States' COVID-19 policy contexts and suicide rates among US working-age adults.

Health affairs scholar Pub Date : 2025-03-15 eCollection Date: 2025-03-01 DOI:10.1093/haschl/qxaf024
Emily E Wiemers, Shannon M Monnat, Douglas A Wolf, Jennifer Karas Montez, Joshua Grove, Iliya Gutin, Elyse Grossman
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Abstract

Despite expectations that suicide rates would surge during the pandemic, the national suicide rate declined in the United States in 2020 before returning to pre-pandemic levels in 2021. Explanations of the decline in suicides at the national level include a "pulling-together effect" in the face of a crisis and a shorter than expected pandemic recession. However, suicide rates and the change over time in suicide rates vary substantially across US states. At various times during the pandemic states enacted physical-distancing and economic support policies that may have affected suicide rates. We examined the association between state-level physical-distancing and economic support policy contexts and suicide rates among US adults ages 25-64 years during the COVID-19 pandemic. We found that a 1-SD increase in the stringency of a state's physical-distancing policies was associated with a 5.3% reduction in male suicide rates but was not associated with female suicide rates. Economic support policies were not associated with suicide rates for the period as a whole. The results support the growing evidence that COVID-19 policies had indirect and unintended consequences beyond their direct effect on COVID-19 transmission and death, in this case to reduce suicides among working-age males.

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