The Center for Disease Control (CDC) noted in 2016, suicide was the tenth leading cause of death in the United States. Due to this, it has been declared an epidemic, making up 1.4% of all deaths. Suicide is not typically caused by one factor, but several on top . When broken down by cause of death, over 50% of were by firearms. (CDC, 2018) Globally, it is the number two cause of death among people ages 15-29. (WHO) Unfortunately, this does not include either attempted suicides, or suicidal ideation- both of which are equally important. It is estimated for every person that commits suicide, there are between 20 and 25 attempts that go unreported. (AFSP) Suicide and mental health issues do not discriminate; there are no socioeconomic or ethnic groups that are exempt from the tragedy. About 70% of suicides in 2016 were committed by middle-aged white men, at a rate about 3.5x higher than women. A non- exhaustive list of risk factors include; mental health conditions, physical health conditions and pain, access to lethal means, prolonged stress, financial crisis, and exposure to other people’s suicides. Suicide cannot be pinned to exactly one cause, one group, or one method, yet, there are ways to prevent it. Protective factors include familial and cultural support, belief systems that discourage suicide and assist in developing coping mechanisms to encourage self-preservation, problem- solving skills, medical and mental health care supports, and support for help-seeking. (CDC, 2018)
There is still a massive stigma around asking for mental help, even though efforts have been made to minimize it. Additionally, the stigma around suicide varies culture to culture. Interestingly, with “white privilege” being drawn to attention more frequently, it would appear that people of color lack opportunities, have significant differences in financial earnings, and have both systemic and systematic disadvantages in the structure and quality of care they are receiving in the United States. Yet, the suicide rate among people of color is approximately 9% lower than white people. (AFSP) This phenomenon, the “cultural paradox”, is potentially due to coping mechanisms and the scale of traumatic events that have occurred over the lifetime. (Gibbs, 2010) For people of color, systemic and systematic discrimination and oppression have been lifelong barriers, to which they’ve had to develop coping mechanisms. If, for instance, they lost a job, or had a financial crisis, it could be a drop in the pool. However, for a white, male, who has grown up without these barriers, the loss of a job or a financial crisis may push them over the edge, as this could be the most challenging thing they’ve experienced. This is potentially because they have not had to develop critical problem solving skills due to privilege creating significantly fewer problems for them. (Sauaia, 2914) Due to the socially- constructed gender roles put forth by the United States, men are expected to be the “breadwinners” or do almost all earning to support their family. Underperforming in this area can put major financial stress on anyone, but it has been shown to impact white males who are thought to be the one creating familial support significantly more. This may be cultural differences in familial values; in other cultures, family tends to offer stronger supports during difficult times.
Poverty is a large social determinant of health. Living in a poor neighborhood in the United States can mean many disadvantages; poor air quality, freeways, low property taxes that fund poor schools, insufficient access to recreational activities, poor public transportation, insufficient access to fresh and healthy food, and insufficient access to healthcare. The World Health Organization (WHO) notes nearly 80% of all suicides in 2016 occurred in middle and low income countries, while a study during the 2008 recession in the United States insufficient opportunities and resources for those living in poverty were correlated to suicide rate. In line with the aforementioned statistic regarding 7/10 suicides being committed by middle aged white men, data has revealed during the recession, real estate foreclosures were correlated to suicide rates. (SPRC, 2017) Approximately 72% of the homeowners foreclosed on and committed suicide were white. (Houle, 2010) The CDC’s first recommendation to lower risk for suicide is to strengthen economic supports. (2018) Poverty is a risk factor for suicide, as “basic and clinical experiments have consistently showed the negative effect of prejudice related stress on the immune system…as well as disabling mental illnesses and unhealthy behaviors.” (Sauaia, 2014) Typically discrimination is thought of in terms of minority groups. However, discrimination is often times against people of lower socioeconomic status; classism remains alive and well in the United States. In the United States, only 9% of white people are impoverished, sobering when contrasted to a poverty rate of 22% for black people across the country. 91% of white people in the US are living above the poverty line, yet they make up nearly 70% of the suicides. (Kaiser Family Foundation, 2018) This may be attributed to the cycle of poverty; poorness is intergenerational. For instance, if your parents are poor, you will live in a poor neighborhood, attend a school that offers a poor education because it is funded by low property taxes, be unable to afford a college education, and be unable to receive a high paying job to end the cycle. Upward mobility is more probable for whites while downward mobility is more probable for blacks. (Torche, 2017) If 22% of blacks are living in poverty, unable to break this cycle, as compared with 9% of whites that are less likely to become impoverished, the weight of the stress inflicted is absorbed differently each race. White people that have poverty or loss of income forced on them for the first time in their lives may well be experiencing classism for the first time, whereas people of color who have this forced on them have more likely experienced a lifetime of “-ism” s. This discrimination, in conjunction with stress from insufficient control over one’s life, physically damage the body’s equilibrium- maintaining mechanisms, creating cumulative stress referred to as “allostatic load”. Though allostatic load may be higher in people of color, they have been observed to engage in stress- lowering activities when faced with stressors. White people, comparatively, have been observed to higher rates of depression correlated with stressors. (Sauaia, 2014)
There are significant disparities in the care received by those in the United States living with serious mental illness below the poverty line when compared to those living significantly above the poverty line. Access to healthcare, especially mental healthcare, for those living in poverty is also limited. Up to ninety percent of suicides in Western society report mental disorders as a contributing factor to the event, yet only 41% received treatment. (Goldsmith; Mental Health America, 2016) This, clearly shows that countless people requiring treatment have not received it. In terms of mental healthcare, people with low income are less likely to spend their already limited resources on something they feel they may not need to survive, as opposed to using those funds for food and shelter for themselves and their families. In communities where food, shelter, or being able to afford to keep the lights on are already difficult, making time to quit working to pay a professional for mental help is difficult. Furthermore, the head of household is likely the one feeling most of the earning pressure having the potential to magnify any existing mental health concerns, or increase the likelihood of the onset of mental illness. (Hudson) If these people have children, further resources must be expended to keep these children while they are attending appointments, which they have to have transportation to get to. Mental healthcare for the poor is out of reach. To receive this care and support, primarily, there needs to be affordable access to the care. Next, transportation to the care facility, at the absolute minimum. At the next level, being able to absorb a pay cut from missing work to go to an appointment, or finding someone to take care of children so a parent can go to an appointment outside of school hours. Then, on a social level, finding the support from those around a person to seek help. All these are risk factors for suicide, and side effects of poverty.
Suicide is a complex issue. Data is revealing that middle-aged, white men are most susceptible to suicide, magnified when poverty is incorporated into the equation. White people only make up 9% of the impoverished, yet white males make up 70% of all suicides. This can potentially be attributed to poor self- preservation mechanisms, as well as problem- solving methods that are underdeveloped. Stigma in white culture around suicide is much less taboo than that in other cultures; rather than it being perceived as a sign of weakness, it is a sign of a lost battle. In other cultures, suicide is considered a weakness and shameful, which is actually a protective factor. White culture and familial values are also a risk factor when compared to other cultures, as other cultures place family bond and faith systems on a higher pedestal, allowing for more open communication and development of trust to talk about challenges.