Aging, Major Life Transitions, and Suicide Risk

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SUMMARY Suicide is the 10th leading cause of death in the US, with over 42,000 cases annually. There is an urgent need to identify modifiable risk factors that can inform public health prevention strategies. This proposed research seeks to leverage and integrate several existing datasets to support novel secondary analyses aimed at identifying predictors, moderators, and mitigators of suicide risk from a life course approach. This proposal will (1) Examine how major life transitions in four domains (e.g., social relationships, health, work/school, and residence/moving) relate to suicide-risk behaviors and suicide mortality over the life span; and (2) Examine individual-level moderators (e.g., age, sex, race/ethnicity, mental health history, and medical comorbidities) of the relationship between major life transitions and suicide risk over the life span; and (3) Examine how contextual characteristics (e.g., neighborhood socioeconomic status, residential segregation, indicators of social capital) moderate the relationship between major life transitions and suicide risk over the life span. This proposed research will use two ongoing, nationally-representative longitudinal studies that collectively cover adulthood: the Americans’ Changing Lives (ACL, ages 25+, surveyed six times since 1986) and the Health and Retirement Study (HRS, ages 51+ surveyed biennially since 1992). The ACL and HRS have multiple measures of suicide-risk behaviors and are being linked to the National Death Index (NDI) to identify suicide deaths. The ACL and HRS have existing linkages to multiple external datasets which index macro-level contextual characteristics. In addition, we will leverage restricted-access data from the National Violent Death Reporting System (NVDRS), the most comprehensive registry of suicide mortality in the US (n~250,000 suicide deaths of all ages from 2003-2018), which contains both quantitative and qualitative data on major life transitions in the context of suicide mortality. We will link the NVDRS data using geographic identifiers to multiple external datasets to characterize macro-level contextual moderators of suicide mortality. Impact: Empirical research on the long-term influences of complex, intersecting and time-varying factors that contribute to suicide risk within and across subpopulations is lacking. This project will address this gap in scientific understanding by providing an innovative, integrated set of analyses that seek to comprehensively examine the ways that life transitions intersect with individual and macro-level characteristics to shape suicide risk over the life span. Findings will examine theorized but under-researched risk factors, clarify potential points of engagement, and inform targeting and prioritization of existing preventive interventions.