A new report on suicide in Alaska from the State Division of Public Health’s epidemiology section, found rates are higher in more northern regions. Erik Woelber is a graduate student intern with the epidemiology section. Woelber says the study breaks communities into three categories by size and road access and looks at factors that may have contributed to the suicide rate. Woelber says the rates of suicide at higher latitudes merits more research.
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Townsend – The study was exploratory, but there was an interesting finding regarding higher rates at higher latitudes. Tell us about that?
Woelber – According to the model, the suicide was higher at higher latitudes. And the result was statistically significant even when you controlled for things like median income, or the size of the population or whether it was rural or urban, so it’s a really interesting result. Because the study was exploratory , we can’t really say conclusively that suicide does vary with latitude, but it’s certainly an area that we should focus more work on in the future to see if it actually does make a difference.
Townsend – Were there findings within the higher latitude areas, where the higher the latitude, the more the rate or were there distinctions in that regard?
Woelber – Well the rates actually fluctuate quite a bit from community to community. When you’re dealing with suicide, you’re actually dealing with a low probability event. So, in many communities there are actually zero suicides and then you’ll have a few communities that even with one or two suicides, over an eight year period are already at four to five or ten times the national average just because the communities are so small. So, it’s difficult to look at one community and draw a conclusive data from one, which is why we looked at every community statewide. We have about 300 or so census designated places in Alaska and so when you look at 300 communities you can actually start to develop trends statistically.
Townsend – Any idea what may be going on there with the higher latitudes?
Woelber – It’s actually really unclear what the reason is for the association is with latitude. You could say that is has to do with differences that vary with latitude in access to services. You could say there are collinear relationships with funding for suicide prevention or weather or physical activity, access to firearms. At this point, it’s just educated conjecture which one of these variables it might be or if it’s in fact a combination of all of them.
Townsend – Has this been looked at before or was this a surprising finding?
Woelber – Geographic latitude hasn’t really been looked at this way in the state of Alaska. Latitude has been shown to correlate with higher suicide rates in Japan for instance. They have higher suicide rates in more northern prefectures. There are also high suicide rates in circumpolar communities such as in Greenland, which actually has the highest suicide rate in the world, which is five times Alaska’s average.
Townsend – In this study, states that have the highest rates of suicide, also have a lot of geographic area that is rural communities. Talk a little bit about what those findings were and the states that are associated with those higher rates that are in the top one or two in the nation.
Woelber – So this study didn’t look at suicide rates by state nationwide, but the correlation we can draw from national data are still relevant for Alaska. For instance when you look at the rates that have the highest rates of suicide, they’re Alaska, Montana, Wyoming. These are all states that have quite a few things in common. Among those are high amounts of rural areas and also high rates of self reported gun ownership.
Townsend – What’s next, do you plan to zero in the latitude issue and also some of these other factors that come into play in states that have a lot of rural territory.
Woelber – In terms of follow up to this study. I think the main thing is to look at latitude more closely and perhaps design a study that’s more focused on figuring out why there’s a correlation there. As I said before, this study was really exploratory so, when you design an epidemiological study like this, you design it differently when it’s exploratory versus where you’re looking at one variable specifically. So what we’d want to look at if we wanted to look more closely at latitude, is looking for some of the variables that actually affect the relationship between latitude and suicide rate and see if it’s not really latitude or if it’s something else because latitude is just a number. So there’s quite a bit that could correlate with it.
Townsend – How long does it take to develop a study like this?
Woelber – I would say the research community in this area is pretty wide. So it’s not just in Alaska that this type of research is going on. It’s really nationwide or even global. So when you release a study like this, it’s possible that future researchers even if they’re in England or Norway or Sweden or Greenland will see it and then determine that maybe they should control for latitude and for further studies in the future.
Townsend – Other findings?
Woelber – We found a couple things. One was that of all the suicides that happen in Alaska, roughly 79% were male. Which is roughly in line with previous studies that have shown that men are at three to four times increased risk for suicide compared to females. Another was 60% occurring in cities, 14% occurring in small hubs and towns and roughly 26% occurring in rural villages. Rates are still higher in rural areas. They’re about 40 to 45 per 100,000 people per year and cities are 15 to 16 per 100000 per year. The national average is somewhere around 10 to 11 per 100,000 per year and Alaska’s rate overall is 20 to 23 per 100,000
Townsend – In the findings, where you were looking at latitude, were there implications that suggested it was because of the extreme change of light and darkness?
Woelber – So when people hear that suicide rates correlate with latitude, one of the ways that a lot of people have interpreted this is that suicide rates are higher in areas where there are low levels of daylight in the extreme winter months in December and January. However, in Alaska and also in many other places, there’s actually no increase in suicide rates during the winter months. In fact if you look at the last eight years of data, there really isn’t any cyclical trend in suicide rates that’s seasonal over the course of the year. If anything, those rates are slightly higher in May and June. That would seem to suggest that it doesn’t have to do with darkness or seasonal affective disorder in the winter, but we certainly can’t rule out that the extreme seasonal fluctuations in daylight don’t cause some other affect by some other mechanism that’s perhaps not an acute affect.