Number of deaths due to suicide per 100,000 population (age-adjusted). The 2023 County Health Rankings used data from 2016-2020 for this measure.
Suicide serves as an important measure of the mental health of a county’s population. Outside of the impact on the emotional and mental health of surviving friends, family members, and loved ones, suicide also has an economic impact and costs the United States an estimated $70 billion per year.1
Data and methods
National Center for Health Statistics - Mortality Files
Data on deaths and births were provided by NCHS and drawn from the National Vital Statistics System (NVSS). These data are submitted to the NVSS by the vital registration systems operated in the jurisdictions legally responsible for registering vital events (i.e., births, deaths, marriages, divorces, and fetal deaths). In prior years of the Rankings, Premature Death was calculated by the National Center for Health Statistics, but this year the Mortality-All County (micro-data) file was requested. This allowed us to calculate Premature Death and Life Expectancy ourselves. While most calculations of mortality rates can be downloaded from CDC WONDER, the calculation of Years of Potential Life Lost and Life Expectancy requires raw data files.
Key Measure Methods
Suicides is a rate
Suicides is the number of deaths from self-inflicted injuries per 100,000 population. Rates measure the number of events (e.g., deaths, births) in a given time period (generally one or more years) divided by the average number of people at risk during that period. Rates help us compare data across counties with different population sizes.
Suicides is age-adjusted
Age is a non-modifiable risk factor, and as age increases, poor health outcomes are more likely. We report an age-adjusted rate in order to fairly compare counties with differing age structures.
Deaths are counted in the county of residence for the person who died, rather than the county where the death occurred
It is important to note that deaths are counted in the county of residence of the deceased. So, even if a suicide occurred across the state, the death is counted in the home county of the individual who died.
Some data are suppressed
A missing value is reported for counties with fewer than 10 suicide deaths in the time frame.
The numerator is the number of deaths in a county over the 5-year period due to suicide as defined by ICD-10 codes X60-X84 (self-harm).
The denominator is the aggregate county population over the 5-year period.
Can This Measure Be Used to Track Progress
This measure can be used to measure progress with some caveats. It is important to note that the estimate provided in the County Health Rankings is a 5-year average. However, in most counties, it is relatively simple to obtain single-year estimates from the resource included below.
Finding More Data
Disaggregation means breaking data down into smaller, meaningful subgroups. Disaggregated data are often broken down by characteristics of people or where they live. Disaggregated data can reveal inequalities that are otherwise hidden. These data can be disaggregated by:
We recommend starting with the CDC WONDER database, which contains information on homicide rates by race, ethnicity, age, gender, geography, and more. Rates can be exported as raw or age-adjusted. Small counties might need to combine multiple years of data to see rates, as CDC suppresses any rates when there are fewer than 10 deaths.
1 Centers for Disease Control and Prevention. Suicide Prevention – Facts About Suicide. Last August 30, 2021. Accessed February 15, 2022. https://www.cdc.gov/suicide/facts/index.html