Socio-Spatial Patterns of Suicide Mortality in the United States

Abstract

Suicides cause over 49000 deaths yearly in the United States, 55% involving firearms. Suicide mortality exhibits substantial geographical and sociodemographic heterogeneity; yet the role of social networks remains underexplored. To assess how suicide risk and firearm restriction policies propagate through social ties, we integrate county-level suicide mortality data (2010-2022) with the Facebook Social Connectedness Index (SCI). We also examine Extreme Risk Protection Orders (ERPO), state-level policies restricting firearm access for individuals at risk of self-harm. In two-way fixed effects regressions, a one-standard-deviation increase in the SCI-weighted average suicide mortality rate of connected counties was associated with +2.78 deaths per 100,000 in a focal county, while a one-standard-deviation increase in ERPO social exposure was associated with -0.214 deaths per 100,000. These associations persisted when adjusting for geographic proximity and including state-by-year fixed effects, and confirm the effect of social networks on diffusion of both harmful exposures and protective interventions.