Geographical isolation, mental health, economic stress and firearm suicide in Harris County, Texas

Combining medical and Harris County Medical Examiner records with socio-economic data, 750 firearm suicides that occurred between 2018 and 2020 in Harris County, Texas were studied to understand the interaction of geographical isolation with mental illness, economic stress, and alcohol abuse. Spatial variation in the shooting locations by distance from downtown Houston explored center-periphery differences. Regression modeling by census block groups analyzed the relationship between firearm suicides per capita with neighborhood factors. Males were more likely to die by firearm suicide as were persons of non-Hispanic White ethnicity. Almost half had a mental health diagnosis or suspicion, in particular depression. The firearm suicide rate increased with age and by distance from downtown Houston as did depression and anxiety disorder. More firearm suicides per capita occurred in block groups farther from downtown Houston and in those that had higher poverty rates and more bars. The results suggest that firearm suicides are associated with an interaction of aging, geographical isolation, mental illness, and economic stress. There is a need for increased outreach, community services, and mental health services in suburban and rural areas as well as a need to improve firearm safety policies. • 750 persons dying by suicide from firearms in Harris County, TX between 2018 and 20 were examined. • Males, non-Hispanic Whites, and older persons were more likely to die from firearm suicide. • 43 % were diagnosed with a mental health problem, particularly depression • The firearm suicide rate increased with distance from downtown Houston, as did mental health disorders • Spatial correlates suggest geographical isolation, aging, mental illness and economic stress increase suicide likelihood.