险和保护因素的综合方法是预防自杀的一个重要组成部分。需要更好地了解这些因素的作用，特别是在受影响不成比例的人群中。
2022 年国家生命统计系统确定了自杀死亡人数。从联邦数据来源中确定的县级因素包括医疗保险覆盖范围、家庭宽带互联网接入和家庭收入。按三分位数分类的因素的比率和水平按种族和族裔、性别、年龄和城市划分进行计算和呈现。
2022 年，自杀率总体为每 10 万人 14.2 人；非西班牙裔美洲印第安人或阿拉斯加原住民（AI/AN）人群的自杀率最高（27.1），男性（23.0）和农村居民（20.0）。平均而言，医疗保险覆盖率（13.0）、宽带互联网接入（13.3）和收入>联邦贫困水平的 100%（13.5）的人群或家庭比例最高的三分之一的县自杀率最低。这些因素与一些不成比例的受影响人群中的较低自杀率更密切相关；在 AI/AN 人群中，这些因素最高三分位的县的自杀率约为最低三分位的县的一半。
社区中更高水平的医疗保险覆盖、家庭宽带互联网接入和家庭收入可能在降低自杀率方面发挥作用。疾病预防控制中心的自杀预防资源行动中详述的上游计划、实践和政策可以由决策者、政府机构和社区共同实施，因为他们共同努力解决特定社区的需求并拯救生命。
