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Increases in deaths of despair in the USA have been associated with economic conditions and drug availability. In the state of Illinois, deaths of despair represent a significant public health issue. This study aims to examine the relationship between county-level economic distress, drug availability and mortality from deaths of despair collectively and for each contributing cause of death individually in the state of Illinois to better understand drivers of mortality locally.

Two cross-sectional analyses were conducted for 2010–2014 and 2015–2019. Correlations, regression analyses and relative weight analyses were applied to assess the relationship between deaths of despair mortality rate and the individual variables.

Deaths of despair mortality collectively and for each cause of death individually increased significantly from 2010–2014 to 2015–2019 in Illinois. Suicide mortality was higher in rural counties and was related to economic distress, while drug poisoning and alcohol-related deaths were higher in urban counties and were related to drug availability indicators.

While all three causes of death increased in the state, suicide mortality was inversely related to deaths of despair mortality. This may be because of different individual risk factors in rural versus urban areas or issues with coding cause of death. The findings of this study point to a rising public health challenge of deaths of despair mortality, particularly from substance use, in urban counties and from suicide in rural counties.

This chapter uses quarterly county-level data from 2006 to 2014 to examine the direction of causality in the relationship between per capita opioid prescription rates and employment-to-population ratios. We first estimate models of the effect of per capita opioid prescription rates on employment-to-population ratios, instrumenting opioid prescriptions for younger ages using opioid prescriptions to the elderly. We find that the estimated effect of opioids on employment-to-population ratios is positive but small for women, while there is no relationship for men. We then estimate models of the effect of employment-to-population ratios on opioid prescription rates using a shift-share instrument and find ambiguous results. Overall, our findings suggest that there is no simple causal relationship between economic conditions and the abuse of opioids. Therefore, while improving economic conditions in depressed areas is desirable for many reasons, it is unlikely on its own to curb the opioid epidemic.

The purpose of this paper is to examine the Golden Gate Bridge (GGB) as a work of art and the role of the bridge in shaping community identity and discourse. Particular attention is focussed on the discourse surrounding mental illness and suicide, which perpetuate the problem of suicides involving the bridge as a means and mechanism of death. An analysis of the person who attempts or completes suicide is also performed.

Multiple research articles, writings, and a cinematic production are drawn on to frame the argument in terms of Michel Foucault's adaption of Pantopticism Theory and Jacques Lacan's Mirror Theory, which includes the concepts of the Real, the Imaginary, and the Symbolic.

The GGB is a major factor in shaping the discourse on mental illness and suicide in the San Francisco community. The influences the GGB exerts combines with and exacerbates a culture of stigma, which perpetuates negative discourse and increases the risk of suicides in those already vulnerable.

The research for this paper was performed at a distance and was conducted, with the exception of one personal communication, by literature search and application to theory. Ethnographic research would be a logical next step to study the phenomenon further.

Theory developed from this paper could be used in determining a relevant course of action for adding to existing suicide prevention efforts in the San Francisco Area and any other community with a prominent icon, such as the GGB, that may be exerting a negative influence on the suicide rates of that area.

An awareness of how art, culture, and psychology interact would increase awareness of the creation of a stigmatized environment and perhaps precipitate a change in the underlying negative discourse.

This paper takes a fresh look at the phenomenon of violent death by suicide where a physical object/icon (the GGB) is used as a means to die. The particular theories and approach used to explain the interactions that intensify the suicide death rate have never been combined and interwoven in such an interdisciplinary way to seek an explanation.

Death by suicide among Black people in the USA have increased by 35.6% within the past decade. Among youth under the age of 24 years old, death by suicide among Black youth have risen substantially. Researchers have found that structural inequities (e.g. educational attainment) and state-specific variables (e.g. minimum wage, incarceration rates) may increase risk for suicide among Black people compared to White people in the USA. Given the limited understanding of how such factors systematically affect Black and White communities differently, this paper aims to examine these relationships across US states using publicly available data from 2015 to 2019.

Data were aggregated from various national sources including the National Center for Education Statistics, the Department of Labor, the FBI’s Crime in the US Reports and the Census Bureau. Four generalized estimating equations (GEE) models were used to examine the impact of state-level variables on suicide rates: Black adults suicide rate, Black youth (24 years and younger) suicide rate, White adult suicide rate and White youth suicide rate. Each model includes state-level hate group rates, minimum wage, violent crime rates, gross vacancy rates, and race-specific state-level poverty rates, incarceration rates and graduation rates.

Across all GEE models, suicide rates rose between 2015–2019 (ß = 1.11 – 2.78; ß = 0.91 – 1.82; ß = 0.52 – 3.09; ß = 0.16 – 1.53). For the Black adult suicide rate, state rates increased as the proportion of Black incarceration rose (ß = 1.14) but fell as the gross housing vacancy rates increased (ß = −1.52). Among Black youth, state suicide rates rose as Black incarcerations increased (ß = 0.93). For the adult White suicide rate, state rates increased as White incarceration (ß = 1.05) and percent uninsured increased (ß = 1.83), but fell as White graduation rates increased (ß = −2.36). Finally, among White youth, state suicide rates increased as the White incarceration rate rose (ß = 0.55) and as the violent crime rate rose (ß = 0.55) but decreased as state minimum wages (ß = −0.61), White poverty rates (ß = −0.40) and graduation rates increased (ß = −0.97).

This work underscores how structural factors are associated with suicide rates, and how such factors differentially impact White and Black communities.