Batchelor, Katz, Cox: The issue of female suicide in Arizona

Jordan Batchelor, Ph.D.

Submitted photo

Charles Katz, Ph.D.

Deanna Dent/Arizona State University

Taylor Cox, Ph.D.

Submitted photo

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Suicide is a tragic public health concern that affects nearly every community.

Despite the many efforts to stem suicide in the U.S., its rate grew steadily from 2000 to 2022. Men are disproportionately impacted, as they make up about 80% of all fatal suicide attempts, but there is reason to focus on suicide among women as well.

While men die by suicide at higher rates, women exhibit more non-fatal suicide behavior. Additionally, suicide among girls and women is often misunderstood, primarily because of a greater focus on other subpopulations so, it’s instructive to increase awareness about the risks and warning signs of female suicide.

At the Center for Violence Prevention and Community Safety, a research unit at Arizona State University, we’ve collected data on Arizona suicides since 2015.

We manage Arizona’s only violent death reporting system, AZ-VDRS — a CDC-sponsored surveillance system that collects data on suicide, homicide and more. We can do this thanks to agreements with Arizona Department of Health Services, medical examiners and law enforcement agencies, who provide us with death certificates, medical examiner reports and police reports.

We’d like to share some of what we’ve learned about suicide among females in the hope that it can raise awareness.

Females who die by suicide are more likely to have had prior suicide attempts

It is often found that females make more non-fatal suicide attempts than males, and AZ-VDRS data reflect a similar trend. Specifically, about 36% of females who died by suicide in Arizona between 2015 and 2022 had at least one past attempt, while about 19% of males did.

This represents an opportunity to identify girls and women who are most at risk of suicide, as non-fatal suicide attempts are among the strongest predictors of future fatal suicide attempts. In other words, Arizonans with a history of suicide attempts deserve special attention.

Figure 1. Percent of suicide decedents with past suicide attempts by sex, according to AZ-VDRS

Females are more likely to die by poisoning than males

Firearms tend to be the preferred method of choice for carrying out suicide, especially for males. AZ-VDRS data show that males used a firearm in 65% of suicides, while only 39% of females used a firearm.

What explains this difference? A primary reason is that females are more likely to die by suicide through poisoning (30% for women vs. 8% for men). Here, poisoning refers to multiple things but especially intentional drug overdose. Past research has shown that men and women show similar rates of suicide via opioid poisoning. But considering the higher rate of male suicide, that females and males die by intentional opioid overdose at similar rates suggests that this is a significant risk factor for females. Prevention efforts could target ways of reducing the use of prescription drugs as a means of suicide.

Female military veterans deserve special attention

We’ve written elsewhere about the risk of suicide among Arizona’s military veterans. For a variety of reasons, veterans tend to be at higher risk of suicide than the general population.

As the presence of women in the military is steadily increasing, this community deserves particular attention. There is evidence that female veterans disclose suicidal thoughts more often than once assumed, and AZ-VDRS data back this up: 39% of female veterans disclosed their intent prior to suicide, while 27% of men did so.

Warning signs 

Looking out for signs of suicidal behavior, then, and providing guidance and support when found, is a potentially effective means of prevention. Some of these warning signs might include:

• Talking about wanting to die, having great guilt or shame, or feeling like a burden to others

• Changing behavior, such as withdrawing from friends or family or acting more reckless

• Experiencing mood changes, such as feeling depressed, anxious or irritable

While these signs may be present in veterans and non-veterans alike, veteran-specific services are also available. For example, veterans experiencing a crisis can connect with the veteran’s crisis line by calling 988 and pressing 1, or simply texting 838255.

Suicide is an unnecessary tragedy that affects almost every community, including Arizona. Here, we’ve highlighted some risk factors associated with females, as being aware of the unique characteristics of particular groups can help tailor effective prevention efforts.

Spreading awareness is also valuable. For example, our new data dashboard allows users to make custom searches about Arizona’s violent deaths, including suicide.

If you are in need of support, reach out to a trusted person and call the 988 Lifeline.

Editor’s note: Research Analyst Jordan Batchelor, Ph.D., Director Charles Katz, Ph.D., and Project Coordinator Taylor Cox, Ph.D., are with the Center for Violence Prevention and Community Safety at Arizona State University. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.