Increased rates of suicide ideation and attempts in rural dwellers following the SARS‐CoV‐2 pandemic

• Published in: The Journal of rural health Vol. 39; no. 1; pp. 30 - 38
• Main Authors: Salt, Elizabeth, Wiggins, Amanda T., Cerel, Julie, Hall, Claire‐Marie, Ellis, Misty, Cooper, Gena L., Adkins, Brian W., Rayens, Mary Kay
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 2023; John Wiley and Sons Inc
• Subjects: Adult; Adults; Child; COVID-19; COVID-19 - epidemiology; Demographics; Economic factors; emergency department; Emergency medical care; Emergency medical services; Emergency services; Ethnicity; Health care access; Hispanic people; Humans; inpatient; Inpatient care; Latin American cultural groups; Male; Males; Mental health; Minority & ethnic groups; Original; Pandemics; Pediatrics; Race; Risk Factors; rural; Rural areas; Rural communities; Rural health care; Rural Population; Rural populations; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Statistics; Substance abuse; Substance use; Suicidal Ideation; Suicide; suicide attempt; suicide ideation; Suicides & suicide attempts; urban; Weapons; suicide ideation; urban; inpatient; rural; suicide attempt; emergency department; demographics
• ISSN: 0890-765X; 1748-0361
• DOI: 10.1111/jrh.12686

Purpose
Those factors identified to increase the risk of suicide in rural dwellers were exacerbated by the SARS‐CoV‐2 pandemic, specifically economic factors, substance use, access to health care, and access to lethal weapons. Because the effects of SARS‐CoV‐2 on suicide ideation and attempts in rural populations have not been fully characterized in published literature, this study compares: (1) the rates of suicide ideation and attempts between the 6 months affected by SARS‐CoV‐2 to same months of the preceding year (3/18/2020‐9/18/20; 3/18/2019‐9/18/19), (2) demographics (ie, age, sex, residence, race, and ethnicity), and (3) the locations in which the encounters were billed (inpatient, outpatient, and emergency department).
Methods
Deidentified claims data associated with patient encounters billed for Suicide Ideation and Suicide Attempt were grouped based on time period and analyzed using descriptive statistics, incidence rate ratio (IRR), 2‐sample t‐test, chi‐square test of association, or Fisher's exact test.
Findings
Suicidal ideation encounters increased in the 6 months post‐SARS‐CoV‐2 when compared to the 6 months of the prior year (IRR = 1.19; P < .001). Males (IRR = 1.27, P < .001), those residing rural areas (IRR = 1.22, P = .01), and Black, non‐Hispanic (IRR = 1.24, P = .024) were found to have increased rates of suicide ideation post‐SARS‐Cov‐2. In adults, White, non‐Hispanics (IRR = 1.16; P < .001) had increased rates of post‐SARS‐CoV‐2. In the pediatric subset, those who were aged 14‐17 (IRR = 1.50; P < .001), resided in rural areas (IRR = 1.61, P = .009), and idenitifed as Hispanic (IRR = 1.89; P = .037) or Black, non‐Hispanic (IRR = 1.61, P = .009) had increased rates post‐SARS‐CoV‐2.
Conclusions
Our study identified rural dwellers to be at increased risk for suicide ideation.