People with debt burden significantly more likely to attempt suicide
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Debt burden significantly increased risk for suicide attempt, according to results of a national study of adults in the United States published in Journal of Clinical Psychiatry.
“Several studies conducted in the United States [have evaluated] associations between debt and health, and one previous report of suicide rates based on national death certificate records in the United States found that financial difficulties contributed to suicide for persons with and without mental health conditions,” Diana E. Naranjo, MPH, of the department of health services at the University of Washington’s School of Public Health, and colleagues wrote. “However, national-level data on the association between self- perceived debt burden, specifically, and suicide are needed to describe the extent of this problem in the United States.”
The researchers analyzed data of 36,278 adults aged 18 years or older who participated in the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013) using logistic regression to assess the link between self-reported past-year debt burden and past-year and lifetime suicide attempt, controlling for sociodemographic characteristics with proven links to debt burden and suicide attempt.
Results showed past-year debt burden among 13.03% of participants, past-year suicide attempt among 0.37% of participants and lifetime suicide attempt among 5.16% of participants. Those who reported debt burden had higher likelihood of self-reported attempt compared with those without debt burden, including for past-year suicide attempt, with an unadjusted OR of 7.96 (95% CI, 5.45-11.64) and an OR of 3.39 (95% CI, 2.15-5.34) when adjusted for sociodemographic variables and mood disorders. Naranjo and colleagues reported an adjusted prevalence of past-year suicide attempt among those with and without debt burden of 0.75% (95% CI, 0.5-1) and 0.23% (95% CI, 0.17-0.29), respectively.
“Findings identify debt burden as a strong social determinant of suicide risk and potentially a call for strategies to reduce financial debt among U.S. adults to improve population health,” the researchers wrote. “Future research is needed to better understand the experience of debt burden and suicide in U.S. adults, who are increasingly experiencing this burden.”
Perspective
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This study takes an important first step in understanding the role of debt in suicide risk. Debt is often associated with larger social structures, such as housing and education, both of which are rife with inequity and discrimination. Most suicide research focuses on individual and intrapsychic risk factors. While important, understanding the role of systems-level factors on suicide risk is essential. After adjusting for sociodemographic characteristics, adults with debt burden were nearly six times as likely to report past-year suicide attempt than adults without debt burden.
I hope future studies parse out types of debt, like student debt. If those studies find a similar trend of increased debt correlating with increased risk for suicide attempt, it would provide a strong argument for reducing or forgiving student debt, particularly for Black and American Indian/Alaska Native Americans. Suicidologists should welcome this study as contributing to the growing recognition of the need to understand the social determinants of health.
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