National Vital Statistics Reports Volume 69, Number 11 September 11, 2020

State Suicide Rates Among Adolescents and Young Adults Aged 10–24: United States, 2000–2018 by Sally C. Curtin, M.A.

Abstract adolescents and young adults (3). A recent report from the National Center for Health Statistics found that the suicide death Objectives—This report presents suicide death rates among rate among persons aged 10–24 increased 56% from 2007 persons aged 10–24 for the United States and by state for 2000 through 2017 (1). This report extends the previous analysis of through 2018 and percent change between 3-year periods of deaths by suicide among youth aged 10–24 by including rates for 2007–2009 and 2016–2018. Suicide rates are compared among 2018, the latest year for which final mortality data are available, states for 2016–2018. and by presenting suicide numbers and rates for persons aged Methods—Data are from death certificates from all 50 states 10–24 by state where it is possible to provide a statistically and the District of Columbia. Suicide rates among persons aged reliable rate, from 2000 through 2018. Three-year averages of 10–24 per 100,000 population are computed for each year from suicide rates for 2007–2009 are compared with those for 2016– 2000 through 2018 for the states and years where sufficient 2018 for all states. cases existed to produce reliable rates. Percent change between 3-year averages of suicide rates for 2007–2009 and 2016–2018 are computed for each area except the District of Columbia. Data Source and Methods Suicide rates for 2016–2018 are compared among states. Results—Nationally, the suicide rate among persons aged Mortality data are from the National Center for Health 10–24 was statistically stable from 2000 to 2007 and then Statistics’ 2000–2018 multiple cause-of-death mortality files (4). increased 57.4%, from 6.8 per 100,000 in 2007 to 10.7 in 2018. Deaths to persons aged 10–24 that were assigned an International Between 2007–2009 and 2016–2018, suicide rates increased Classification of Diseases, 10th Revision (5) underlying cause- significantly in 42 states, increased nonsignificantly in 8 states, of-death code for suicide (U03, X60–X84, and Y87.0) were and were not possible to assess in the District of Columbia due selected. Data are based on 100% of resident deaths registered to small numbers. Significant increases ranged from 21.7% in in the United States. Maryland to a more than doubling of the rate in New Hampshire. In 2016–2018, suicide rates for persons aged 10–24 were Rates and significance testing highest in Alaska, while some of the lowest rates in the country The suicide rate is the number of deaths due to suicide were among states in the Northeast. to persons aged 10–24 per 100,000 population aged 10–24. Keywords: intentional self-harm • underlying cause of death • Numbers are presented for the areas and years in which suicides National Vital Statistics System numbered at least 10, and rates are computed when suicides numbered at least 20. The District of Columbia had fewer than 10 suicides to persons aged 10–24 for each year of the period, Introduction and thus their numbers and rates are suppressed for every year. Population data for 2000 and 2010 are April 1 bridged-race census Youth suicide has become an increasingly prominent counts, for 2001–2009 they are July 1 intercensal estimates, and public health issue (1,2). Recent research has documented for 2011–2018 they are July 1 postcensal estimates based on increases from 2005 to 2017 in serious psychological distress, the 2010 census. major depression, and suicidal thoughts and attempts among

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm. 2 National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020

Figure 1. Percent increase in suicide death rates among persons aged 10–24 years: United States and selected states, 2007–2009 to 2016–2018

Maryland 21.7 Mississippi 26.6 Florida 29.2 Iowa 30.2 Arizona 30.3 Alaska 31.4 Minnesota 32.9 Wisconsin 33.7 Tennessee 33.8 California 38.0 North Carolina 38.6 Nebraska 38.8 New Jersey 39.0 Illinois 41.4 North Dakota 43.0 Alabama 43.0 New York 43.9 Kentucky 43.9 Arkansas 45.1 Louisiana 45.3 Montana 45.9 Hawaii 46.2 Texas 47.1 Total 47.1 (U.S. average) Ohio 48.0 Utah 49.5 Colorado 51.3 Pennsylvania 53.6 Idaho 55.0 Nevada 55.8 South Carolina 56.0 Maine 56.0 Virginia 58.6 Indiana 59.2 Kansas 60.2 Massachusetts 64.1 Washington 67.1 Michigan 70.1 Oklahoma 70.3 Missouri 71.3 Georgia 76.3 Oregon 79.3 New Hampshire 110.0

