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Comment by kevadk | Hacker News Reader

For comparison, here are a few of the highest rates per 100k in the US:

98.7 - Kusilvak Census Area, AK; 75.1 - Nome Census Area, AK; 64.2 - Sioux County, ND; 58.9 - Buffalo County, SD; 49.3 - Carbon County, UT

https://vizhub.healthdata.org/subnational/usa

Extend the list and you see lots of high latitudes, low incomes, remote rural settings, and indigenous American populations (e.g. Yupik and Inupiaq in Alaska, Sioux in the Dakotas).

Alcoholism is often common in these places, although survey data do not show it affecting the groups in northern Alaska so heavily. Deaths due to chronic liver disease are not particularly high for them, either. There's a distinct history in Nunavut, though, so the story might be different.

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Great link. This is the interactive graphic that should have appeared with the article. Instead of a single narrative, users can explore various scenarios as they read along. Looking at this strictly from a geographic standpoint, for instance, there's something weird going on in North Dakota between Carson County and Sioux County. It really stands out on the map. Alaska also looks quite odd.

"something weird" being the native american population, who have been getting trampled on by Americans for hundreds of years now.

Not sure why this is being downvoted? Clearly these people have no idea about the Plains Wars, Custer's Last Stand and Wounded Knee. They have absolutely been trampled on and worse (murdered).

Wounded Knee happened 130 years ago, so in order to explain today's problems with it you would have to know the rate at which historical impacts decayed through time.

Its being downvoted because its childish simplistic view of things. I grew up in Grant county, literally west of Sioux county. There are a lot of reasons for the high suicide rate in Sioux county, historical facts like Custer aside, unless you've lived in this part of the country, you really have no idea what its like there. Did westerners do a number on the Nakota/Dakota/Lakota/Sioux/Mandan/etc..? Duh, but thats not really why kids are killing themselves today. Hell even in the surrounding counties suicide is pretty common for the same reasons as in the reservation. There is no opportunity, and depression is pretty common.

Side note, I have family in Sioux county as well. I'll be blunt and say, if you've only grew up on the coasts, kindly butt the fuck out of why the suicide is high. I could name 10 people in and out of Sioux county I know that ate a bullet, if all you're going to do is use this for internet points piss off.

I'm going to hold my tongue but I'd love to hear you say that to my face. You are not the only one affected by suicide, I don't care if you live in bumfuck or the East Coast. You know nothing about how suicide has impacted me personally. I'm making an observation about historical events which have led to the lack of opportunity.

This is not the right way to go about it. His point is sound, no matter your personal experinces. The midwest is a distinct culture alien to the majority of americans. I routinely see the issues we face minimized, and suicide is where i draw the fucking line.

I'm sure you also have good reason to feel personally intense about this topic. But please follow the site guidelines when posting here, especially on topics where feelings are understandably strong. Note the first one listed under "Comments": Be kind.

https://news.ycombinator.com/newsguidelines.html

I know it's difficult to stay even about something so personal and intense, but please don't break the site guidelines like that, even when feelings are high. It only makes things worse, as other people then feel entitled to lash back more strongly.

https://news.ycombinator.com/newsguidelines.html

It wouldn't explain why places that haven't been trampled on by Americans would have high suicide rates. South Korea and Japan both have pretty high suicide rates for example.

Also, a large chunk of the suicides are young people who didn't leave through the eras where oppression occurred. I am not sure why somebody would commit suicide because something happened to their ancestors.

>It wouldn't explain why places that haven't been trampled on by Americans would have high suicide rates. South Korea and Japan both have pretty high suicide rates for example.

I wasn't trying to say anything about anywhere else.

>Also, a large chunk of the suicides are young people who didn't leave through the eras where oppression occurred. I am not sure why somebody would commit suicide because something happened to their ancestors.

Oppression still occurring, thanks.

How is oppression still occurring?

One of the causes in the ND patch is that there is a ton of space with nothing there. The amount of time for any medical care to arrive and then reach a hospital would be extremely high.

How do you show suicide rate in that interactive graphic? By choosing "self-harm" as cause I assume?

Alcoholism is always rampant when a population is first introduced to the drug.

Over centuries, evolution acts to produce a population less prone to it, since people who drink themselves to death don't tend to reproduce.

The population that has had access to alcohol for the longest (8000 years, according to a guess I saw somewhere) is the Chinese, where the "asian red flush" gene has developed as a protection against alcoholism.

Well, I'm confused. Something seems off.

Evolutionary pressures / adaptations over 8000 years would just as likely make a population less likely to suffer adverse effects from, for example, alcohol. (see sickle cell tradeoffs in malaria-risky areas). This genetic syndrome you reference makes damage from alcohol 4x more likely over time.

We'd expect long-time drinking societies to have higher alcohol tolerance to better avoid adverse effects of drinking.

To me, an adaptation that makes you avoid something damaging is a great way to make a population less likely to suffer adverse effects from it.

