Increase in Suicides Associated With Home Eviction and Foreclosure During the US Housing Crisis: Findings From 16 National Violent Death Reporting System States, 2005–2010

摘要

Objectives. We aimed to determine the frequency, characteristics, and precipitating circumstances of eviction- and foreclosure-related suicides during the US housing crisis, which resulted in historically high foreclosures and increased evictions beginning in 2006. Methods. We examined all eviction- and foreclosure-related suicides in the years 2005 to 2010 in 16 states in the National Violent Death Reporting System, a surveillance system for all violent deaths within participating states that abstracts information across multiple investigative sources (e.g., law enforcement, coroners, medical examiners). Results. We identified 929 eviction- or foreclosure-related suicides. Eviction- and foreclosure-related suicides doubled from 2005 to 2010 (n?=?88 in 2005; n?=?176 in 2010), mostly because of foreclosure-related suicides, which increased 253% from 2005 (n?=?30) to 2010 (n?=?106). Most suicides occurred before the actual housing loss (79%), and 37% of decedents experienced acute eviction or foreclosure crises within 2 weeks of the suicide. Conclusions. Housing loss is a significant crisis that can precipitate suicide. Prevention strategies include support for those projected to lose homes, intervention before move-out date, training financial professionals to recognize warning signs, and strengthening population-wide suicide prevention measures during economic crises. In 2010, 36?364 persons in the United States died by suicide (age-adjusted rate?=?12.08 per 100?000 population), making it the second leading cause of death for US adults aged 25 to 34 years, and fourth for adults aged 35 to 54 years. 1 Furthermore, the overall suicide rate in the United States has increased over the past decade, 2 especially among adults aged 35 to 64 years. 3 Suicide carries enormous costs to society, such as emotional trauma for friends and family members (including heightened risk of subsequently attempting suicide themselves), and medical and work loss costs estimated at $34.6 billion a year. Persons who engage in suicidal behavioral typically have multiple risk factors for suicide such as depression, substance abuse, or chronic or acute life stressors such as financial problems. In some instances, a precipitating event prompts an attempt in an already vulnerable person. Several studies of US and international economic cycles have found that suicides increase in step with adverse economic events. 4,5 For example, a recent study examining the impact of austerity measures taken in England during the European financial crisis on unemployment and subsequent suicides attributed more than 1000 excess suicides to these economic conditions between 2008 and 2010. 6 Another found that in Greece, one of the worst-hit economies in Europe, suicide mortality rates among men have increased by more than 22% since 2007. 7 Similar trends were observed in several countries (e.g., Japan, Hong Kong, South Korea) following the Asian monetary crisis of 1997. 8 An analysis of US business cycles and suicide rates between 1928 and 2007 recently demonstrated that suicide rates in the United States have also generally increased and decreased along with economic conditions. 4 The findings demonstrated that US suicide rates peaked during the Great Depression, and decreased during times of economic expansion and low unemployment. Working-age adults were most affected. One recent study attributed up to 25% of the US suicide rate increase seen over the past decade specifically to rising unemployment. 9 There were other important dimensions of the recent US economic downturn that may be associated with the observed increase in suicides. Beginning in late 2006, the US experienced a housing crisis characterized by historically high rates of home foreclosure 10 and increased evictions. 11 Media reports of suicides associated with eviction or foreclosure appeared in national news outlets during this time, 12–14 although little information exists about the frequency or characteristics of these events. Although the full impact of the housing crisis on public health is not yet known, several studies have documented adverse effects associated with mortgage delinquency such as 2 or more times greater odds of major depression 15,16 and 8 times greater odds of elevated depressive symptoms related to acute stress. 17 In addition, a recent study found higher suicide rates in regions experiencing higher rates of foreclosure. 18 These findings suggest that eviction or foreclosure may be related to elevated risk of suicide. However, to date, no study has described or directly investigated suicides associated with home eviction and foreclosure. We determined the frequency and circumstances of suicide deaths linked to eviction (i.e., renters evicted for financial reasons) and foreclosure (i.e., homeowners losing homes to foreclosure) in the years 2005 through 2010 with data from 16 states participating in the National Violent Death Reporting System (NVDRS). Within this sa