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Positive association between altitude and suicide in U.S. counties
- feiss 3y ago[flagged]
- ketanmaheshwari 3y agoHN, please shred my work to pieces while sipping coffee.
- h2odragon 3y agoThats why there's so few COBOL programmers left.
- wryoak 3y agoAltitude as a proxy for isolation, perhaps
- scarmig 3y ago> Controlling for... population density of each county,
- lm28469 3y agoIt's a very weak indicator, I'm living in the densest city I ever lived in and I have less social life than ever. Random 5 seconds search: https://academic.oup.com/innovateage/article/2/suppl_1/19/5170860# https://academic.oup.com/innovateage/article/2/suppl_1/19/51... > Follow-up analyses showed there was a significant (p = .005) relationship between population density and isolation in Whites, Hispanics, and others, in that higher population density was associated with greater social isolation. In any case it's much more complex than "many people = no one feels alone" Also if you compare the "suicide by county" and "distance to nearest metro area" map there is a very nice overlap: https://en.wikipedia.org/wiki/Suicide_in_the_United_States#/media/File:Suicide_rate_by_county.webp https://en.wikipedia.org/wiki/Suicide_in_the_United_States#/... https://www.washingtonpost.com/blogs/wonkblog/files/2018/02/REMOTE_purple_1k_small_cities_1k.png https://www.washingtonpost.com/blogs/wonkblog/files/2018/02/...
- rcarr 3y agoI'd say it's not necessarily isolation, but lack of opportunity. Presumably the higher up you are, the less transport links and settlements there are, so geographically you now have less opportunities within a commutable distance. When I say "opportunity" I mean it in a very general sense - it could be social opportunity, dating opportunity, work opportunity, hobby opportunity whatever. When you're deep in the hole of depression, by definition you have lost hope of things improving, which would indicate a dearth of opportunity or novel experiences that could change your mindset. I'd say that cities can feel extremely lonely, because you can see all these people all around you but you can't connect with any of them so you kind of feel disconnected or unwanted which heightens the feeling of loneliness. Wheres if you are in a rural location, you might be lonely for lack of people but feel that if you were to find some people that you would get on with them well. Tying this back to the original point, I think if you can take advantage of the huge variety of opportunities the city offers you can easily overcome "city loneliness" whereas "rural loneliness" is much harder to overcome - if you don't get on with the small set of people nearby or don't enjoy any of the small hobby groups available, you're shit out of luck in terms of social interaction and will have to either move, hope someone new moves nearby, attempt to start your own hobby club or get used to your own company.
- rhplus 3y agoPerhaps there’s some economic FOMO too. You can find coastal (sea level) town with the same population density and median incomes as mountain towns, but the former feels much more connected and accessible than the later. Even a large city like Denver has a remoteness about it… it’s either an 8+ hour drive to the next big city or you have to fly. Compared to west coast, east coast, gulf coast cities and counties, it might as well be an island.
- deleted 3y ago[deleted]
- FollowingTheDao 3y agoIt is so frustrating that people have such a hard time that our mood can be effected by anything other than emotional inputs. It has nothing to do with isolation, it has to to how living in a place that does not match our genetics effects us as biologically animals. This effect is revealing the fact that people ho were genetically adapted to live ate low altitudes should not live at high altitudes.
- eminence32 3y ago> This retrospective study examines 20 yr of county-specific mortality data from 1979 to 1998. I've only read the abstract (so I don't know if my question is answered somewhere in the full report), but does anyone have any insight about why newer data wasn't included in this study?
- bannedbybros 3y ago[dead]
- rmellow 3y agoInteresting correlation! This looks like variable omission. What happens if we control for distance to a body of water? I suspect that has a more direct impact on wellbeing.
- cosmicvarion 3y agoI haven't dug into their controls, but it seems to me that higher altitude may be associated with remoteness.
- Waterluvian 3y agoAlso altitude’s correlation with climate.
- rconti 3y agoI'd say Utah and Colorado probably have better climate due to their elevation. If they were at sea-level they would probably be insanely hot.
- CydeWeys 3y ago.
- andsoitis 3y agoFrom the article: Increased altitude has recently been shown to have a protective association with certain medical illnesses, with apparent decreases in mortality among patients with end-stage renal disease receiving dialysis (Winkelmayer et al., 2009), coronary artery disease (Baibas et al., 2005; Faeh et al., 2009), and stroke (Faeh et al., 2009). By contrast, increased altitude may enhance psychiatric disorders, such as panic attacks (Roth et al., 2002). AND Controlling for... population density of each county
- nabla9 3y agoNope.
