”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.
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?
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.
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.
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.
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.