0 20 40 60 80 100 120 Percent

NOTES: The 42 states shown are those that had significant percent increases between 2007–2009 and 2016–2018. Suicide deaths are identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes U03, X60–X84, and Y87.0. SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality. National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 3

Due to small (fewer than 20) single-year numbers in some rates increased significantly in 42 states. Nonsignificant areas, 3-year averages of suicide rates were computed for the increases occurred in 8 states. Due to small numbers, trends periods 2007–2009 and 2016–2018 to facilitate comparisons in were not possible to assess in the District of Columbia. Significant those areas. All of the changes in rates noted in the text were increases ranged from 21.7% in Maryland (from 6.0 in tested for statistical significance. The percent change between 2007–2009 to 7.3 in 2016–2018) to a more than doubling of the 2007–2009 and 2016–2018 was tested using the z test statistic rate in New Hampshire (from 7.0 to 14.7) (Figure 1). The majority at an alpha level of 0.05 when both rates were based on 100 or of states, 32 in total, had significant increases of between more births or a comparison of the 95% confidence limits for 30%–60%. rates where one or both were based on fewer than 100 deaths to determine if the limits overlap. More detail on statistical State comparisons in suicide rates for significance tests are published elsewhere (6). 2016–2018 The 2016–2018 suicide rate among persons aged 10–24 Results was highest for Alaska (31.4 per 100,000) (Figure 2). Other states with among the highest suicide rates were South Dakota (23.6), Trends in suicide rates Montana (23.2), Wyoming (20.5), and New Mexico (19.6). The lowest suicide rates were among states in the Northeast: New After a period of stability from 2000 to 2007 as shown Jersey (5.7), Rhode Island (5.9), New York (5.9), Connecticut previously (1), the suicide rate among adolescents and young (6.3), and Massachusetts (6.4). Despite having among the lowest adults aged 10–24 in the United States increased 57.4% from rates, New Jersey had a 39.0% increase between 2007–2009 6.8 per 100,000 in 2007 to 10.7 in 2018 (Table). When examining and 2016–2018, New York had an increase of 43.9%, and the change in rates between 3-year averages of the periods Massachusetts had an increase of 64.1%. 2007–2009 (7.0) and 2016–2018 (10.3), the national percentage increase was 47.1%. From 2007–2009 to 2016–2018, suicide

Figure 2. Suicide death rates for persons aged 10–24: United States, 2016–2018

WA ME MT ND VT OR MN NH ID SD WI NY CT MA WY MI RI IA PA NE NV OH NJ IN UT IL DE CO WV MD CA VA KS MO KY DC NC TN AZ OK NM AR SC GA MS AL 10.0 and under 10.1–11.4 TX LA 11.5–14.9 15.0 and over FL Rate not shown; AK fewer than 20 U.S. rate = 10.3 deaths

HI

NOTES: Rates are 3-year averages of suicide deaths in 2016–2018 per 100,000 population of persons aged 10–24 in each area. Suicide deaths are identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes U03, X60–X84, and Y87.0. SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality. 4 National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020