- onlyrealcuzzo 3y agoDid they do a study in Colombia or Mexico?
- andsoitis 3y ago
- deleted 3y ago[deleted]
- danesparza 3y agoI don't want to come of as flippant, but I'm genuinely curious: Is there a correlation to how many stories the person's residence has as well? If they live on a 3rd story of an apartment, is there a higher suicide rate than the first floor of an apartment?
- JimtheCoder 3y agoGetting granular data like this on a large scale can be rather difficult. Even knowing things like where the final act was committed (at home, not at home, etc) would be super useful, but that data is hard to come by i'm sure, especially at scale.
- rmellow 3y agoSurely the rate of successful defenestration is lower at the 3rd vs the 13th floor.
- smeej 3y agoThe percentage of time spent at home would vary too much from person to person anyway, whereas percentage of time spent in the county of one's home is much more homogenous.
- Symmetry 3y agoGiven that even a 1000 meter change in height above sea level only leads to a large but not huge change in suicide rates, I'd be very surprised if a 6 meter change in where you spend half the day would be statistically detectable.
- twobitshifter 3y agoThat’s actually a really interesting field of study https://buildingtheskyline.org/highrise-living/ https://buildingtheskyline.org/highrise-living/ High rises have their own associations with mental illness. I don’t know if anyone has ever looked at pure altitude as possible effect.
- CrimsonCape 3y agoHigh-rise depression is caused by the architectural design. Rental apartments in a high rise are for-profit, and 99.9% of the time a developer is maximizing the rentable amount of square footage and minimizing the amount of non-rentable square footage. This eliminates all common spaces that might foster inter-personal interaction and relationships with your neighbors. Anecdotally, a 1:5 relationship is about ideal, for every x5 700 square foot apartments, there should be 700 square feet of common space. Think 5 doors attached to one courtyard that itself is about the size of an apartment. From a for-profit point of view, this is a waste of construction cost.
- plamic 3y agoME: Current resident of Asheville NC (elevation 2,134′). current mood: depressed/agitated. suicide risk: low/medium-low.
- josu 3y agoI'm completely detached from the world of academia. If I want to look at the raw data how can I obtain it?
- ForgottenPwd 3y agoYou contact the study author(s).
- seltzered_ 3y agoI recall seeing this article from 2014 referring to suicides in Utah ('utah paradox') and how neuroscientist Perry Renshaw was trying to link it to altitude: http://mic.com/articles/104096/there-s-a-suicide-epidemic-in-utah-and-one-neuroscientist-thinks-he-knows-why http://mic.com/articles/104096/there-s-a-suicide-epidemic-in... which links to another study from 2011: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2010.10020289 http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.201... "Together, the stray statistics and stories about life out west tipped off Renshaw to a common culprit: altitude-induced oxygen depletion. [...] Renshaw believes that oxygen-poor air tampers with brain chemistry, leading to a drop in serotonin and an uptick in dopamine."
- newsclues 3y agoThis aligns with my similar theory (lack of O2 leads to depression) that was born from observations of yoga, meditation and walking all forced people to breath more air through breath work, exercises or going outside, lead to better mental health outcomes. I am going to assume that in urban vs rural areas that is a similar effect from air pollution. But all my doctors have been inclined to give me pills for depression, and aren't interesting in exploring the relationship with O2.
- jraby3 3y agoI understood that rural air is significantly worse than urban due to all the pesticides.
- AnimalMuppet 3y agoWorse than urban air with auto pollution? I'd want to see a source for that...
- boesboes 3y agoYeah, ppl on the ring road of Amsterdam live 10 years shorter afaik, for instance
- user_7832 3y agoFrom the abstract: > Controlling for percent of age >50 yr, percent male, percent white, median household income, and population density of each county, the higher-altitude counties had significantly higher suicide rates than the lower-altitude counties. Similar findings were observed for both firearm-related suicides (59% of suicides) and nonfirearm-related suicides. So (median) income has been considered, in case anyone is wondering.
- lm28469 3y agoWhich is dumb, what matters is the income of the person who commits suicide, not the median income of their county
- JimtheCoder 3y agoGetting income data from specific people can be hard...
