Record suicide toll rocks Colorado. Could altitude be to blame?

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By Katie Kerwin McCrimmon
Health Policy Solutions

The iconic Western cowboy has long enchanted artists and pioneers alike. Who could be more carefree than a man alone on his horse, herding cattle as jagged peaks tower overhead?

The romance with the Rocky Mountain West is fundamental to our American DNA. Yet, there is a hidden peril for these mavericks and stoic ranchers, as poisonous as cigarettes were to the rugged Marlboro man.

Depression and suicide rates are alarmingly high among ranchers and rural residents in Colorado.

Throughout the state, Colorado has set an unfortunate record with the highest number of suicides ever recorded in state history. Altogether, 940 people took their own lives in 2009, the most recent year for which data is available.

Among the stark statistics:

• The toll marked a 17 percent increase over the next highest year, 2007, and the highest suicide rate per capita in Colorado since 1988.
• Nearly twice as many people died by their own hands last year as those who died in car accidents.
• Almost 80 percent of those who committed suicide were men.
• While the state no longer tracks suicides specifically among ranchers or farmers, the suicide rate is disproportionately high in Colorado’s rural counties.
• While the suicide rate is higher in rural Colorado, the number of suicides is greater in more populated, urban areas.
• Colorado consistently ranks among the top 10 states in the country for suicide.
• In 2007, the last year for which national statistics are available, Colorado had the sixth highest suicide rate in the country.

Now, a new study may help explain the high suicide rates that have long confounded mental health workers in Colorado and the Rocky Mountain West.

Dr. Perry Renshaw, a psychiatrist at the University of Utah’s Brain Institute and an investigator with the Veterans Affairs Rocky Mountain Mental Illness Research, Education and Clinical Center based in both Salt Lake City and Denver, has found a new overwhelming link between high altitude locations and suicide. The study could have profound implications for suicide prevention in Colorado – the state with the highest average altitude in the country.

“At 6,000 feet (above sea level) suicide rates increased by approximately 70 percent. It’s huge,’’ said Renshaw, the lead researcher on the study.

Causes for suicide can be extremely complicated. Renshaw and fellow researchers looked at other risk factors in the region including a high rate of gun ownership and isolation from low population density. Gun ownership is a well recognized contributing factor for suicide and past studies have shown that suicide rates are higher in rural areas. But suicide experts hadn’t ever looked specifically at the impact of altitude on mood disorders.

The Utah team’s research found that gun ownership and low population density alone could not sufficiently explain increased rates of suicides at higher altitudes. They found that altitude was an independent risk factor. Renshaw cautions that more research needs to be done, but he believes that oxygen deprivation at higher elevations, known as hypoxia, may cause metabolic stress on people with depression and other mood disorders.

“We calculated the altitude for every county in the U.S. and you get this whoppingly  high correlation between high altitude and suicide risk,’’ Renshaw said. “The take-home message is that it’s exceedingly unlikely that this would happen by chance. It would be just one chance in a gazillion.”

Veteran suicide researchers remain skeptical about a direct link between high altitude and suicide. Many had theorized that there was something unique about the people drawn to the American West that elevated suicide risk. To test for this, Renshaw and his team looked at data from Korea,  a country with varying high-altitude topography similar to the Rocky Mountain region. They found exactly the same trend in a totally different culture.