Summary Detailed Table Between 2007 and 2018, the national suicide rate among Suicide death rates among persons aged 10–24: United persons aged 10–24 increased 57.4%. The increase was broad, States, each state and the District of Columbia, 2000–2018 and 3-year averages for 2007–2009 and 2016–2018 ...... 5 as it was experienced by the majority of states. Forty-two states had significant increases in their suicide rates between 2007–2009 and 2016–2018, and eight states had nonsignificant increases. Most states had increases of between 30%–60%. Suicide rates in 2016–2018 were highest in Alaska and lowest in New Jersey. A limitation of this report is that the small number of suicides to persons aged 10–24 in some states in a given year can make it difficult to evaluate changes in rates between years. Three-year averages in rates were computed for 2007–2009 and 2016–2018 to facilitate comparisons in areas where single-year comparisons were not possible. Even using 3-year averages, some areas had relatively small numbers, which can result in a lack of the statistical power needed to achieve statistical significance even when the percent change between rates is relatively large. For example, the suicide rate for Delaware increased 48.4% between 2007–2009 and 2016–2018, from 6.2 to 9.2 per 100,000, a percentage increase that was higher than the national average and among the top one-half of percentage increases among states. However, the Delaware rates are based on a relatively small number of deaths for both 3-year periods (34 and 49, respectively), and therefore the increase was not statistically significant. Accordingly, assessment of changes by state should take into account the number of deaths and indications of statistical significance presented in the Table and Figure 1.

References 1. Curtin SC, Heron M. Death rates due to suicide and homicide among persons aged 10–24: United States, 2000–2017. NCHS Data Brief, no 352. Hyattsville, MD: National Center for Health Statistics. 2019. 2. David-Ferdon C, Simon TR. Preventing youth violence: Opportunities for action. National Center for Injury Prevention and Control. 2014. Available from: https://www.cdc.gov/ violenceprevention/youthviolence/pdf/opportunities-for-action. pdf. 3. Twenge JM, Cooper AB, Joiner TE, Duffy ME, Binau SG. Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. J Abnorm Psychol 128(3):185–99. 2019. 4. National Center for Health Statistics. CDC WONDER. Underlying cause of death, 1999–2018. 2020. Available from: https://wonder. cdc.gov/ucd-icd10.html. 5. World Health Organization. International statistical classification of diseases and related health problems, 10th revision (ICD–10). 2008 ed. Geneva, Switzerland. 2009. 6. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf. National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 5 * … … … … … … … … … … … 14.5 48.4 † 45.1 † 31.4 † 29.2 † 30.3 † 38.0 † 47.1 † 51.3 † 43.0 Percent change Percent and 2016–2018 between 2007–2009 * 49 19 6.3 8.4 6.9 9.2 238 134 145 916 551 577 323 13.2 31.8 12.9 10.3 17.4 11.3 1,624 2018 2016– 19,735 * 34 13 9.1 5.5 6.5 9.9 5.0 6.2 7.0 7.9 162 118 115 703 395 349 234 24.2 11.5 1,216 2009 2007– 13,463 * 41 45 22 74 †† 5.8 8.7 7.0 320 212 546 205 116 12.3 30.2 14.7 12.5 10.7 18.5 12.2 6,807 2018 * * 56 47 14 96 †† 7.9 8.5 7.1 310 179 561 192 109 31.1 12.6 10.6 16.0 17.5 11.4 6,769 2017 * * 37 53 13 68 †† 98 5.2 7.9 6.5 9.6 286 160 517 180 34.1 11.3 11.3 16.3 10.2 6,159 2016 * 38 60 21 61 †† 93 5.3 8.4 6.3 9.2 9.6 303 170 506 183 37.6 12.1 11.7 10.1 16.7 5,900 2015 * * 46 39 †† 69 †† 74 6.3 7.9 5.5 8.5 7.5 288 153 444 150 24.1 10.9 11.4 13.9 5,515 2014 * * 32 44 15 74 †† 84 4.4 6.9 6.0 8.1 8.5 251 139 486 143 27.0 10.0 12.2 13.5 5,264 2013 * * 38 38 19 67 †† 75 5.3 7.8 5.3 8.0 7.5 284 143 432 140 23.7 10.4 11.1 13.4 5,178 2012 * 43 36 20 62 †† 83 6.0 7.1 5.7 7.9 8.3 255 156 466 122 22.6 11.4 10.9 10.3 11.8 5,104 2011 * * 51 13 58 †† 82 39 5.4 6.4 5.7 7.6 9.7 8.2 228 144 468 125 32.4 10.6 12.2 4,867 2010 * * 37 12 59 †† 77 43 6.6 9.3 5.1 7.2 9.9 7.7 6.0 238 125 418 139 23.7 13.7 Year Year 4,630 2009 * * 45 12 61 †† 80 42 6.5 9.7 5.0 7.0 8.0 5.8 232 130 409 116 28.3 10.3 11.5 4,513 2008 * * 33 10 42 94 †† 77 33 6.5 4.8 6.8 7.1 9.4 7.8 4.6 233 140 389 20.6 10.6 4,320 2007 * * 44 14 45 †† 88 36 5.9 5.2 6.9 7.6 8.9 5.0 208 165 424 120 27.1 12.8 12.0 4,405 2006 * * 31 †† 62 †† 67 35 6.6 4.8 7.0 6.8 4.9 231 163 388 142 19.1 12.9 10.5 14.3 4,482 2005 * * 47 †† 40 †† 87 40 6.6 5.6 7.3 6.8 8.9 5.7 225 140 449 114 29.0 11.4 11.5 4,599 2004 * * 35 12 43 87 †† 65 24 5.0 6.7 7.3 8.8 6.7 3.5 6.0 136 394 199 22.0 11.3 4,232 2003 * * 33 12 59 †† 68 26 4.4 6.9 7.0 3.8 6.4 142 346 113 207 21.0 12.0 10.1 11.5 4,270 2002 * * 15 50 †† 69 39 28 4.4 9.9 6.9 8.6 7.2 5.9 6.7 338 114 108 209 18.4 11.2 4,243 2001 * * †† 96 54 †† 75 34 51 4.6 7.2 9.4 7.9 5.3 6.6 344 135 199 12.0 10.4 35.0 4,294 2000 ...... Area Total Total Alaska Florida Arizona ...... Alabama Colorado Delaware Arkansas

