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Study Shows Pandemic Tied To Spike In Suicide Among Black People

MICHEL MARTIN, HOST:

We're going to move to another topic now - one that also touches on guns. The statistics show that a majority of gun deaths in America are actually suicides. And for the past year, many experts and laypeople alike have worried that the mental health stresses of the pandemic - isolation, job loss, lockdowns, the constant reminders about sickness and death - could lead to an increase in suicides. And while scientists are still combing through the data, the early findings suggest that might not have been the case except for one group - African Americans.

According to one alarming recent study focusing on just one state during the first weeks of the lockdown, but alarming nonetheless, suicide mortality among African Americans nearly doubled while decreasing substantially among white residents.

We wanted to learn more about this study, which focused on Maryland, so we called one of the co-authors. Dr. Paul Nestadt is assistant professor of psychiatry at Johns Hopkins University in Baltimore and a researcher who studies suicide. And before we continue, let me note that we know that this is a topic that may be upsetting to some, so if that's the case, we invite you to step away for a few minutes, and we'll be happy to welcome you back later on.

Having said that, Dr. Nestadt, thank you so much for joining us.

PAUL NESTADT: Thank you for having me.

MARTIN: So let's get all the sort of the disclaimers and the metrics and the caveats out there. Again, the study focused just on data from Maryland. And you compare data from three distinct periods - pre-COVID, while closures were happening, and then while reopening was happening - and you compared this information to the same periods in previous years. Do I have that right?

NESTADT: That's absolutely right.

MARTIN: So let me just read from the paper. (Reading) Among Black residents, suicide mortality appeared to double during period two compared with the means in 2017 to 2019. In contrast, suicide mortality appeared nearly halved among white residents during period two and three compared with the means of 2017 to 2019. And you point out that the population didn't change substantially between 2017 to 2019, so this would be - that's a significant change.

NESTADT: Yeah, it's very significant. It actually was surprising in a couple of different ways. For one, as you mentioned, many experts thought that suicides in general were going to go up a lot during the pandemic because of all of those stressors that you listed at the beginning of the show. We didn't see that happen in aggregate.

But when we disaggregated the data, as you said, the - during that, I guess we can call it now, the first wave of COVID in Maryland, in the United States in general, there was this incredible doubling of the suicide numbers in African Americans here.

MARTIN: What made you want to look at this? As you point out in the piece, that to your knowledge, this is the first to characterize suicide trends by race and ethnicity during COVID-19. What made you take a look at this?

NESTADT: Well, part of it is knowing that even if there is an aggregate decrease in suicide during COVID, as we were starting to see in Maryland, there are vulnerable populations that were hit more by COVID than others. We know that Black Marylanders had higher rates of COVID infection - this is the case nationwide as well - and also, once infected, higher case fatality rate.

So, basically, this pandemic hit Black Marylanders a lot harder than white Marylanders. So there was reason to believe that there might be more distress, and suicide has traditionally been a marker of distress in our data.

MARTIN: But why do you think that is, though, given that - I think your study indicates that suicide is more common generally among the white population. Is that accurate?

NESTADT: That's true. That's true about nationwide, a majority of suicides are white. White Americans have a higher rate of suicide than Black Americans in general.

MARTIN: And in Maryland as well.

NESTADT: In Maryland as well.

MARTIN: So this is a significant change. Do you have a theory about why that is?

NESTADT: Yeah. Well, you know, we can make a lot of assumptions. I have some theories. I think part of it, as I mentioned, Black Marylanders were hit harder by the pandemic. They might have had less of an economic cushion to withstand things like job loss or less ability to draw on resources for things like child care. And there is no way to know for sure with these particular suicides if the pandemic played a role. But the correlation to the increase in infections and deaths and the suicide rate is hard to ignore.

It might also be an issue of access to care. We know that Black Americans in general - and Black Marylanders are no exception - have more difficulty accessing care, have a higher likelihood of not having insurance. And that applies to mental health care as well. So having the ability to reach out and get help when you need help is really important. And that's something that we can prioritize and make sure there are resources available for everyone that needs psychiatric help when needed.

MARTIN: I am going to make an assertion here which you may or may not agree with, but I'm going to make an assertion here that I think we don't often see African Americans as people who are vulnerable to suicide. And I wonder if you feel that this study amplifies our understanding of this as a significant concern.

NESTADT: I absolutely think that you're correct. Because the majority of suicides have been among white Americans, there's been too little focus on suicides on people of color. We have had a relatively good history of looking at suicide in Native American, American Indian populations because there's high rates there as well. But specifically Black Americans, the rates have been going up faster than they have in white Americans.

But we're recognizing more and more that risk for suicide is up there and increasing for Black Americans, especially younger Black males. In the white population, we see suicides more in middle age and sort of very old, like after 85. But the risk period is highest for Black Americans around age 20. And that's arguably much more tragic, to lose someone so young.

MARTIN: Dr. Paul Nestadt is assistant professor of psychiatry at Johns Hopkins University. He's one of the co-authors of a recent study on suicide mortality in Maryland during the early weeks of the coronavirus pandemic. The study's published in the April 2021 issue of JAMA Psychiatry.

Dr. Nestadt, thanks so much for talking to us today.

NESTADT: Absolutely. Thanks for having me.

(SOUNDBITE OF BLAZO'S "DOUBLE SILVER") Transcript provided by NPR, Copyright NPR.