In a study that looked at suicide deaths during 2020’s first wave of the COVID-19 pandemic in Maryland, Johns Hopkins Medicine researchers found that, contrary to general predictions of suicides skyrocketing, suicides in the overall population actually dropped, relative to previous years. However, the researchers also discovered that suicide deaths increased dramatically among Black Marylanders during the same period.

The researchers say that their findings, published Dec. 16, 2020, in JAMA Psychiatry, highlight the importance of timely identification of high-risk groups and vulnerable populations to reduce suicide numbers.

Black Americans have been disproportionately affected by the COVID-19 pandemic, underlining long-standing health and social inequities. “Looking at suicide trends by race emphasizes the economic divide we’re seeing in America and unfortunately, that divide also is a racial one,” says Paul Nestadt, M.D., assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine.

According to Nestadt, the increase in suicides among Black Marylanders — during the period when COVID-19 deaths peaked and the state was locked down — could be reflective of a socioeconomic divide. In comparison, he adds, the unexpected decrease in suicides in white Marylanders could be due to greater capacity for remote work or benefit from economic relief efforts.

“I think we’re all in this COVID-19 storm together, but not everyone is having the same experience,” says Nestadt. “Folks who are in places of economic privilege have been able to continue working more or less remotely, to take time off for themselves, reconnect with family, start a new hobby and so on, but it’s a very different story for people working in service industry jobs.”

In their study, the researchers looked at suicide deaths from Jan. 1 through July 7, 2020. The data were divided into three periods: a pre-COVID-19 period 1 (Jan. 1 to March 4, 2020); a “progressive closure” (lockdown) period 2 (March 5 to May 7, 2020); and a “progressive reopening” period 3 (May 8 to July 7, 2020). Daily suicide mortality was divided by race and compared with the same periods, from 2017 through 2019.

During period 1, daily suicide mortality did not differ from the same period in 2017 through 2019 for either race, and, in period 3, the rates did not differ for Black residents compared with previous years. However, period 2 daily suicide deaths among Blacks increased by 94% and decreased 45% among whites, compared with the same period in 2017 through2019.

“The implications of our findings are more far-reaching than just suicidology,” says Nestadt. “It should help policymakers recognize the importance of things like economic relief and increasing access to equal care, so that there’s an end to such disproportionate deaths.”

Nestadt says further research is needed to characterize these trends. As continuing pandemic restrictions drive public health priorities, he says, policy interventions and targeted resource allocation are needed to mitigate disparities affecting Black Americans.