Comparing gender-specific suicide mortality rate trends in the United States and Lithuania, 1990-2019: putting one of the "deaths of despair" into perspective.
Level 4 - case-series / case-control
Ecological time-trend study comparing national mortality registry data across two countries
PubMed 35177011 · doi:10.1186/s12888-022-03766-w
What was done
Researchers evaluated 30-year secular trends (1990–2019) in gender-specific, age-standardized suicide mortality rates in the United States and Lithuania. Using Joinpoint regression, they compared trajectories among individuals aged 15 and older, middle-aged adults (aged 45–54), and the male-to-female suicide mortality rate ratios between the two nations.
What was found
Between 1990 and 2019, age-standardized suicide mortality rates among middle-aged US adults (45–54 years) increased annually on average by 0.89% (95% CI: 0.66%, 1.12%) among men and 1.21% (95% CI: 0.75%, 1.66%) among women. In contrast, middle-aged suicide mortality rates in Lithuania showed an overall downward trend across the study period (no specific figures for Lithuania reported in abstract). The average annual percent change in the male-to-female suicide mortality rate ratio was not statistically significant in either country.
Why it matters
These findings suggest that rising suicide rates among middle-aged adults in the US do not reflect a universal trend across developed countries, providing perspective on the US "deaths of despair" narrative.
Limits
The abstract does not provide numerical estimates or confidence intervals for Lithuania's downward trend. As an ecological study comparing only two countries, it cannot determine underlying causal drivers or generalize across all developed nations, and it is vulnerable to differences in national mortality classification and reporting.