A recent Washington state government report about suicide prevention lists several population groups that have an increased risk of suicide. Bizarrely, males are not included on the list.
Below we’ve provided a marked-up screenshot of page 2 of the report, which was jointly issued by the Department of Health and Health Care Authority in November 2023. It is the first annual report required under recent legislation about implementing the nationwide 988 Suicide & Crisis Hotline.
In Washington, 77% of suicide deaths are males. That is a ratio of 3.3 boys and men dying by suicide for each woman or girl dying by suicide. And this does not account for the additional gender disparities in deaths from drug overdoses and alcohol abuse, which together with suicide deaths comprise what are referred to as deaths of despair.
Parallel to Richard Reeves’ criticism of the CDC
Richard Reeves is president of the American Institute for Boys and Men and author of the book Of Boys and Men: Why The Modern Male Is Struggling, Why it Matters, and What to Do About It.
Our criticism here of Washington’s Department of Health and Health Care Authority parallels Reeves’ criticism of the U.S. Centers for Disease Control in his September 2023 article with this headline: By far the biggest risk factor for suicide is being male.
Reeves says, “We should pay attention to disparities in suicide rates, especially the biggest one.” He continues:
“It is very good that the CDC has a whole section of its website devoted to disparities in suicide. But it is very bad that the CDC manages to completely ignore the biggest disparity of all: the one between men and women.”
Reeves’ observation was correct then and it remains true in March 2024. If you view the CDC’s webpage about Disparities in Suicide today, you’ll find that the problem persists.
The CDC acknowledges that suicide rates differ by:
- Age
- Race and ethnicity
- LGBTQ status
- Veteran status
- Disability status
- Industry and occupation
- Geographic region
What the CDC leaves off the list is that suicide rates differ significantly by sex and gender.
The graph below illustrates what a conspicuous lapse this is by both the CDC and our state’s Department of Health and Heath Care Authority.
A narrative violation
Here is another excerpt from Richard Reeves’ article referenced above:
“Why does the CDC downplay or even ignore the glaring gender gap in suicide risk, even in the context of highlighting disparities. I don’t know. Perhaps someone from the CDC would be willing to debate some of our concerns. Maybe we’re missing something. But it’s hard to avoid the conclusion that highlighting any gender gaps that disfavor boys or men is what Ezra Klein called, in his podcast with me, a “narrative violation”. It goes against the grain of certain assumptions about the shape and direction of inequality. But when the stakes are as high as this, such neglect is just unacceptable, and from a public health perspective, a dereliction of duty.”
Parallels to other local examples
Washington Initiative for Boys and Men has observed a pattern of our state government officials overlooking instances when males as a group are experiencing disparate outcomes. Considering that it is really no one’s job within government or outside of government to ensure that male gender gaps are addressed, this may be attributable to a lack of awareness.
Here are three more examples:
- House Bill 1177 established a Missing and Murdered Women & People Cold Case Unit in the Washington State Attorney General’s Office. Males are the majority of Indigenous homicide victims and the majority of cold cases. However, other than Blair Daly of WIBM, no one who testified on the bill spoke the word “men,” “boys,” or “males” even one time in 20+ testimonies. Learn more.
- House Bill 1354, if passed, would have established a state commission to study the causes of youth suicides. However, other than WIBM, no one who testified on the bill acknowledged in any way that most youth suicides are boys and young men. Learn more.
- A Washington Department of Health press release about drug overdose fatalities called attention to race-related disparities and age-related disparities, but it said nothing of the sex-related disparity in overdose deaths. Depending on the year, between two and three times as many boys and men are dying compared to women and girls. Learn more.
“To the Washington Health Care Authority, health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences…Health equity is a core value.”
– Washington State Health Care Authority
Leaving out concern for boys and men
In Washington, explicit efforts to achieve equity for population groups consistently exclude concern for males as a group. Given the wide range of disparities impacting Washington’s boys and men, this cannot be due to males already enjoying the fruits of equity.
Some municipal governments in Washington have shown a willingness to acknowledge disparities affecting males. For example, see the International Men’s Day proclamations issued by the City of Ellensburg in 2022 and the City of Bellevue in 2023.
State law also does not mention males
The same section of state law that requires an annual report about the 988 Suicide & Crisis Hotline is worth examining from the standpoint of what it says about boys and men as a population group.
It starts by emphasizing that guidelines for appropriately serving high-risk populations should pay attention to gender.
Later, the law fails to note the gender-based inequity in deaths by suicide.
A matter of properly informing policymakers
For our policymakers to be effective in reducing harms, they need accurate information about where those harms are concentrated. Currently, they are rarely exposed to the range of gender gaps that disfavor boys or men.
Literally a one-word fix
If the government’s report had simply included the word “males” on its list of groups who are at increased risk for suicide, that would have sufficed.
This is a very easy fix to make for the Department of Health and Health Care Authority in next year’s report.
See related: National Organization Partnership for Male Youth Endorses Washington’s Commission on Boys and Men Bill