- lm28469 3y agoHarder than publishing bogus studies for sure
- cykotic 3y agoWe live in a world of imperfect knowledge. We look for patterns to try to determine cause/effect. The beginning process for this is to point out correlations and then further investigate. It’s not possible to account for all variables when it comes to things like suicide. It is possible and worthwhile to try to study the phenomenon as best we can.
- lm28469 3y agoThese thing end up on wikipedia and in dubious news sites as "Suicide is caused by high altitude", so yes it does matter a lot actually. It's poor science at best, if you can't control variables then the whole thing is next to useless, which happens a lot these days. At the end you have correlations, not causations
- iraqmtpizza 3y ago[flagged]
- andsoitis 3y agoFrom the article: Similar findings were observed for both firearm-related suicides (59% of suicides) and nonfirearm-related suicides.
- iraqmtpizza 3y agoThey literally corrected for whiteness. So we don't even know what the actual rate would be. Also, studying firearm and nonfirearm separately just screams bias. Why not pharmaceutical vs nonpharmaceutical?
- whimsicalism 3y agoWell it is a good thing you don't have your name on this comment.
- iraqmtpizza 3y agoGood thing I didn't waste six months of my life writing a paper about "what if mountainous areas and lowland areas were equally white, how would the firearm suicide rates compare? we'll throw in some laughable speculation about sleep apnea and mood disturbances to spice it up" also, why isn't the headline "low altitude people more likely to die"
- deleted 3y ago[deleted]
- the_economist 3y agoHigh altitude is also associated with longevity, reduced heart disease, and more efficient mitochondria.
- inpdx 3y agoThey do say this: "Despite a negative correlation (r = −0.31, p < 0.001) between county altitude and the all-cause mortality rate, there was a strong positive correlation (r = 0.50, p < 0.001) between altitude and suicide rate at the county level (Fig. 1)."
- deleted 3y ago[deleted]
- adamgordonbell 3y agoLower BMI as well. https://slatestarcodex.com/2016/12/05/thin-air/ https://slatestarcodex.com/2016/12/05/thin-air/
- programmarchy 3y agoI'd wager a hidden factor is that slopes are more common in higher altitudes i.e. there are simply more hills and stairs one needs to navigate leading to incidental exercise.
- PaulDavisThe1st 3y agoMost population centers in the US west are built on flat land. Think Salt Lake City, Denver, Albuquerque. Even relatively small (80k) Santa Fe, despite having a 5000' elevation gain on its northern edge, is itself almost entirely flat.
- FollowingTheDao 3y agoThis is why it is important to take genetics into account when looking at these studies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460084/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460084/ Not all of us were meant to live at higher altitudes.
- brigadier132 3y agoWhat's the correlation between altitude and the amount of sunlight in a day?
- mrosett 3y agoIn the US, I would assume generally positive. The mountain west gets more sun than the northeast or northwest.
- brigadier132 3y agoI would assume that higher altitudes would have more intense winters that then result in people staying indoors and isolated for longer periods of time? I would guess that altitude and longitude are not correlated globally (at least I don't know why they would be) but in the US I generally associate altitude with snow.
- deleted 3y ago[deleted]
- misja111 3y agoCountries like Finland and Iceland are consistently in the top 5 of happiest countries in the world. Of course that has many non-related reasons, but the effect of intense winters can't be too bad.
- crznp 3y agoFinland and Iceland also have some of the highest suicide rates in Europe. It seems that the correlation between happiness (or well-being) and suicide is complex. Which makes sense: it can be isolating if everyone around you seems to be thriving and you aren't.
- giantg2 3y agoThe definition of "happy" can vary greatly between countries. My understanding is that Finland's "happy" is more similar to the US's "content".
- fulltimeloser 3y agoRelated map of Italian data: https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2Ffzj18fcou0ib1.png https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2Ff...
- paxys 3y agoTL;DR – brain needs oxygen
- FollowingTheDao 3y agoIt is not about oxygen, it is about catecholamine depletion via a decrease in BH4 https://www.liebertpub.com/doi/10.1089/ham.2015.29000.stg https://www.liebertpub.com/doi/10.1089/ham.2015.29000.stg
- vasco 3y agoIt'd be funny if it turned out to be that somehow it's safer to live at higher altitude meaning suicides rates would be proportionally higher since you die less of other things. It's something I've mused about in the past, if you extend technological advances long enough into the future, suicide rates would go up because there'd be less other things to die from due to advances in medicine and so on.
