Indigenous residents of Alaska (Alaska Natives)
die by suicide at a rate nearly 4 times the US
average and the average for all American
Indians and Alaska Natives (AI/ANs).1---3 An
astonishing 7% of Alaska respondents to
a 2003 international household survey of
Arctic Indigenous people indicated that they
had seriously contemplated suicide within the
past year.4 Studies have shown that alcohol is
directly or indirectly involved in most of these
deaths.5---9
Although Alaska Natives have encountered
alcohol for well over a century, the high suicide
risk is an entrenched but comparatively recent
phenomenon affecting only the past 2
generations.9,10 Figure 1 shows that crude
suicide rates for this group rose rapidly in the
decade after Alaska achieved statehood in
1959. The 3-year moving average rate peaked
at more than 50 per 100 000 in the early
1980s, before declining to a level of about
40 per 100 000 during the past decade. The
dip in suicide rates in the late 1970s likely
represents faulty data rather than a real
departure from the secular trend.11
An emerging new pattern of risk drove the
increase in suicide rates in the 1960s. Higher
suicide rates among young men led the rise
in suicide as a whole.9,12,13 More recently,
another important pattern of differential risk
emerged as more Alaska Natives moved to the
state’s growing urban areas in search of jobs.
Suicide rates among Alaska Native residents
remaining in small rural communities are more
than twice as high as those among Native
residents of urban areas and vary greatly
among communities even in the same region
(Alaska Bureau of Vital Statistics, unpublished
data).13 In fact, suicide rates may have declined
since the peak in the 1980s (Figure 1) only
because the lower risk population of urbandwelling
Alaska Natives has grown relative
to the more vulnerable rural population.
The large disparities among populations with
similar ethnicity and histories suggest that the
elevated suicide risk is not simply an unfortunate
side effect of rapid social change but
may be influenced directly by contemporary
living conditions.
The associationYe