That said, the surviving populations probably also have a higher alcohol tolerance than their sober ancestors. That seems hard to measure though.

> Over centuries, evolution acts to produce a population less prone to it

Is this a supposition? Or is there any evidence for this effect being real and/or it being significant over such evolutionarily short timescales?

Evolution can occur quickly! See e.g. the Peppered Moth.

True, but it helps that moths can lay thousands of eggs one or more times a year. Evolution can be quick but people reproduce very slowly.

All evolution ultimately is, is the result of factors favorable to reproduction staying the gene pool, since those with them quite tautologically tend to reproduce more, while factors unfavorable to reproduction get culled vice versa.

For a recent example of evolution on a practically real time scale see this [1]. Scientists released millions of genetically engineered mosquitoes into the wild. The genetically engineered mosquitoes were all male and engineered to produce infertile offspring. However, rare abnormalities allowed some mosquitoes to end up producing fertile offspring. The entire target population (in the wild) then began to adopt these characteristics and ended up rebounding from near extermination to near pre-release numbers.

That is evolution in fast forward due to a rapid reproduction rate, but even on a generational level this would have been an extremely rapid evolutionary adaptation.

And the same applies to humans. A seemingly ever larger number of things have major genetic factors -- alcoholism being one we've known about for quite some time. Alcoholics are less likely to live to successfully reproduce, and even when producing may produce defective offspring as a result of their alcoholism. So it creates an evolutionary imperative against susceptibility to alcoholism.

[1] - https://www.nature.com/articles/s41598-019-49660-6

The actual difference in susceptibility to alcoholism is big evidence. And the idea that alcoholism might make you have 3% less kids per generation or whatever small difference would suffice when multiplied over a few centuries is very plausible.

I don't believe this is the case, do you have any sources to back it up?

I've seen it discussed several times, and believe it's at least a respected hypothesis. To what extent it's "established science" I don't know.

I don't have any source links handy. Do you have any sources for your disbelief? :)

It's the onus of the one making the claim to back it up. My 30 second google search didn't turn up much one way or the other so I can't say for sure. I was curious if you had read any articles studies to make you believe that, or whether it was just your personal hypothesis. To me, it doesn't seem like that would be true, but I have nothing to back that up

> It's the onus of the one making the claim to back it up

Agreed. I don't have the time/energy to look up any sources, and I support anyone being skeptical about exotic claims made by anonymous forum posters :)

Indigenous Americans made alcoholic fermented beverages

https://en.wikipedia.org/wiki/Alcohol_and_Native_Americans#P...

Sure, but I think it was expensive and complicated enough with their technology that becoming an alcoholic was very hard, compared to the modern world with unlimited supply of cheap bottles of hard liquor.

I agree, was curious so did some digging and found the results interesting.

In addition to lower concentration, I'd imagine the mollusk and tobacco wine wouldn't have been as palatable as contemporaneous whiskey, but I'm not a fan of seafood in general so YMMV. Sounds like indigenous peoples in temperate climates tended to only use alcoholic beverages ceremonially rather than multiple-times-daily of colonists.

You are likely to find the highest suicide rates in less-populated areas because the average of fewer numbers tends to have a greater variance than the average of more numbers. The suicide rate could be the same everywhere and you would still be guaranteed to find the most suicides in rural counties.

If "small numbers" were the dominant effect, we'd expect to see it move around. This year the highest would be somewhere in the Dakotas, next year in NW Oklahoma, etc. If the rankings are stable over time it must be something else.

From a statistical standpoint, it's logical that the most extreme numbers come from the lowest populations. So if the lowest rates are also in remote rural areas, this says more about statistics than anything else.

I'm not sure which of these two points you're trying to make:

1) These specific counties could be flukes because of their small population.

We can account for that by making multiple observations--i.e. look at multiple years of data--and seeing if the counties change rank. The visualization has yearly data for 1980-2014, and the specified counties are consistently high compared to the national average

https://vizhub.healthdata.org/subnational/usa

2) The 'rural' component of these counties isn't necessarily a factor, since the counties with lowest rates may be rural as well.

A bit of searching turns up a clear correlation between population density and suicide:

https://www.researchgate.net/figure/How-population-density-a...

I was trying to make point 1, but you definitely showed this is not the case.

That last graph is a really nice one, as it shows more variance on low populations, but on average still way higher than on high populations.

Thanks for the clarification! :)

>Extend the list and you see lots of high latitudes, low incomes, remote rural settings, and indigenous American populations

Gloomy weather, little opportunity for future economic advancement exacerbated by a government hundreds of miles away made up of people nothing like you making up rules for you that make life harder (rural area generally make money on resource extraction and western government are regulating that more tightly for climate reasons) and it's been this way for generations.

This isn't quite shocked pikachu territory but it should come as no surprise people living like this kill themselves more than the baseline.

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