- frud 3y agoI think they kept those factors separate. From the abstract: > Although there was a negative correlation between county altitude and all-cause mortality (r = −0.31, p < 0.001), there was a strong positive correlation between altitude and suicide rate (r = 0.50, p < 0.001).
- marcosdumay 3y agoThat's not the GP's question. In fact, that reinforces the question. To paraphrase the question: since total mortality must be exactly 100%, is the increase in suicides just an automatic and meaningless numeric compensation for the decrease in all-(health related)-cause mortality? The answer to that is somewhere within their methodology on controlling for age. But I was unable to grasp the jargon on this one.
- nabla9 3y agoSuicide is not like cancer vs. heart disease where one replaces another. Older people do slightly less suicides. Suicide rates are up in absolute sense.
- gonzo41 3y agoEh it's all just Lies and Statistics. It's like how 'non drinkers' die earlier than those who lightly drink. But no one who reports it writes the next sentence to explain that, non drinkers include people who don't drink to manage chronic health conditions and thus skew things with their ill health making it seem like alcohol is required to be healthy. I suspect in the future death by choice, in a palliative setting may go up. Though with the current waves of deregulation, maybe we're headed for more industrial accidents. But as for the article. Places that are high up, are cold and isolated and people are social beings.
- dist-epoch 3y agoThey don't mention about temperature. Is it controlled for? Winter months are know to be "sadder" than summer months.
- sokoloff 3y agoI'd expect that difference to be driven by sunlight amount rather than by temperature. Cold is easier to deal with than dark and gloomy when I go to work and dark and gloomy when I come home.
- philote 3y agoI'm curious if they controlled for sunlight then. I'm in a mountainous area and many areas (like where my house is) have mountains blocking sunlight for multiple hours in a day. Couple that with being in a wooded area and even some summer days can feel dark and gloomy. But in my case, being surrounded by nature far outweighs the lack of light in terms of depression.
- PaulDavisThe1st 3y agoPeople who live at altitude in the US western states, particularly in cities, generally have high levels of insolation.
- nonameiguess 3y agoThe figure 1 makes it look like an awful lot like there is no pattern at all for the vast majority of counties, and then the few with the very highest suicide rates are all very high altitude. They also mention this, but I'm not sure country is a great way to measure this. Death Valley and Mt Whitney, the lowest and highest altitude points in the contiguous states, are in the same county. Might also want to remove Vegas, which is high altitude and high suicide, but obviously for unrelated reasons.
- evancox100 3y agoThe appearance of figure 1 is due to the majority of counties being at / near sea level. Suppose we take as true that there is a direct link between altitude and some other phenomenon, for example rates of altitude sickness. If 90% of the counties are near sea level, with some variation, you would only see increased altitude sickness in the 10% highest counties. The graph would look similar to what you see here.
- chongli 3y agoYou could probably control for the Vegas issue by excluding suicides of non-residents, though I don’t know if that information is tracked or not. If that information is not tracked then it’s really useless!
- cozzyd 3y agogambling addiction is a problem for locals as well (perhaps more so).
- PaulDavisThe1st 3y ago> They also mention this, but I'm not sure country is a great way to measure this. Death Valley and Mt Whitney, the lowest and highest altitude points in the contiguous states, are in the same county. Citing the exception to try to disprove the rule generally doesn't work out so well. Most high-elevation counties in the US are situated in extremely large high elevation regions.
- FollowingTheDao 3y agoOh boy, this is a favorite topic of mine because I get psychosis over 7000 feet. And it is all about my genetics. I am a lowlander by heritage, a Sami from Finland, and I carry genetic changes in NOS1AP that lower my ability to make nitric oxide at altitude. But the other factor is polymorphisms in GCH1, a gene linked to altitude adaptation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460084/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460084/ See GCH1 is the enzyme critically needed to make something called tetrahjydrobiopterin (BH4), and BH4 last at the center of the creation of all the catecholamines, like dopamine and serotonin, but also Nitric Oxide. https://www.researchgate.net/figure/Fig-1-Tetrahydrobiopterin-BH4-is-an-essential-cofactor-all-three-hydroxylases-and_fig1_51019292 https://www.researchgate.net/figure/Fig-1-Tetrahydrobiopteri... They make a drug called Kuvan which is a BH4 analogue but they only sell it in the EU because they want those of use with mental illness in the U.S. to suffer. But zinc will increase the activity of GCH1 and alleviate many of these issues for me. https://www.sciencedirect.com/science/article/abs/pii/S0006291X19321667 https://www.sciencedirect.com/science/article/abs/pii/S00062... It has nothing to do with low oxygen, but rather low catecholamines.
