Introduction Approximately 49,000 persons died by suicide in the United States in 2022, and provisional data indicate that a similar number died by suicide in 2023. A comprehensive approach that addresses upstream community risk and protective factors is an important component of suicide prevention. A better understanding of the role of these factors is needed, particularly among disproportionately affected populations. Methods Suicide deaths were identified in the 2022 National Vital Statistics System. County-level factors, identified from federal data sources, included health insurance coverage, household broadband Internet access, and household income. Rates and levels of factors categorized by tertiles were calculated and presented by race and ethnicity, sex, age, and urbanicity. Results In 2022, the overall suicide rate was 14.2 per 100,000 population; rates were highest among non-Hispanic American Indian or Alaska Native (AI/AN) persons (27.1), males (23.0), and rural residents (20.0). On average, suicide rates were lowest in counties in the top one third of percentage of persons or households with health insurance coverage (13.0), access to broadband Internet (13.3), and income >100% of the federal poverty level (13.5). These factors were more strongly associated with lower suicide rates in some disproportionately affected populations; among AI/AN persons, suicide rates in counties in the highest tertile of these factors were approximately one half the rates of counties in the lowest tertile. Conclusions and Implications for Public Health Practice Higher levels of health insurance coverage, household broadband Internet access, and household income in communities might play a role in reducing suicide rates. Upstream programs, practices, and policies detailed in CDC's Suicide Prevention Resource for Action can be implemented by decision-makers, government agencies, and communities as they work together to address community-specific needs and save lives.

中文翻译：

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生命体征：自杀率和选定的县级因素 - 美国，2022 年。


简介 2022 年，美国约有 49,000 人死于自杀，临时数据表明，2023 年也有类似数字死于自杀。解决上游社区风险和保护因素的综合方法是预防自杀的重要组成部分。需要更好地了解这些因素的作用，特别是在受影响较大的人群中。方法 2022 年国家人口动态统计系统中确定了自杀死亡人数。从联邦数据源确定的县级因素包括健康保险覆盖范围、家庭宽带互联网接入和家庭收入。按三分位数分类的因素的比率和水平是按种族和民族、性别、年龄和城市化来计算和呈现的。结果 2022年，总体自杀率为每10万人14.2人；非西班牙裔美洲印第安人或阿拉斯加原住民 (AI/AN) 人 (27.1)、男性 (23.0) 和农村居民 (20.0) 的比例最高。平均而言，在拥有健康保险覆盖率（13.0）、接入宽带互联网（13.3）和收入达到联邦贫困线>100%（13.5）的个人或家庭百分比前三分之一的县中，自杀率最低。在一些受影响较大的人群中，这些因素与较低的自杀率密切相关；在 AI/AN 人群中，这些因素最高三分位县的自杀率大约是最低三分位县自杀率的一半。结论和对公共卫生实践的影响更高水平的健康保险覆盖范围、家庭宽带互联网接入和社区家庭收入可能在降低自杀率方面发挥作用。 决策者、政府机构和社区可以共同实施 CDC 自杀预防行动资源中详细介绍的上游计划、实践和政策，共同满足社区的特定需求并拯救生命。