Freakonomics Radio: Gambling With Your Life — or: Why Las Vegas is the Suicide Capital of the U.S.

Suicide city: Las Vegas has the highest metropolitan suicide rate in the country (Photo: Hemera)

One of the upcoming hour-long Freakonomics Radio shows we’re currently producing (which will be heard on public-radio stations across the country, not just in the podcast stream) is about suicide. It’s hard to pinpoint the thesis — perhaps we don’t quite have one — but there are any number of interesting things to know about the problem, and ways to think about it.

The single most surprising fact to me is that suicides are more than twice as numerous in this country as homicides. Some questions that naturally arise from this fact: where are suicides most prominent, and among whom, and why?

Freakonomics Radio

”Gambling With Your Life”: Does Las Vegas increase your risk of suicide? A researcher embeds himself in the city where Americans are most likely to kill themselves.

Listen Now

To that end, we’ve just put out a new podcast (you can download/subscribe at iTunes, get the RSS feed, listen live via the link in box at right below, or read the transcript here) about suicide in Las Vegas, which has the highest metropolitan suicide rate in the U.S. The podcast features an interview with Matt Wray, a sociologist at Temple who studies, as he puts it, “losers.” (Trust me, he doesn’t use the word lightly, or disparagingly.) Wray is the author of Not Quite White: White Trash and the Boundaries of Whiteness and co-author of a 2008 paper called “Leaving Las Vegas: Exposure to Las Vegas and Risk of Suicide” (online here, download here):

Residents of Las Vegas, Nevada have much higher suicide rates than residents of other metropolitan counties in the USA. Whether the risk of suicide among visitors to Las Vegas is also significantly elevated has been difficult to assess because person-time denominator information is not available. We used a case–control design to examine the association between exposure to Las Vegas and risk of suicide expressed as mortality odds ratios. We conceptualized four different types of potential suicide risk with respect to Las Vegas: (1) risk of suicide among usual residents of Las Vegas (‘‘chronic risk’’), (2) risk of suicide among temporary visitors to Las Vegas (‘‘acute risk’’), (3) risk of suicide among Las Vegas residents visiting elsewhere (‘‘leaving Las Vegas risk’’), and (4) risk of suicide among travelers in general (‘‘traveler risk’’). Controlling for age, gender, marital status, and year effects, the odds of suicide among Las Vegas residents was at least 50% greater than among residents elsewhere in each of the three decades we observed. Visitors to Las Vegas were at double the risk compared to those who stayed in their home county. Leaving Las Vegas was associated with a greater than 20% reduction in risk for suicide. Traveling to Las Vegas is associated with a twofold increase in risk compared to traveling elsewhere. We discuss three possible theoretical frameworks to help explain our observed results: ecological effects, whereby social factors unique to Las Vegas, or uniquely amplified in Las Vegas, result in increased risk to both residents and visitors; selection effects whereby those predisposed to suicide disproportionately choose Las Vegas to reside in and visit; and contagion effects, whereby high numbers of suicides tend to lead to even greater numbers over time, as people emulate the suicides of others. We compare our empirical evidence for each of the effects with existing sociological and historical scholarship on Las Vegas.

Temple sociologist Matt Wray

In the podcast, we discuss Wray’s motivation, methodology, and his thinking about causal factors. Some excerpts:

I was living in Las Vegas and I wanted to understand more about Las Vegas as a community. I’d just moved there and was struck by the exceedingly high suicide rate in Las Vegas. So, I wanted to know what’s causing this, and more specifically could it be something about the place that actually is effectively sort of suicidogenic. You know, what’s generating this high rate of suicide over such an extended period of time? Because as far back as I could go in the statistics for decades I was seeing this consistently high rate. So it was a puzzle really that more than anything else, a curiosity that led me down this road.

And:

So the story here, and this was the famous sociologist Emile Durkheim’s point at the end of the nineteenth century, that suicide, rather than being a story about the individual’s struggles, is telling us something about society and social groups that we ought to listen to. … I think that we’re kind of schizophrenic about suicide, which is that we have both devoted — intellectuals, and scholars, and public-health officials, and sociologists, and especially psychiatrists and psychologists — have devoted so much ink to thinking, and talking, and exploring suicide that it’s hard to say that it’s, that it’s under-examined. We also tend to be obsessed with suicides in pop culture.

And:

We do seem to be far more focused on that form of violence than the lethal self-directed violence that is suicide. And I think that there’s a way in which the need for justice that we feel when a homicide occurs motivates us to take a greater collective interest in it. A crime has occurred, the most heinous kind of crime has occurred, a life has been taken, someone did it, that person is bad, we need to identify that person, and we need to bring about some justice and some retribution. Those ingredients are really missing, they’re really missing with suicide. We see it as tragedy; we see it as loss. It’s deeply saddening, and depressing, and grim, very, very grim. And so, I think it doesn’t mobilize people in the same way that homicide mobilizes people, or even in some ways accidents.

Our hour-long program on suicide isn’t quite done, so if there’s something you’re particularly interested to know, please say so in the comments section below.