California Columbia District of Connecticut Number Rate Number Number Rate Rate Number Rate Number Rate Number Number Rate Rate Number Rate Number Rate Number Rate Number Rate Table. Suicide death rates among persons aged 10–24: United States, each state and the District of Columbia, 2000–2018 3-year averages for 2007–2009 Table. 2016–2018 [Rates per 100,000 population enumerated as of April 1 for 2000 and 2010, estimated July all other years] See footnotes at end of table. 6 National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 … … … … … … … … … … … † 59.2 † 55.0 † 76.3 † 30.2 † 41.4 † 46.2 † 60.2 † 43.9 † 21.7 † 45.3 † 56.0 Percent change Percent and 2016–2018 between 2007–2009 87 90 8.2 7.3 202 675 218 620 289 501 309 251 302 12.1 18.6 10.4 11.2 11.4 15.7 11.8 10.9 13.1 2018 2016– 62 64 7.6 5.9 8.6 5.8 7.8 9.8 8.2 6.0 7.5 8.4 122 364 164 468 179 313 214 211 219 12.0 2009 2007– 87 72 21 93 30 8.1 8.4 8.2 229 201 111 179 114 103 13.0 23.5 10.5 11.1 18.1 13.0 11.3 13.3 2018 59 79 35 99 92 85 98 24 9.8 9.3 7.4 213 235 165 12.0 16.3 12.1 13.8 16.1 10.5 10.6 10.5 2017 56 67 31 79 73 36 7.2 6.3 233 184 157 103 101 11.4 15.7 10.8 10.3 12.0 12.8 11.8 10.8 15.6 2016 56 78 70 41 64 96 21 9.9 9.2 8.1 5.5 9.0 198 211 137 105 15.9 12.0 15.3 11.2 12.0 10.1 2015 53 70 61 29 76 80 92 31 9.2 7.1 7.1 9.8 8.6 6.8 9.6 153 187 128 15.2 10.8 10.8 13.2 2014 48 65 59 31 92 86 83 30 9.1 7.6 6.8 9.5 7.4 8.6 163 180 127 13.8 10.1 11.6 10.4 12.6 2013 59 65 84 25 97 76 69 23 9.2 6.4 6.0 9.4 6.5 7.1 9.5 137 160 127 17.1 10.2 13.7 11.0 2012 50 58 70 38 95 76 69 81 26 6.9 6.3 9.1 6.8 8.7 5.9 8.3 133 182 14.5 14.4 11.4 10.6 2011 38 52 62 31 62 65 74 26 7.8 7.3 8.2 5.6 7.1 5.5 7.6 152 151 107 11.2 11.8 10.2 10.5 2010 * 36 61 48 27 79 76 61 16 6.4 9.6 5.6 7.9 8.3 9.1 6.5 6.3 132 151 115 10.6 10.3 Year Year 2009 * * 39 56 68 19 94 58 65 79 17 6.0 8.8 5.3 6.8 6.7 5.5 8.2 124 144 11.5 11.2 2008 * 47 47 63 16 77 70 79 31 5.3 7.4 6.4 7.6 8.9 5.9 8.2 108 173 104 13.9 10.3 12.1 2007 * 35 57 52 25 98 75 76 72 14 5.3 8.8 5.0 9.3 8.4 7.1 8.6 6.4 7.5 105 135 10.5 2006 * * 31 57 48 11 62 67 96 14 9.4 5.9 8.8 5.1 7.8 8.3 7.1 5.7 9.2 116 139 114 2005 * 34 59 60 16 99 75 64 92 28 7.3 9.0 5.9 9.7 7.2 8.6 5.5 8.7 143 160 10.4 10.7 2004 * * 36 58 47 17 80 81 80 81 15 7.1 8.9 4.8 7.6 5.9 9.3 7.0 7.7 135 131 11.1 2003 * * 33 54 65 13 73 81 90 18 5.9 8.3 6.2 7.7 8.4 7.2 8.6 111 168 104 10.3 10.5 2002 47 64 63 24 98 60 73 26 68 8.0 9.9 6.4 9.4 7.3 6.9 6.2 7.0 149 172 14.8 10.3 10.2 2001 * 35 49 53 19 72 79 28 81 8.0 7.6 5.8 8.8 8.5 8.5 7.6 7.6 143 155 112 11.3 11.1 2000 ...... Area Iowa Idaho Maine Illinois Hawaii Kansas Indiana Georgia ...... Kentucky Maryland

