Research Article| Volume 60, ISSUE 6, P802-811, June 2021

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Suicide Distribution and Trends Among Male Older Adults in the U.S., 1999–2018

  • Sanae El Ibrahimi
    Address correspondence to: Sanae El Ibrahimi, PhD, Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, 4505 S Maryland Pkwy, Las Vegas, NV 89154.
    Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada

    Research and Evaluation Division, Comagine Health, Portland, Oregon
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  • Yunyu Xiao
    School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana

    School of Social Work, Indiana University Bloomington, Bloomington, Indiana
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  • Caroline D. Bergeron
    Division of Aging and Seniors, Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada

    Center for Population Health and Aging, Texas A&M University, College Station, Texas
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  • Niema Y. Beckford
    Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada
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  • Eddy M. Virgen
    Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada
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  • Matthew L. Smith
    Center for Population Health and Aging, Texas A&M University, College Station, Texas

    Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas
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Published:February 27, 2021DOI:


      This study examines the distribution and trends in suicide death rates among male adults aged ≥65 years in the U.S. from 1999 to 2018.


      Suicide mortality data were derived from Multiple Cause of Death from the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database. Suicides were identified from the underlying causes of death. Joinpoint regression examined the distribution and shift in suicide age-adjusted death rates overall and by age groups, race/ethnicity, method of suicide, and urbanicity. Analyses were conducted in 2020.


      Between 1999 and 2018, a total of 106,861 male adults aged ≥65 years died of suicide (age-adjusted rate=31.4 per 100,000 population, 95% CI=31.2, 31.6). Suicide rates showed a V-shaped trend. They were declining annually by 1.8% (95% CI= −2.4, −1.2); however, starting in 2007, there was a shift upward, increasing significantly by 1.7% per year for the next decade (95% CI=1.0, 1.6). Suicide rates were highest among those aged ≥85 years (48.8 per 100,000 population with an upward shift in 2008), Whites (35.3 per 100,000 population with an upward shift in trend in 2007), and the most rural communities (39.0 per 100,000 population). Most suicides were due to firearms (78.3% at a rate of 24.7 per 100,000 population), especially in rural areas, and shifted upward after 2007.


      Increases in suicide rates among male older adults in the U.S., particularly after the 2007–2008 economic recession, are concerning. Tailored suicide prevention intervention strategies are needed to address suicide-related risk factors.
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