12/n It's interesting at this point to note that the overall suicide rate in Whites in Maryland appears to be 2-3x higher than that of Blacks, which raises the question of age-adjustment and whether it would impact these results
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13/n That being said, it is immediately pretty obvious that the overall rates have not changed at all in Maryland over the first 6 months of the year for Black people. The yearly avg noise is bigger than the margin between 2019 and 2020pic.twitter.com/5R3ynhbSIE
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14/n Conversely, there is clearly a strong decreasing trend for the suicide rate in White people in Maryland, which has gone down by quite a bit every year for the last fourpic.twitter.com/nvh0D47UiC
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15/n So overall in this time period Black suicides haven't changed, and White suicides have gone down quite a lot per 100k person-years This doesn't really seem to support the authors conclusion that COVID-19 has caused divergences in the suicide rate by race
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16/n If we look at the individual time-periods, the data gets a lot more noisy, and it's very hard to discern an impact. In period 3, for instance, both Black AND White suicides appear to be trending downpic.twitter.com/dDUnVVnCmM
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17/n In period 2, this is reversed, with White suicides still trending down but Black suicides trending uppic.twitter.com/mxWv5nFmyS
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18/n Indeed, the exact thing that the authors have attributed to COVID-19 - a doubling in the Black suicide rate - happened in 2017/18 in period 2
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19/n Ultimately, the numbers just aren't there to take home much meaning from this in my opinion. Overall, there have been no changes in suicide rates by race in Maryland in the first half of 2020 - the figures show that quite clearly
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20/n This is not to say that there should not be targeted efforts to help Black people with mental health, which is of course a priority that cannot be ignored. Public health equity is a really important consideration
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21/n And it's also not to say that a study with larger numbers may not be able to show such a difference. It is certainly possible that there is a meaningful change here that is simply not possible to see with so few events
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22/n That being said, numerically I think it's important to note that the doubling of suicides in the Black community during Mar/Apr in Maryland was entirely offset by a 20% reduction in suicides in the preceding and following months
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23/n There may be a statistical test that shows significance of a sort here, but conceptually I don't think there is much meaning to be garnered from numbers like this
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