- selimthegrim 3y agoOn a related note, how do you feel about the WaPo headliner today about misappropriation of Sami remains for (anthropological, not even medical) "research" https://www.washingtonpost.com/history/interactive/2023/smithsonian-brains-collection-racial-history-repatriation https://www.washingtonpost.com/history/interactive/2023/smit...
- FollowingTheDao 3y agoThanks for that. Makes me hate the how much humanity moved away from nature even more than I already did. They took our language and our spirituality so why not take our brains as well. Sometimes I wonder if my mental illness, and my utter disgust of capitalism, is from the legacy of trauma in my lineage. What is even more interesting is that my senior thesis paper was on a man named John Collier who was the head of the Indian Affairs Bureau in the early 1900's and really into eugenics. He wanted to ship Indigenous Americans all over the country so we could all get their genes and be more like them. Funny that wikipedia called him an "advocate"! https://en.wikipedia.org/wiki/John_Collier_(sociologist) https://en.wikipedia.org/wiki/John_Collier_(sociologist)
- throwaway154 3y agoCompletely tangental: Higher air pressure makes me feel happier.
- frogger8 3y agoI live in Utah and left the LDS / Mormon church in May. I am dating woman that, like most modern American woman, are open to having sex before marriage. It’s not polite to kiss and tell but turns out being touched starved IMHO is a really shi77y way to live.
- deleted 3y ago[deleted]
- oldstrangers 3y agoWonder if they've looked at Vitamin D considering there's an association with living at high-altitude and Vitamin D deficiency.
- knice 3y agoWould higher altitude not correlate with colder, gray, gloomier (highly scientific term) winters?
- hx8 3y agoColder, sure. If by gray/gloomier you mean cloud cover then I don't think so. Regardless, high altitude cities like Denver, Salt Lake City, Reno or Boise are neither particularly cold or cloudy when compared to other US cities.
- giantg2 3y agoWe also have to consider that temperatures feel different at altitude (and the mountain west is generally very dry). A dry 20F at 10k' feels more like 40F at sea level on the East coast.
- twobitshifter 3y agoMight be associated with worse air quality however. Denver is particularly bad in terms of ozone. “at high altitudes, atmospheric pressure is reduced, and oxygen is less available (commonly referred to as the air being “thinner”). This has a couple of effects on air quality for the people in the area. First, combustion engines perform less efficiently than they do at lower altitudes, causing an increase in emissions. Second, UV rays from the sun have a greater impact at high elevations, leading to an increase in photochemical smog, the result of airborne pollutants reacting with sunlight.” https://www.aprilaire.com/blog/altitude-and-healthy-air-air-quality-at-higher-elevations/ https://www.aprilaire.com/blog/altitude-and-healthy-air-air-...
- sigtstp 3y agoJust to nitpick > strong positive correlation between altitude and suicide rate (r = 0.50, p < 0.001). That is not strong. Put differently, altitude only explains 25% of the suicide rate. I know some fields have lower thresholds for what they consider strong, but still. An effect, sure, but I'd bet on this pointing to something else. Not familiar with the demographics vs geography here, but how do typical high-altitude places look like in terms of society? They control for median household income and population density, but what about social attitudes? (are these places more rural? more traditionalist?), number of ways people can engage socially (say, cultural events, clubs, and so on), does their diet differ? etc etc. Also, maybe putting the year (2011) in the title might be good. There may be more recent work / reviews. EDIT: I forgot to mention diet
- itronitron 3y agoHere's another nitpick for you, Figure 1 is showing the independent variable (elevation) on the y-axis instead of the x-axis. And I don't know why they used a line plot instead of a proper histogram.
- victor106 3y agoWhy is elevation the independent variable?
- selectodude 3y agoBecause they’re trying to see if the suicide rate depends on the altitude.
- hx8 3y agoIs there a biological process that explains how high altitude impacts suicide rates, or are there social variables that aren't controlled for. This paper gets a lot of scrutiny, but it's been out for over a decade and hasn't been debunked or explained. I've been mulling over this one for awhile, and have had several conversations with reasonably informed individuals in related fields. There's a lot of theories, many of which are explored in the comment section here. If you strongly believe in a theory, I'd like to remind you that this is a line of inquiry that could have life saving implications.
