On Suicide and Social Inequality: Using FCT to Present a Time-Oriented Examination of Suicide Mortality

Sean Clouston, University of Victoria
Marcie Rubin, Columbia University
Cynthia G. Colen, Ohio State University
Bruce Link, Columbia University

Suicide is the 11th most common cause of death, killing more than 30,000 U.S. residents ever year. Recently, Selective Serotonin Reuptake Inhibitor (SSRI) use has been posited to reduce suicidal impulses and behaviours.FCT posits that when preventions become effective, that individuals with more resources preferentially gain access to those preventions through the effective use of resources including education, money, power, prestige, and beneficial social connections. We use negative binomial regression and change-point models on 40 years of population-level cause-specific mortality data from the United States to show that following the introduction and widespread use of SSRIs into the population, that social inequalities in suicide mortality rose substantially while suicide rates declined. Our results suggest that the specific historical and social context in which a disease is present is fundamental to understanding how social inequalities arise and how they change over time.