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States’ COVID-19 Policy Contexts and Suicide Rates Among US Working-Age Adults

Emily E. Wiemers, Shannon M. Monnat, Douglas A. Wolf, Jennifer Karas Montez, Joshua Grove, Iliya Gutin, Elyse Grossman

Health Affairs Scholar, March 2025

Emily Wiemers

Emily Wiemers


Shannon Monnat

Shannon Monnat


Douglas A. Wolf

Douglas A. Wolf


Jennifer Karas Montez

Jennifer Karas Montez


Joshua Grove headshot

Joshua Grove


Iliya Gutin headshot

Iliya Gutin


Despite expectations that suicide rates would surge during the pandemic, the national suicide rate declined in the United States in 2020 before returning to pre-pandemic levels in 2021. Explanations of the decline in suicides at the national level include a “pulling-together effect” in the face of a crisis and a shorter than expected pandemic recession. However, suicide rates and the change over time in suicide rates vary substantially across US states.

At various times during the pandemic states enacted physical-distancing and economic support policies that may have affected suicide rates. We examined the association between state-level physical-distancing and economic support policy contexts and suicide rates among US adults ages 25–64 years during the COVID-19 pandemic.

We found that a 1-SD increase in the stringency of a state's physical-distancing policies was associated with a 5.3% reduction in male suicide rates but was not associated with female suicide rates. Economic support policies were not associated with suicide rates for the period as a whole.

The results support the growing evidence that COVID-19 policies had indirect and unintended consequences beyond their direct effect on COVID-19 transmission and death, in this case to reduce suicides among working-age males.