Joe Ellebracht

I am interested in suicide among the terminaly ill. Is it about avoiding pain? The end result of thinking about death all the time? Or what?

Dave

Is the breakdown the same for men and women in Vegas?

josh

No the breakdown is not the same. It is significantly higher in males, especially the age of 40+.

James

I have to admit to a certain amount of prejudice. I live in northern Nevada - a place about as different from Las Vegas as it's possible to be, yet all-to-often linked to it in many minds - and have seen a number of acquaintances move to Las Vegas and go nuts, so in some ways suicide seems a perfectly rational means of escaping that place.

However, a serious question: Las Vegas is perhaps one of the most artificially-constructed places around, and one which celebrates its deliberately-created separation from all aspects of the natural world. If we accept the biophilia hypothesis, this lack of connection should result in increased psychological problems, of which suicide would be one. So do we see similar increases in suicide rates in other deliberately non-nature-connected environments?

sue

I have visited both Las Vegas and New Zealand, and have been struck by the trapped feeling that the remoteness gives you. LV is an island of decadence and plenty plunked down in miles of wasteland. NZ is a charming little place in miles of ocean. They are both smiley smiley tourist havens in the middle of...nothing. Living in either place would be very different from visiting there (I can say this holds true for NZ at least). Both places with high suicide rates and oddly high reported happiness rates. I don't know about Vegas, but in New Zealand you are either part of the in-group or you are very much "out", and if you do not integrate well with their cohesive society, you miss out on many benefits that improve your quality of life. There is also an awareness on the part of the people that a good impression of New Zealand has to be perpetrated in order for the island nation to survive, given that it depends on tourism and thus reputation. There is also the effort and money it takes to leave New Zealand if you decide you can't go ON living there - a great deal, compared to other places you might want to leave. Housing is very expensive, and many people will sadly rent their whole lives, kicked by landlords from one house to another but never owning a home. That first rung on the property ladders is much higher than in other places, and even if you make it, the resulting debt with low wages can make for a pretty miserable, work-heavy, penny-pinching life. If you can't get it together to leave (as many Kiwis do, across the Tasman, to find work in Australia), you are stucker than a stuck thing, struggling to keep afloat on an expensive island in the middle of nowhere. The drinking and cannabis use are through the roof in New Zealand as well, and for good reason. I imagine the service jobs in the Vegas hotels are fun, but don't exactly propel you anywhere in life.

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bob

I'm surprised that it surprises you that murders are half as popular as suicides. Most people I know can talk of someone who offed themselves but knowledge of a murder would be very rare. I suppose murder is more natural in the purest animal sense but to a European it doesn't feel it.

Joel Upchurch

Maybe the problem is that the people is Las Vegas are too happy? Studies have shown that states with high life satisfaction also have high suicide rates. http://www.ibtimes.com/articles/137214/20110422/happiest-countries-suicide-life-satisfaction-happiness-and-suicide-rates-environment-income-unemploy.htm

From what I've seen, there is a correlation for people with bipolar disorder with both gambling and suicide. That would imply to me that if you have a population with high rates of gambling addiction, then you are also probably going to have high suicide rates, because of a higher percentage of the population with bipolar disorder.

I have philosophical reservations about whether the state should intervene in someone's end of life decision. If the state can't intervene to prevent a person from having an abortion, then by the same logic the state shouldn't intervene when you try to commit suicide. Even government assisted suicide makes sense, since many people commit suicide in an unsafe manner that puts other people at risk. The government could also require organ donation for suicides and design the procedure to maximize the organs that can be harnessed.

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Shane

Interesting. If individuals judge their own sense of self worth by comparing themselves with neighbours, it might make sense that more people kill themselves in a thriving, generally happy place than in a poor, unhappy place. If everyone is miserable and poor, maybe there is a sense that the individual cannot take blame for his or her personal failures. But in a prosperous place the unsuccessful individual must face his or her failures.

Ben

Vegas is a place you go to put it all on the line. Win big or never go home. I imagine the big winners have a slightly lower rate of suicide than the guy who loses his home to the roulette wheel.

kebmo

I wonder how a city like Atlantic City would compare and if it's stats don't line up with Vegas then why? Is it too narrow minded to automatically assume that the gambling culture is responsible?

jcody

Could the major factor be the lack of familiar ties? Compared to every other major metropolitan area Las Vegas has an extremely high percentage of residents who relocated from out of state. Less than a quarter of Las Vegas residents are from the state of Nevada.

Also while they have a much higher transplant rate than other cities they are also fairly far apart from any other major metropolitan areas. So while a lot of the "out of state" residents in other big cities might have family and friends within a 100-200 miles (an easy drive anytime one has a couple days off), there is not much population to draw from in the area surrounding Vegas. The nearest sizable population centers would be Los Angeles or Phoenix, both of which would be a 500-600 mile round trip. So even the transplants from "nearby" are probably too far away to visit family & old friends with any kind of regular frequency.

People without close family connections or long time friends would seem far more likely to be at high risk for suicide.

