A sweeping new study reveals that America’s youth suicide crisis has been quietly escalating, with each generation since the Baby Boomers dying by suicide at higher rates, and at younger ages, than the one before.
The study, co-authored by Bernice Pescosolido, Distinguished Professor of Sociology in the College of Arts and Sciences at Indiana University Bloomington with colleagues from the University of Utah and the University of Virginia, challenges some widely held beliefs, including the idea that rural men and the elderly are the groups most at risk. It also suggests that the interventions that practitioners, policymakers, and public health officials have relied on may need to be refocused.
The researchers find that while suicide rates of older Americans have trended slowly and steadily downward since 1900, becoming more stable over time, suicide rates for Americans under 35 began climbing sharply in the mid-1950s and have largely kept climbing since.
In addition, each successive age cohort appears to carry heavier risk into adulthood than the one before. At age 30, Millennial men (born 1981 to 1996) have suicide rates roughly a third higher than Generation X men (born 1965 to 1980) had at the same age. Gen Z women and girls (born 1997 to 2012) are seeing a steeper climb than any previous generation of young females.
Published in the Proceedings of the National Academy of Sciences, the research draws on 122 years of U.S. death records,from 1900 to 2021, painting the most complete picture ever assembled of suicide trends in America. The study findings show that suicide rates follow a cyclical pattern, rising and falling roughly every 10 to 25 years, unlike almost any other cause of death.
Suicide among young Americans began a sustained climb, the researchers note, with each generation born after World War II facing higher suicide rates than the one before it. Further, the study finds that rural women, not rural men, are now driving the sharpest increases outside of cities.
Yet the new data add an important insight, namely, that living in a large metropolitan area appears to help shield people, especially women, from suicide risk, likely reflecting better access to mental health services and stronger social support networks, though the full picture remains unclear.
“The prevention efforts we’ve been focusing on treat suicide as an individual medical problem,” said Professor Pescosolido. “But when rates double and then halve repeatedly over decades, that tells you something much larger is going on in society itself.”
Pescosolido, who holds a joint appointment at the IU Irsay Institute, has spent decades studying how society shapes mental health outcomes. To conduct the research, the team built a new database called STACK (Suicide Trends and Archival Comparative Knowledgebase), pulling together more than a century of federal death records from sources that did not always use consistent methods of tracking cause of death.
The researchers note that news reports frequently describe today’s suicide rate as the highest in American history, but that’s not entirely accurate. According to the authors’ analysis, the peaks actually occurred during the Progressive Era of the 1910s and the Great Depression in the 1930s.
In addition, the data reveal that suicide doesn’t follow the same steady upward or downward path as most other diseases. Instead, it rises and falls in a cycle, reversing direction roughly every 10 to 25 years. By contrast, cancer death rates decline steadily as treatments improve. Motor vehicle accident deaths fell as seat belt laws were passed and automakers built safer cars. Suicide behaves more like a tide, and no one yet fully understands what drives the trendlines.
But the most striking finding involves young people. For most of the 20th century suicide risk was highest among the elderly. The oldest Americans were dying by suicide at rates 10 times higher than teenagers and young adults. That started to change in the mid-1950s, when suicide rates among people under 35 began climbing while rates among older adults began falling. By the late 1970s, however, the gap had almost disappeared. And the upward trend among young people has never fully reversed.
“We’re finding that age patterns are sensitive to the varying social forces that serve to define the distinct lived experiences of each age group,” Pescosolido said. “What this means in practice is that individual suicide risk depends not only on how old a person is, but on the historical moment in which they grew up.”
The data further show that since the late 1990s the gap between city and rural suicide rates has widened sharply. Rural women are driving the most dramatic increase, the study authors explain, and this pattern challenges the prevalent narrative that economic decline in rural areas is hitting men hardest. The data suggest women in those communities may be bearing an underappreciated burden.
The cyclical, society-wide nature of suicide trends indicates that prevention efforts that focus only on identifying and treating at-risk individuals may be missing the bigger picture. The researchers point to the U.S. Air Force Suicide Prevention Program as a model worth emulating, as it treats suicide as a community-wide challenge requiring community-wide action, not merely a problem for individuals. During its 12 years of full application, the program produced measurable reductions in suicide rates across the service branch.