Air Pollution and Suicide in Rural and Urban America: Evidence from Wildfire Smoke

<b>This repository contains replication code and publicly-available data accompanying the article "Air Pollution and Suicide in Rural and Urban America: Evidence from Wildfire Smoke".<br></b><br>Reproducing the results of the study requires the restricted-access Detailed Mortality Files (2007-2019) from the National Center for Health Statistics (NCHS), which is not provided as part of this repository. Instructions for requesting the data can be found in the accompanying article. This repository contains all code and cleaned publicly-available data, allowing users with access to the NCHS data to replicate all results of the study.<br><br>Article Abstract:<br><br>Air pollution poses well-established risks to physical health, but little is known about its effects on mental health. We study the relationship between wildfire smoke exposure and suicide risk in the United States in 2007 to 2019 using data on all deaths by suicide and satellite-based measures of wildfire smoke and ambient fine particulate matter (PM2.5) concentrations. We identify the causal effects of wildfire smoke pollution on suicide by relating year-over-year fluctuations in county-level monthly smoke exposure to fluctuations in suicide rates and compare the effects across local areas and demographic groups that differ considerably in their baseline suicide risk. In rural counties, an additional day of smoke increases monthly mean PM2.5 by 0.41 μg/m3 and suicide deaths by 0.11 per million residents, such that a 1-μg/m3 (13%) increase in monthly wildfire-derived fine particulate matter leads to 0.27 additional suicide deaths per million residents (a 2.0% increase). These effects are concentrated among demographic groups with both high baseline suicide risk and high exposure to outdoor air: men, working-age adults, non-Hispanic Whites, and adults with no college education. By contrast, we find no evidence that smoke pollution increases suicide risk among any urban demographic group. This study provides large-scale evidence that air pollution elevates the risk of suicide, disproportionately so among rural populations.