Louisiana Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Rate Number Rate Number Table. Suicide death rates among persons aged 10–24: United States, each state and the District of Columbia, 2000–2018 3-year averages for 2007–2009 Table. 2016–2018—Con. [Rates per 100,000 population enumerated as of April 1 for 2000 and 2010, estimated July all other years] See footnotes at end of table. National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 7 … … … … … … … … … … … 16.0 † 70.1 † 71.3 † 32.9 † 45.9 † 64.1 † 26.6 † 38.8 † 55.8 † 39.0 † 110.0 Percent change Percent and 2016–2018 between 2007–2009 6.4 5.7 354 140 258 186 142 680 537 223 248 111 291 11.4 14.9 10.9 23.2 10.0 11.8 13.4 19.6 14.7 2018 2016– 95 98 56 6.7 8.7 8.2 3.9 7.9 8.5 8.6 7.0 4.1 268 157 154 427 322 138 220 211 15.9 16.9 2009 2007– 46 82 66 40 78 90 37 6.1 9.9 6.1 120 251 185 102 12.8 15.5 11.0 22.8 10.7 13.9 21.4 14.7 2018 47 86 62 53 80 99 42 6.4 6.3 123 212 182 108 10.7 15.2 11.3 23.5 10.0 13.2 14.4 23.4 16.6 2017 47 90 58 49 65 59 32 81 6.7 9.3 4.8 111 217 170 10.8 14.1 10.2 23.5 12.2 11.8 13.9 12.6 2016 33 82 68 50 63 80 20 95 6.1 7.8 5.5 116 209 140 10.3 11.5 10.7 16.4 10.8 12.5 11.4 18.7 2015 37 65 48 40 58 70 32 94 4.8 7.5 5.4 119 211 122 10.3 10.0 11.0 18.4 10.1 10.5 16.2 12.4 2014 42 84 48 30 50 62 21 88 9.5 9.6 9.4 6.3 7.5 7.7 9.1 8.1 5.1 101 196 118 21.0 14.3 2013 * 95 25 80 44 38 39 67 18 93 9.6 9.9 8.9 6.0 6.8 9.9 7.1 5.4 199 122 12.7 15.4 2012 28 72 46 27 67 63 27 85 8.1 9.4 5.4 7.1 7.0 4.9 101 169 123 10.0 14.2 12.3 14.5 10.3 2011 93 34 81 40 26 49 62 22 92 8.7 8.6 6.0 6.2 6.8 8.6 9.0 8.4 5.3 182 106 17.4 14.3 2010 92 39 55 46 28 96 38 75 23 68 6.8 8.5 4.1 7.1 7.3 7.8 7.0 8.7 3.9 143 19.8 17.4 Year Year 2009 * 90 33 48 57 36 52 78 17 66 6.9 8.2 3.6 8.8 9.4 9.7 3.8 146 126 16.5 10.2 18.0 2008 * 86 23 54 51 34 48 67 16 77 6.4 7.8 4.0 7.8 8.8 8.0 9.1 4.5 138 100 11.4 15.4 2007 * 89 30 46 38 46 64 68 12 65 5.7 8.0 3.5 5.8 8.9 3.8 124 111 14.6 11.7 12.5 15.6 2006 * 35 56 57 30 98 58 70 17 75 6.4 9.4 4.2 8.6 7.6 7.8 4.4 105 140 17.0 11.8 16.0 2005 * 92 27 52 52 36 40 84 18 84 6.7 8.2 3.9 7.8 9.1 8.0 8.4 4.9 148 100 13.1 19.2 2004 95 29 51 41 32 93 62 59 22 65 6.0 8.5 3.9 6.1 8.1 7.5 8.2 3.9 132 14.1 13.7 13.6 2003 92 29 56 61 27 89 42 25 53 55 6.9 8.3 4.3 9.1 6.9 7.2 9.6 9.5 3.2 150 14.2 12.8 2002 87 21 58 54 31 38 29 65 44 6.6 8.0 4.5 8.1 8.0 9.4 9.0 4.0 143 115 10.4 10.4 11.3 2001 * 26 56 54 41 43 76 13 65 67 6.5 7.1 4.5 8.1 8.7 4.1 138 104 13.1 10.7 10.8 16.2 2000 ...... Area Nevada ...... Montana Missouri Michigan Nebraska

