State public health authorities have launched a new line of attack in their fight against suicides, using sophisticated data analytics to investigate the causes behind a sharp rise in the number of Minnesotans taking their own lives.
Nearly two years after they first sounded the alarm about the state’s surging suicide rate, researchers at the Department of Health have built a database to help pinpoint where, how and why nearly 700 Minnesotans die by suicide each year — a number that is up 30 percent in the past decade.
Now the state is using that data to craft targeted prevention campaigns in communities where suicide outbreaks, or “clusters,” have emerged. “We have come many miles from where we were just two years ago, and the implications for the state are huge,” said Dan Reidenberg, executive director of SAVE, a national suicide prevention organization based in Bloomington.
The effort is already bearing fruit for one community. In the West Side neighborhood of St. Paul, residents have long suspected that the High Bridge on Smith Avenue had become a common spot for suicides. Periodically, traffic on the bridge would be halted at rush hour as police recovered a body or attempted to talk someone off a railing. Yet without reliable data, residents had a hard time making the case for structural changes to the bridge.
That changed last fall, when state researchers culled county coroner data and confirmed that at least six people — the highest on record — had died by jumping from the bridge last year.
The finding led to a series of meetings, and now the Minnesota Department of Transportation is exploring a set of changes, such as higher railings, artwork and better lighting, on the High Bridge, which was already scheduled for a multimillion-dollar renovation in 2018. And, for the first time, the agency has created an internal work group dedicated to finding ways to prevent suicides on bridges, roads and highways across the state, using data mined by the Health Department.
Meanwhile, residents in St. Paul’s West Side neighborhood have begun community walks across the bridge, and have stenciled suicide hot line numbers on its sidewalk, in the hopes of preventing more deaths. There is also talk of installing miniature kiosks, filled with messages of hope and perseverance, at spots along the bridge’s rusted railings.
“It’s profound, really, how far we’ve come,” said Jolene Olson, 38, of St. Paul, one of the project leaders. “We’ve gone from not knowing if this was a serious problem to significant changes in policy.”
Dana Bogema, 44, a West Side resident who saw a man fall to his death as she jogged across the High Bridge one afternoon last July, said she hopes the renovations will “change the narrative” about the bridge.
“A bridge should be a hopeful place, a crossing to brighter future,” Bogema said, as she walked across it one day last week. “Any changes here should affirm life.”
Drowning? Or suicide?
The catalyst for the changes was a decision by the Health Department in late 2014 to join a nationwide data collection effort known as the National Violent Death Reporting System, or NVDRS. The initiative links state agencies with local law enforcement, coroners and medical examiners to obtain a more up-to-date and complete picture of violent deaths.
At the time, health officials were at a loss to explain a sharp and sustained increase statewide in suicides, across virtually all age and ethnic groups. Suicide is now the eighth leading cause of death in Minnesota — far ahead of homicides — with nearly two suicides for every motor vehicle-related death.
To identify trends, the state had relied almost exclusively on death certificates, which list the cause of death and basic demographic information but provide little additional detail. For instance, a fatal leap from a bridge may be identified as a “drowning” on a death certificate, with no mention of a jump or where it happened.
“Suicide prevention is extremely complex,” said Melissa Heinen, suicide prevention coordinator for the Health Department. “You can’t just pull a program off a shelf and expect it to work. You have to be responsive to local communities, and that starts with reliable data.”
With a five-year grant through NVDRS, the state finally has the staff to sift through reams of data that were previously ignored and identify emerging patterns. From small cubicles in the Hennepin County and Ramsey County medical examiners’ offices, the state now has full-time researchers methodically reviewing thousands of medical examination reports for information on suicides.
The goal is to build a database big and varied enough to forecast patterns, in much the same way that data can predict shopping habits. “You can’t prevent what you can’t count,” said Jon Roesler, injury epidemiologist supervisor at the Health Department, who is leading the data-gathering effort. “We were operating for much too long in the dark.”
Clues in clusters?
Already, the state is using the data to react more quickly to prevent a phenomenon known as “contagion,” in which clusters of suicides occur in the same place or community. In the Twin Cities’ Laotian refugee community, for instance, the Health Department is trying to identify trends after residents raised concerns about a rash of suicides. That meant looking beyond death certificates, which typically group Laotians into the broader ethnic category of “Asian Pacific Islanders.”
State researchers also are concerned by a troubling 82 percent spike in suicides among blacks in Minnesota between 2010 and 2014, a group that had previously seen stable rates.
They hope the death reports can tell them whether the rise is occurring among U.S.-born African-Americans or more recent immigrants from Somalia and other African countries. The findings, expected later this spring, should influence how authorities craft a response, Roesler said.
While Bogema supports more aggressive prevention efforts, she hopes people don’t forget the “small things,” such as friendly conversations and expressions of hope, that can prevent someone from acting on suicidal thoughts.
Sometimes, as she jogs or walks along the High Bridge, Bogema replays the events of that July afternoon when she witnessed the man’s fall. She imagines what she would have said had she been close enough to speak to him.
“I probably would’ve said, ‘Hey, you wanna grab some coffee?’ ” Bogema said. “Then I would’ve told him that I’ve had days like that, too … And after that? I guess I would’ve just been there, you know, to listen.”