Date of Award

6-26-2026

Date Published

August 2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Sociology

Advisor(s)

Jennifer Karas Montez

Keywords

Education;Gender Equality;Suicide

Subject Categories

Public Affairs, Public Policy and Public Administration | Public Policy | Social and Behavioral Sciences

Abstract

ABSTRACT Suicide consistently ranks among the top five causes of death for the U.S. population aged 25-64, and suicide rates have been rising in the United States since 2000. Although targeted efforts have been made to reduce suicide deaths among high-risk individuals, the upstream, or “contextual,” causes of poor mental health that drive suicidal ideation and completion are fueling a national mental health crisis that is overwhelming available mental health resources, resulting in a significant and needless loss of life. This three-chapter dissertation examines how suicide rates among midlife adults in the United States are associated with several upstream contexts that have fluctuated in recent decades, and whether those contexts are differentially salient for men versus women. The first chapter examines the association between U.S. state gender equality contexts and suicide rates, while the second and third chapters investigate the association between local-level educational composition and suicide risk among adults across education levels. Chapter 1: This chapter investigates the extent to which state-level gender equality is associated with suicide rates among midlife adults (aged 35-64) in the United States from 1980 to 2019. Drawing on the cultural-structural theory of suicide and a structural sexism framework, the chapter argues that evolving trends in gender equality across economic, educational, and political domains shape suicide risks differently for men and women. The analysis leverages fixed-effects regression models using annual state-level data on suicide mortality, measures of gender equality across economic, educational, and political domains, and a battery of demographic and contextual covariates. Results demonstrate that gender equality in each of the three domains is negatively associated with suicide rates for midlife women overall. For men, the relationship is more subtle: while greater gender equality in political representation is associated with lower suicide rates, greater gender equality in economic and educational domains shows a positive association with suicide, suggesting a potential “zero-sum” effect where a perception of status loss among some men as women gain ground may be associated with suicide. In sum, the study concludes that as women participate more similarly to men in the political domain, suicide rates among both men and women decrease, while as women participate more similarly to men in the economic and educational domains, only women experience declines in suicide rates. These findings suggest that policies promoting gender equality may reduce suicide risk for women across multiple domains, but should also anticipate potential adverse effects on men—especially in economic and educational contexts where perceived status loss could elevate suicide risk. Chapter 2: This chapter examines the relationship between individual and contextual educational attainment and suicide risk among working-age adults (aged 25-64) in the United States during 2018–2019. While higher individual educational attainment is consistently associated with reduced suicide risk, national suicide rates have continued to rise despite increasing levels of education. Using a multilevel approach, this study investigates whether “educational sameness”— defined as the proportion of individuals in a commuting zone with the same education level as the focal individual—is associated with suicide risk. Analyses are stratified by sex and categorize education level into three groups: high school credential or less, some college credit but less than 4 years, and 4 or more years of college. Data from the National Vital Statistics System (NVSS) and the American Community Survey (ACS) are combined and geocoded to commuting zones, enabling simultaneous estimation of individual and contextual effects. Results indicate that for men with at least four years of college, educational sameness decreases suicide risk, while for men with some college credit, educational sameness increases suicide risk. No significant association between educational sameness and suicide risk is found among men with a high school credential or less. Among women, educational sameness as defined in this study is not significantly associated with suicide risk. This chapter advances the sociological study of suicide by considering the importance of educational context, beyond individual educational attainment, in shaping suicide risk. Chapter 3: Suicide rates among working-aged adults in the United States rose by 32% between 2005 and 2019, even as educational attainment increased nationally. While higher education is generally protective against suicide risk, the simultaneous growth in both educational attainment and suicide rates highlights the complexity of this relationship. This study examines how the association between “educational sameness”—the proportion of similarly educated adults in a commuting zone—and suicide risk has changed over time, with attention to differences by education level and sex. Using a dataset that links individual-level suicide deaths from the National Vital Statistics System (NVSS) to American Community Survey (ACS) respondents across 17 U.S. states from 2005 to 2019, the analyses estimate longitudinal multilevel logistic regression models controlling for individual and area-level confounders. Results reveal that higher-educated adults have increasingly benefited from living in highly educated areas, with educational sameness offering growing protection against suicide risk over time. Conversely, the protective effect of educational sameness for lower-educated adults has eroded—albeit to a lesser extent—indicating a cumulative disadvantage as social and economic resources in lower-educated communities decline. Sex-specific analyses show these patterns are especially pronounced among men. The findings support cumulative inequality theory and underscore the importance of both individual and contextual education for suicide prevention. This study highlights the critical role of place and social context in shaping suicide risk as educational and geographic inequalities grow.

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