Minnesota Mississippi New Jersey New Mexico Massachusetts New Hampshire Number Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Number Rate Rate Rate Number Rate Number Rate Number Table. Suicide death rates among persons aged 10–24: United States, each state and the District of Columbia, 2000–2018 3-year averages for 2007–2009 Table. 2016–2018—Con. [Rates per 100,000 population enumerated as of April 1 for 2000 and 2010, estimated July all other years] See footnotes at end of table. 8 National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 … … … … … … … … … … … 15.7 14.0 † 70.3 † 43.0 † 43.9 † 79.3 † 48.0 † 38.6 † 53.6 † 33.8 † 56.0 Percent change Percent and 2016–2018 between 2007–2009 88 37 5.9 9.7 5.9 655 334 754 590 766 376 415 341 125 15.5 18.3 14.7 11.1 10.6 10.7 11.7 23.6 2018 2016– 57 35 9.1 4.1 8.2 7.5 7.0 6.9 5.1 8.0 7.5 497 184 537 403 530 213 306 213 106 12.8 20.7 2009 2007– 7 * 28 44 5.9 9.9 213 129 271 202 256 108 139 122 13.4 17.7 16.9 12.0 10.8 10.7 12.5 24.7 2018 * 32 18 45 5.8 9.8 218 107 268 200 268 138 142 108 17.1 20.2 14.1 11.8 11.2 10.9 11.1 25.6 2017 * 28 98 12 36 5.9 9.4 9.3 224 215 188 242 130 134 111 16.1 17.2 13.0 10.0 10.3 11.5 20.4 2016 * * 13 90 15 96 44 5.0 9.7 8.1 9.0 9.9 191 224 165 219 105 131 12.9 12.0 10.0 25.2 2015 * 31 97 16 94 32 5.3 8.5 8.7 7.8 9.8 9.7 205 197 176 192 109 128 13.5 19.0 12.9 18.3 2014 * 36 92 88 †† 88 38 4.8 7.7 7.2 9.0 8.9 9.1 187 180 145 226 116 10.9 22.5 12.2 21.9 2013 * 22 74 †† 97 75 25 5.6 9.8 8.4 7.7 8.2 7.5 7.8 219 197 154 207 117 14.6 14.4 14.7 2012 * * 19 74 93 12 91 82 29 5.8 9.8 9.0 7.5 8.1 7.1 8.5 230 211 149 207 11.7 17.0 2011 * 28 54 81 12 81 35 4.7 7.2 8.2 7.1 9.0 8.7 8.4 189 193 138 231 111 10.3 19.1 20.7 2010 * 23 61 73 15 70 43 4.8 8.1 6.6 7.2 7.2 9.3 9.2 7.3 190 157 139 185 117 15.7 25.3 Year Year 2009 * * 16 64 78 †† 89 36 3.9 8.5 8.5 7.4 6.6 8.1 9.4 154 202 141 171 103 10.0 21.1 2008 * * 18 59 62 11 86 54 27 3.8 7.9 7.5 6.5 6.7 7.9 6.8 5.8 153 178 123 174 15.7 2007 * 28 74 74 †† 98 61 32 3.8 9.9 7.6 8.1 7.2 9.4 7.8 6.6 152 183 151 185 18.0 18.3 2006 * 30 62 73 11 92 76 27 4.3 8.3 7.7 6.7 6.9 9.3 7.4 8.3 173 187 121 177 19.3 15.4 2005 * 20 70 78 15 67 28 4.5 9.4 8.2 7.8 7.0 9.9 8.3 7.3 179 199 140 179 103 12.8 15.8 2004 * 21 63 75 †† 46 22 86 4.0 8.4 5.7 8.1 7.5 9.5 7.0 5.1 161 139 142 191 13.6 12.4 2003 * * 11 63 95 81 11 51 24 74 4.9 8.5 6.9 5.4 7.8 6.1 5.7 194 168 197 10.3 13.6 2002 * * 10 49 71 16 58 26 89 4.5 6.7 6.8 8.4 6.6 9.1 7.4 6.5 179 165 144 164 14.8 2001 * * 17 79 73 13 53 22 4.7 6.4 7.7 7.0 9.5 8.6 6.1 182 151 129 173 101 11.0 12.6 2000 ...... Area Ohio Oregon ......