- DoreenMichele 3y agoThere are a lot of biological processes that happen at altitude, but HN is a great place to get pilloried for speaking off the cuff about "hypotheses" of this sort.
- porkbeer 3y agoIf you only look at gun deaths, and dont control for gun ownership, wtf is this study for?
- squokko 3y agoI think mountain/hillbilly culture in the US is very much its own thing and cannot be understood by lowland Americans. Maybe people in Scotland / Afghanistan / etc. will understand it better.
- slowmovintarget 3y agoNeeds a [2011] tag.
- nurumaik 3y agoRelated interesting read: https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-part-i-mysteries/ https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-p... TLDR: Author researches obesity epidemic in US, finds out negative correlation between obesity and altitude and comes to a hypothesis that it may be due to possible higher concentration of lithium in the water in lower areas Wonder if this is also the reason in this case since lithium is an antidepressant
- forgetfreeman 3y agoMedian household income seems like a pretty bullshit metric when talking about parts of the country where it's not uncommon for multi-million dollar ridgetop mansions to coexist with gross poverty. All of the high elevation country I've visited (disregarding obvious outliers like Denver and the front range) had a few things in common: very wealthy people enjoyed having homes there and the rest of the locals were dirt poor with no obvious opportunities for social or economic advancement.
- incangold 3y agoThis is so important and I notice studies missing it all the time. Tragedy and desperation mostly kick in at the bottom of the distribution, especially in the US where median income is in most places not completely awful. So controlling for the bottom 20th percentile or something makes way more sense.
- CaptainNegative 3y agoWhy is this a bad case for using the median, which is normally pretty resilient to influence from outliers?
- wnoise 3y agoBecause the variance (or any other measure of spread) is a useful explanatory variable that is ignored and left on the floor. Switching from mean to median, while more "robust" doesn't actually capture something new, just something old slightly better.
- deleted 3y ago[deleted]
- tetrep 3y ago> Using a different methodology, a similar, strong positive correlation between altitude and suicide rates has recently been reported by Kim and colleagues, (2011) using all counties in the United States as well as all 233 counties in South Korea. I assumed culture was a large component to this, but I don't know enough about South Korea to compare its high altitude people to those of the US. Maybe it is something environmental?
- bwanab 3y agoMountains == isolation. I grew up in a mountainous region where the ridges separate the valleys. If your friend lived a mile away, it might take 20 miles of driving to get there because of the separation. I wonder if they've measured that people who are very isolated have more suicide?
- scoofy 3y agoThe problem is that there are low altitude mountains. The argument here is that the suicide rate of Denver or Park City should be higher than folks living in the isolated mountains of Maine or Oregon.
- exclusiv 3y agoAnecdotally, I've found mountain people to be much crazier than normal. The desert has high drug use and has crazies, but even desert people acknowledge the mountain people are more unpredictable and unhinged. This may or may not be fair, I don't know, but from my experience, if I'm to theorize a generalization in conjunction with this study: Poor education. Lack of steady jobs. Low ambition. They consider themselves self-reliant people even if they take government subsidies. Don't need to work much to maintain their lifestyle. Would prefer to get a higher hourly rate, not to extrapolate to have a nice income, but to be able to work like 20% of the year, be paid in cash and also take government benefits. Which is likely also driven by the lack of steady jobs that provide healthcare to be fair. Idle time and lack of structure in their lives leading to higher drug and alcohol usage. Financial and health stress. Leading to higher suicide rates. Study mentions altitude itself and hypoxia and controlling for income. But one could have the same income in a lower altitude location and have MUCH better access to healthcare, quality of healthcare, and steadier/structured employment than the higher altitude people that take their life. As with most things, I think it's a combination of factors. And the altitude itself seems to be one of them. Not only from the study's stated hypoxia, but it's a lot harder to work at altitude just like it is in the desert with the heat. When people don't have steady jobs and schedules, they have idle time, and along with other pressures and stress, bad things happen.
- TheGigaChad 3y ago[dead]
- Schattenbaer 3y agoInteresting. The WHO lists Lesotho as having the highest per-capita suicide rate in the world. Lesotho is the country with the highest low point (1,400 metres / 4,593 ft) of any country in the world. More than 80% of Lesotho lies above 1,800 metres (5,906 ft).
- siftrics 3y agoWhat about mine runoff? It almost certainly causes depression, not to mention death, and is highly correlated with altitude.