CDC: Suicides made up majority of violent deaths in 2021

Key takeaways:

• Mental health issues were the most common precipitating circumstance for suicide.
• Homicides accounted for 31.5% of violent deaths.

In the United States, 41,116 people died by suicide in 2021, making suicides the leading type of violent death that year, MMWR data showed.

Healio previously reported that suicide deaths reached a new height in 2022, totaling nearly 50,000 for a 3% increase from the previous year.

“Monitoring the prevalence of violence-related fatal injuries, defining priorities, and informing prevention activities are essential parts of public health surveillance,” Brenda L. Nguyen, MPH, an epidemiologist at the CDC, and colleagues wrote.

The researchers utilized National Violent Death Reporting System (NVDRS) data to assess the number, circumstances and characteristics of violence-related deaths in 2021.

Overall, there were 68,866 fatal incidents involving 70,688 deaths that occurred in 48 states and Washington, D.C. Among the deaths:

• 58.2% were suicides;
• 31.5% were homicides;
• 8.2% were deaths of undetermined intent that could have been due to violence;
• 1.3% were deaths due to “legal intervention,” like law enforcement using deadly force in the line of duty; and
• less than 1% were unintentional firearm deaths.

Nguyen and colleagues also found that 59.2% of deaths involved firearms.

Among suicide victims, when the circumstances were known (84.4%), the suicide was often preceded by mental health conditions, as 49% of victims were currently diagnosed with a mental health problem and 29.2% experienced a depressed mood at the time of death.

“Approximately one-third of suicide decedents had a history of suicidal thoughts or plans, and nearly one-fourth had disclosed their suicidal intent,” the researchers wrote. “Less than one-fourth of suicide decedents were known to be receiving treatment at the time of death, indicating a gap between those receiving treatment and those who would likely benefit from it.”

The most common interpersonal issues or life stressors that preceded suicides included physical health (19.9%), intimate partner issues (25%) and an “impending crisis” (30.1%), according to the researchers.

The overall suicide rate was significantly higher for males aged 10 years or older (26.6 per 100,000 people) than females (6.5 per 100,000). Meanwhile, non-Hispanic American Indian or Alaska Native individuals had the highest suicide rate among all racial and ethnic groups (30.2 per 100,000).

Among homicide victims, those aged 20 to 24 years had the highest rate (30.6 per 100,000) among all age groups. The researchers also found that Black individuals had higher rates of homicides, accounting for 61.1% of male homicide victims and 43.5% of female homicide victims.

Homicides, when the circumstances were known (70.3%), were often preceded by an argument or conflict (33.5%) or an intimate partner issue (14.3%).

There were some study limitations, according to Nguyen and colleagues. For example, they noted that the NVDRS data and findings are not nationally representative. Additionally, suicide deaths among children aged 5 to 9 years were not included in the results due to the small number of suicides within that age group.

“Violence is preventable and reducing deaths in communities is possible with evidence-based approaches,” the researchers wrote.

They added that such interventions can include “social-emotional learning programs, enhanced parenting skills and family relationships, treatment for persons at risk for suicide, and treatment to prevent reattempts.”