New York New York Oklahoma Tennessee Tennessee Pennsylvania North Dakota Rhode Island South Dakota North Carolina South Carolina Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Rate Number Rate Number Table. Suicide death rates among persons aged 10–24: United States, each state and the District of Columbia, 2000–2018 3-year averages for 2007–2009 Table. 2016–2018—Con. [Rates per 100,000 population enumerated as of April 1 for 2000 and 2010, estimated July all other years] See footnotes at end of table. National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020 9 … … … … … … … … 33.8 33.7 † 67.1 † 47.1 † 30.7 † 58.6 † 49.5 † 31.4 Percent change Percent and 2016–2018 between 2007–2009 70 113 548 379 383 566 13.7 38.0 10.3 10.3 11.5 11.1 16.6 11.1 20.5 1,867 2018 2016– 92 54 8.2 7.7 7.0 8.8 7.0 8.3 342 220 294 333 30.0 11.1 15.6 1,152 2009 2007– * 13 46 25 635 203 133 114 195 14.0 10.4 14.2 12.3 17.1 10.0 22.0 2018 * 14 33 27 662 170 135 126 207 15.0 10.9 10.1 10.3 17.8 11.0 23.9 2017 * * 11 34 18 9.5 570 175 111 143 164 11.9 10.2 10.6 14.8 12.4 2016 * 15 30 27 8.4 8.9 9.2 504 152 123 122 161 11.7 16.7 10.5 23.2 2015 23 48 22 9.9 8.3 9.0 492 149 109 127 136 18.3 14.0 15.1 11.0 18.7 2014 * 15 26 95 23 9.9 7.7 7.5 8.0 9.3 449 133 107 136 13.3 19.5 2013 * †† 42 87 22 7.9 8.1 9.4 452 134 108 143 10.4 12.1 12.4 18.9 2012 * * 17 38 77 19 9.5 7.5 8.6 426 141 124 130 10.9 11.1 10.7 2011 * 13 22 78 26 7.5 6.4 6.2 9.7 9.0 420 102 113 122 11.5 22.7 2010 * * †† 29 71 19 8.0 8.4 6.6 8.9 8.7 442 108 104 119 10.6 Year Year 2009 * 11 30 78 80 20 6.3 8.7 8.2 6.8 8.0 345 133 108 11.8 17.4 2008 * * 12 33 71 15 6.8 9.5 6.2 9.2 7.9 365 101 110 106 10.8 2007 * * †† 22 60 71 13 7.0 6.3 6.7 9.2 5.9 9.1 371 109 122 2006 * * †† 32 66 17 7.4 9.0 6.5 8.6 7.9 390 104 104 105 10.2 2005 * * †† 41 66 12 6.8 6.4 9.2 8.2 355 102 111 109 11.4 10.2 2004 * * 10 36 80 19 7.3 7.0 8.5 8.0 372 109 103 106 10.0 12.3 2003 * 11 51 96 61 24 6.8 6.3 9.4 9.3 7.8 345 112 102 14.1 20.8 2002 * * 12 20 65 90 17 7.2 5.5 7.2 8.4 7.0 354 108 100 10.0 2001 * * 12 34 87 66 97 12 7.7 9.4 6.0 9.3 7.7 372 109 10.4 2000 ...... Area Utah Texas Texas Virginia ...... Vermont Vermont