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Hank Myers

It was interesting to hear the implication that New York is a bad place to live if you are concerned about heart attacks (podcast version). It may not be that living in New York causes more heart attacks. Rather, New York has a low survival rate among people who have a heart attack. Nationally, the percentage of people who suffer a heart attack and live to walk out of the hospital is about 20% (1 in 5). In New York the number is 6-7%. In King County (Seattle and environs) the percentage is over 50%, and in Redmond, in eastern King County, the percentage varies from 60-70%. King County has historically had an aggressive Medic One system and outreach to teach CPR, including hands-only CPR. Redmond has a strong resident training program, and has very quick response times for its aid cars. New York logisitics are much more complex, but it may not be the number of heart attacks per capita that is high, but that the survival rate of heart attack victims that is low.

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caleb b

Wow, very interesting point. Thanks for posting.

Taylor

Right now, suicides in the active duty military forces, especially the ground forces, are a major issue that has been increasingly publicized over the last year by top DOD officials. Moreover, these suicides would seem to be different than the ones in Vegas because military units would ostensibly have a very high degree of social cohesion and camaraderie.

Durkheim suggests that suicides in such settings may be understood as triggered by a sort of reverse anomie, meaning the individual values the group over himself and decides that it will be better off without him/her around to hold it back in some way. Whatever insight or attention you could bring to this unique suicide trend would be appreciated, I'm sure, by those in uniform.

Wehttam

What a great question. Sort of jumping on a perceived grenade of their future mistakes? I wonder how many can also be attributed to guilt of "Kill Team" type behavior, and wanting to be neither accomplice (through silence) nor narc.*

Maybe Levitt can use his unique eye on the data and come up with something.

*I know the actions by some members of the 5th Stryker Brigade are not representative of the military as a whole, having worn BDUs for 4 years myself.

neilalice

The piece explicitly compares suicide rates and homicide rates, and it seems to assume that the difference between a suicide and a murder is generally obvious and easy to spot. But I'm not so sure that's the case.

Some unobserved deaths (drug overdoses, poisonings, falls) can likely be classified as a suicide, accident, or homicide. And in many cases, such as where police are overworked or where there is no obvious evidence leading directly to a murderer, there may be pressures on officials to classify a death as a suicide where in other places it may be listed as an unsolved murder.

Las Vegas and Japan may indeed be risky places to live for those at risk of suicide. But I'd pay a little more attention to the suicide, homicide, and accidental-death rates as a total. It might be that what appears to be an increased suicide risk may actually be masking the risk of falling prey to an unsolved murder.

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Amy Zimmer

Great Podcast. Las Vegas is new, like Dr. Wray said, so there aren't generations of close knit families to keep people afloat and give them a feeling of connectedness.
New York, heck, you can't get a minute alone without one of your tribe.

Kate

As a native to Las Vegas (born and raised) I can now say I fully understand the desperation in Las Vegas. I moved from Las Vegas 3 years ago to Toronto, Ontario when I was 18. When I visit home (every 3-4 months) I leave feeling depressed and excited to get home and get a feeling of homesickness almost immediately after the plane touches down in Nevada. I see the desperation and hopelessness in the pictures and status updates from my friends on various social networking sites and as often as I speak to them.

Las Vegas is a superficial dream-like land where anything goes, taboos are normal and people feel as though nothing in life is truly real. The quality of life in Las Vegas is not ideal or even long lasting. People come and go and those who live in Las Vegas enjoy partying, drinking and doing drugs. They suffer eventually from burn out or depression when they are not drinking. The jobs are unstable and dead end, the education is lacking and a majority of my friends had children at a young age. It is a sad place to be and a hard place to move away from. If it was not for my significant other I would have run back to Vegas in 2 months because I missed the illusion of happiness; I missed the smiling tourists who buy you drinks on a whim and tell you lies about themselves to feel better, I missed going out and lying about who I was and what I did to the other tourists. Its hard to adjust anywhere else where people just live and I still do miss the tourists who are taking a break from their lives and just being who they want to be.

If you need evidence of this Vegas caused depression jump on a flight to Vegas and pay attention to the atmosphere of the plane; the chatter amongst passengers, the busy flight attendant delivering drinks to anyone with an I.D. and the utter suspense amongst the passengers waiting to check in to their lavish hotels and pretend to be something they are not. Then fly back home and feel the depression of returning home empty handed with shriveled bank accounts, the burn out from a weekend of drinking and the mistakes that weigh down the plane flying out. The difference is utterly shocking. You can feel the same difference in the check in line versus the check out line in the hotel lobby.

It is an interesting complex and I've got to admit I hate telling people I was born and raised in Las Vegas because immediately I am supposed to be some crazy interesting young person who just wants to have a good time. I love Vegas and it will always be home but I am incredibly happy to have moved; it is truly a wasteland.

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Ashik

we can't take our life...that GOD gives........but in Vegas i think they are doing that
for just Freak out....that's not good......

shastapopsicle

Stephen & Matt,

In the statistic that you gave us at the beginning of this podcast putting the suicide rate so much higher than the homicide rate in the US, does that include euthanasia and assisted suicide?

Thanks!