Key Points:
- Researchers analyzed 122 years of U.S. mortality data to create the most comprehensive long-term picture of national suicide trends ever assembled.
- U.S. suicide rates exhibit a cyclical pattern, rising and falling approximately every 10 to 25 years, with peaks occurring during periods of major social upheaval.
- Suicide risk among young people has been rising steadily for more than half a century, affecting each new generation earlier in life.
IMPACT: The findings support the idea that suicide cannot be understood solely as a matter of individual psychology or biology, but that social context matters – a viewpoint that may spark a fresh approach to prevention efforts.
Suicide rates in the United States follow striking, decades-long cycles likely shaped by broad social forces, according to a major new study published in the Proceedings of the National Academy of Sciences (PNAS). But beneath that long-term rise-and-fall pattern, researchers uncovered a deeply concerning and persistent trend: suicide risk among young people has been rising steadily for more than half a century, affecting each new generation earlier in life.
This study by the REDUCE (Reduce Early Death by Uncovering Causal Explanations) workgroup led by Nina de Lacy, MD, of Huntsman Mental Health Institute at the University of Utah, draws on an unprecedented 122 years of U.S. mortality data, from 1900 to 2021. By combining historically fragmented federal records into the new STACK (Suicide Trends and Archival Comparative Knowledgebase) dataset —the research team, which includes scientists from the University of California at San Diego, Indiana University, and several other units across the University of Utah, offers the most comprehensive long-term picture of U.S. suicide trends ever assembled.
“This is one of the first times we’ve been able to step back and see suicide clearly in a long-term historical context," de Lacy says. "What we found challenges the idea that today’s suicide crisis is purely recent or driven only by individual mental health factors. Suicide appears to be powerfully shaped by what’s happening in society — economically, socially, and culturally — and those forces operate over decades.”
Suicide moves in cycles, unlike most other causes of death
The researchers found that overall U.S. suicide rates exhibit a rare cyclical pattern, rising and falling approximately every 10 to 25 years. Peaks occurred during periods of major social upheaval, including growing industrialization in the early 1910s, the Great Depression in the 1930s, and the women’s rights movement of the 1970s.
“Very few causes of death behave like this,” de Lacy says. “Heart disease, cancer, and motor vehicle deaths generally decline when effective interventions are introduced. Suicide doesn’t follow that pattern. It fluctuates, reverses direction, and resists long-term reduction.”
Despite these cycles and a recent uptick beginning in the early 2000s, the study shows that U.S. suicide rates are not currently at their highest historical levels, countering frequently made claims based on data covering shorter time frames. However, the researchers estimate that, if the nation had consistently maintained its lowest observed age-specific suicide rates, 372,365 deaths could have been prevented between 1969 and 2021.
A youth crisis that began decades earlier than previously thought
The most troubling finding, the researchers note, is the long-term rise in suicide among young people. While public attention often focuses on recent increases among adolescents and young adults, the study found that this trend began in the mid-to-late 1950s — far earlier than previously recognized.
“What we’re seeing is not a short-term spike but a generational shift,” de Lacy said. “Each successive generation has faced higher suicide risk at a younger age than the one before it. That pattern has now persisted for more than 60 years.”
Historically, suicide risk was highest among older adults. Over time, that age divide has narrowed as rates declined among older Americans but climbed among those under 35, including children and adolescents. Today, suicide is among the leading causes of death for people ages 10 to 34.
Surprising shifts in geography and method
The analysis also revealed several unexpected changes in suicide risk patterns:
- Living in large metropolitan areas has emerged as a protective factor, with consistently lower suicide rates than in rural and smaller urban areas since the early 1980s.
- While suicide rates remain higher in rural areas overall, recent increases have been especially pronounced among women in rural and smaller urban communities.
- Suicide by hanging has risen sharply since the 1980s among both males and females, forming what the researchers describe as a “hidden epidemic” that has received less attention than firearm-related deaths, which continue to account for the majority of suicide deaths.
Rethinking suicide as a social phenomenon
The findings reinforce the idea that suicide cannot be understood solely as a matter of individual psychology or biology. Social context matters, often in ways that unfold slowly over generations.
“We can observe them, but we have been mystified by suicide trends over decades,” said Bernice Pescosolido, PhD, a study co-author and director of the Irsay Institute for Sociomedical Research at Indiana University. “But this study and this new dataset are opening up new ideas that we really need to think about.”
De Lacy agrees, emphasizing the implications for prevention efforts.
“If suicide risk rises and falls with broader social conditions, then prevention has to go beyond the clinic,” she said. “We need tailored strategies that address connectedness, community, economic stability, and the lived experience of entire generations, not just interventions targeted at individuals after they’re already in crisis.”
If you or someone you know is struggling, help is available. The Suicide & Crisis Lifeline is available 24 hours a day in the U.S. by calling or texting 988.
Journal
Proceedings of the National Academy of Sciences
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