The Lethal Connection: Investigating the Relationship of Drought Conditions on Firearm and Nonfirearm Suicides Among U.S. Adults.

Drought is one of the most widespread and disruptive natural hazards globally, with environmental and societal effects that may increase psychological distress. Yet, its association with suicide in the U.S. remains understudied. We examined the relationship between drought and suicide mortality across the contiguous U.S. Drought severity was measured using the Evaporative Demand Drought Index, and suicide data from the National Center for Health Statistics. We used Generalized Additive Models (GAMs) to estimate incidence rate ratios (IRRs) and absolute risk differences (ARDs), with 95% confidence intervals. Analyses were stratified by age, sex, and urbanicity. From 2000 to 2018, the U.S. recorded 350,434 firearm-related and 323,225 non-firearm suicide deaths. Drought affected 37.4% of county-months, and both suicide types were positively associated with drought-especially under severe conditions. For firearm suicides, worsening drought was linked to an IRR of 1.109 (95% CI: 1.091-1.128) and ARD of 0.704 (95% CI: 0.595-0.811); improving drought had an IRR of 1.094 (95% CI: 1.076-1.112) and ARD of 0.608 (95% CI: 0.501-0.715). For non-firearm suicides, worsening drought was associated with an IRR of 1.057 (95% CI: 1.037-1.077) and ARD of 0.347 (95% CI: 0.232-0.461), while improving drought had an IRR of 1.073 (95% CI: 1.054-1.093) and ARD of 0.456 (95% CI: 0.344-0.568). Severe drought was associated with higher suicide mortality, including firearm-related deaths, across several subgroups such as older adults, women, and individuals living in non-metro areas; these subgroup-specific findings were not statistically compared.