Sex Differences in Older Adult Suicide

The authors of a study of suicide among adults 60 years of age and older concluded that “a better understanding of the multi-faceted differences between male and female older adults who take their own lives can help to develop a more comprehensive understanding of specific outcomes so that targeted prevention strategies may be implemented.” They suggested that older adult males “may benefit greatly from programs that seek to keep them active in later life, facilitate their access to mental health services, assist them in dealing with immediate crises, and evaluate their access to highly lethal weapons.” Older adult females…may benefit greatly from services to assist them in the earlier stages of the aging process, dealing with widowhood, and close monitoring of prescription medications….”

The researchers carried out this study using 2007-2009 data from the National Violent Death Recording System to learn how to meet the differing suicide prevention needs of older men and women, and to demonstrate the value of surveillance systems for understanding suicide. The data analysis revealed that older men die by suicide at a rate nearly six times that of women. The rate for men increases with age, while the rate for women remains fairly level. There were some patterns common to both men and women. The most common location of suicide by both sexes was the home, the most common means were firearms, and the most common precipitator was physical illness. Fewer than one in four older adults who died by suicide were known to have a history of suicide attempts.

But there were also important differences between men and women. The rate of firearms-related suicide for men was more than 11 times that of women. Firearms were involved in 78 percent of suicides by men and 38 percent of women. The second leading means of suicide by men (behind firearms) was hanging/strangulation/suffocation (10 percent). In contrast, women most often used poison (41 percent). Most suicide by poisoning by both sexes involved prescription drugs, although women were more likely to be tested for drugs after a suicide than men. Depression and dysthymia accounted for about 80 percent of the mental health diagnoses among both sexes. But women were significantly more likely to have been diagnosed for mental health problems, to be in treatment at the time of their death, and to test positive for antidepressants and opiates.

SPRC Commentary:

This study highlights the value of the National Violent Death Reporting System (NVDRS) as a tool for understanding suicide and planning prevention activities. The NVDRS includes a wealth of information that is not included in the National Vital Statistics System, including variables related to mental health issues and treatment (including drug and alcohol abuse); precipitating events (including legal, school, or financial problems and the death or suicide of family members or friends); and whether the person who died had a history of suicide attempts or disclosed an intent to die by suicide prior to the event. The ability of the NVDRS to generate state data is a powerful method of showing how suicide “hits home” which can help generate support for suicide prevention among policymakers and other stakeholders.

Karch, D. (2011). Sex differences in suicide incident characteristics and circumstances among older adults: surveillance data from the National Violent Death Reporting System—17 U.S. states, 2007-2009. International Journal of Environmental Research and Public Health, 8(8):3479-3495. (Full-text of this article is freely available.)

For more information and to access NVDRS data online.