This proposal is a revision of R01 AA021791-01 that was reviewed in June 2010 by BGES. The revisions address methodological shortcomings. The United States economy contracted markedly starting December 2007. There is substantial evidence indicating the impact of contracting economies, particularly levels of unemployment, on suicide mortality risk. But less is known about the role alcohol misuse plays in the complex relationship between economic conditions and suicide. Preliminary data suggest that acute intoxication (blood alcohol concentration (BAC) e .08 g/dl) among male suicide decedents has increased at least 10% since the official start of the recession. Alcohol plays a key role in suicide and, indeed 7,235 deaths and 242,456 years of potential life lost resulted from alcohol-attributable suicides in 2001-05. This project will estimate the effect of the economic downturn on rates of suicide involving acute alcohol intoxication using newly available data from the National Violent Death Reporting System (NVDRS). The NVDRS is a large (57,813 suicide decedents in 2003-09) and demographically well-characterized database with toxicology information (i.e., BACs). The project aims are as follows: (1) describe suicides associated with acute alcohol ingestion by geographic region and by time from before (2003-07) to after the onset (2008-12) of the economic contraction;(2) examine the association between measures of economic distress and rates of alcohol-related suicide by geographic area and by time;(3) analyze the roles of alcohol consumption and alcohol availability in explaining connections (if any) between economic contraction and alcohol-related suicide;and (4) compare relationships among economic contraction, alcohol consumption, and alcohol-related suicide across age, gender, race/ethnicity, and socioeconomic sub-groups of the population. Several levels of data (state, substate, county, and individual) will be combined to capture the nested complexity between economic downturn and variation in alcohol-related suicides. The project will utilize multiple indicators of economic distress, including short- and long-term unemployment, median household income, poverty rates, home foreclosure rates, and median housing prices. Other key environmental indicators will include population drinking patterns, substance use, mental health status, and alcohol-control policies (i.e., alcohol taxes, density of alcohol outlets, and alcohol sales). These data will be obtained from the Bureau of Labor Statistics, Census Bureau, Realtytrac, Federal Housing Finance Agency, National Alcohol Beverage Control Association, Alcohol Policy Information System, state alcohol beverage control boards, Alcohol Epidemiological Data System, and the National Survey on Drug Use and Health. Documenting the effects of the economic contraction on alcohol- associated suicide mortality will be of considerable interest to state and federal decision-makers concerned about public health while dealing with budget deficits and a prolonged downturn.

Public Health Relevance

Suicide and alcohol misuse are major public health problems that may be influenced by economic contraction. This project links recent mortality, toxicology, mental health, alcohol, and economic data to examine connections between financial decline and alcohol-related suicide in substate geographic areas. Multilevel models are used to test hypotheses that address key policy questions pertaining to alcohol and suicide during times of economic distress.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Study Section
Behavioral Genetics and Epidemiology Study Section (BGES)
Program Officer
Freeman, Robert
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University of California Los Angeles
Social Sciences
Schools of Arts and Sciences
Los Angeles
United States
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Kaplan, Mark S; Caetano, Raul; Giesbrecht, Norman et al. (2017) The National Violent Death Reporting System: Use of the Restricted Access Database and Recommendations for the System's Improvement. Am J Prev Med 53:130-133
Kerr, William C; Kaplan, Mark S; Huguet, Nathalie et al. (2017) Economic Recession, Alcohol, and Suicide Rates: Comparative Effects of Poverty, Foreclosure, and Job Loss. Am J Prev Med 52:469-475
Kaplan, Mark S; Huguet, Nathalie; Caetano, Raul et al. (2016) Heavy Alcohol Use Among Suicide Decedents Relative to a Nonsuicide Comparison Group: Gender-Specific Effects of Economic Contraction. Alcohol Clin Exp Res 40:1501-6
Xuan, Ziming; Naimi, Timothy S; Kaplan, Mark S et al. (2016) Alcohol Policies and Suicide: A Review of the Literature. Alcohol Clin Exp Res 40:2043-2055
Kaplan, M S; Huguet, N; Caetano, R et al. (2015) Economic contraction, alcohol intoxication and suicide: analysis of the National Violent Death Reporting System. Inj Prev 21:35-41