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May 27, 2021

A Population-Level Approach to Suicide Prevention

Author Affiliations
  • 1Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland
  • 2Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, New York
JAMA. 2021;325(23):2339-2340. doi:10.1001/jama.2021.6678

The recent signing into law of the $1.9 trillion American Rescue Plan aims to improve the financial security of millions of people with low and middle incomes in the US through extending unemployment benefits, providing direct payments, funding emergency paid leave, and several other measures. The epidemiologic literature connecting financial crises to elevated risk of suicidal behavior raises the possibility that by improving financial security at a population level, the new legislation might help reverse a 2-decades-long gradual national increase in suicide.1

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    1 Comment for this article
    Paul Nelson, MS, MD | Family Health Care, PC retired
    One predominant attribute of our current pandemic is the absence of local, community-by-adjacent-community, population health planning to prevent, mitigate, and ameliorate its own knowable disasters, and to participate in regional and national risk management. I would add suicide prevention to knowable disasters given the diversity of social determinants that are related to suicide, viz reduced social mobility and increased social isolation. This view of suicide prevention then would be in a position to also prevent the cluster phenomena from occurring soon after an isolated successful event. Most local media outlets know about this phenomenon, but community-wide uniformity should be annually encouraged by a community-based collaborative process.

    The concept of some 800 community health forums comes to mind. At about 400,000 resident persons per adjacent-community forum, the generational benefit for our nation's social cohesion would be profound.