Wyoming Wisconsin Washington Washington West Virginia West Number Number Rate Rate Rate Number Number Number Rate Rate Rate Number Number Number Rate Rate Table. Suicide death rates among persons aged 10–24: United States, each state and the District of Columbia, 2000–2018 3-year averages for 2007–2009 Table. 2016–2018—Con. [Rates per 100,000 population enumerated as of April 1 for 2000 and 2010, estimated July all other years] … Category not applicable. † Difference in rates is statistically significant at p < 0.05. †† Number of deaths fewer than 10. based on fewer than 20 deaths in the numerator. * Estimate does not meet National Center for Health Statistics standards of reliability or precision; SOURCE: National Center for Health Statistics, Vital Statistics System, Mortality. U.S. DEPARTMENT OF FIRST CLASS MAIL HEALTH & HUMAN SERVICES POSTAGE & FEES PAID CDC/NCHS Centers for Disease Control and Prevention PERMIT NO. G-284 National Center for Health Statistics 3311 Toledo Road, Room 4551, MS P08 Hyattsville, MD 20782–2064

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National Vital Statistics Reports, Vol. 69, No. 11, September 11, 2020

Contents

Abstract ...... 1 Introduction ...... 1 Data Source and Methods ...... 1 Rates and significance testing ...... 1 Results ...... 3 Trends in suicide rates ...... 3 State comparisons in suicide rates for 2016–2018 ...... 3 Summary ...... 4 References ...... 4 Detailed Table ...... 5

Suggested citation Copyright information National Center for Health Statistics Curtin SC. State suicide rates among All material appearing in this report is in Brian C. Moyer, Ph.D., Director adolescents and young adults aged 10–24: the public domain and may be reproduced Amy M. Branum, Ph.D., Acting Associate United States, 2000–2018. National Vital or copied without permission; citation as to Director for Science Statistics Reports; vol 69 no 11. Hyattsville, MD: source, however, is appreciated. National Center for Health Statistics. 2020. Division of Vital Statistics Steven Schwartz, Ph.D., Director Isabelle Horon, Dr.P.H., Acting Associate Director for Science

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