Suicide rates have increased in nearly every state from 1999 to 2016, according to a study by the Centers for Disease Control and Prevention released Thursday. Since 2016, there have been 45,000 suicides nationwide.
The CDC finds that in Pennsylvania, suicide rates increased 34.3 percent in the 17-year timeframe of the study. That's 10 percent higher than the U.S. average, and the 21st highest increase among the 50 states and Washington, D.C.
North Dakota has seen the biggest increase in suicides at 57.6 percent. Only Nevada has seen a decrease, at about 1 percent.
Rachel Levine, Secretary of Health for Pennsylvania, said that the Department of Health has found similar numbers. That office's data only goes back to 2004, but between that time and 2016, they found 9,000 suicide deaths in the state, an increase of 22 percent.
The CDC study cautions that no single factor contributes to a suicide or attempted suicide, and that more than half of people who die by suicide do not have a known mental health issue. The most prominent contributing factors include relationship problems, recent crisis and substance abuse.
"It really goes down to what we call the social determinance of health: the different family, economic, and other stresses that affect daily life both in Pennsylvania and in the nation," Levine said.
Levine said that substance abuse, which is also on the rise in Pennsylvania, often goes hand-in-hand with suicidal thoughts, sharing similar triggers.
"That's highlighted by the opioid crisis," Levine said. "Wherever you see loss of hope, wherever you see despair, that's where you're going to see an increased risk of substance abuse, overdoses, and potential for suicides."
She is also concerned about mental health among young people, who she says can make impulsive decisions in the heat of anger or sadness. And she worries about the stigma of mental health issues and suicide in the state of Pennsylvania.
Levine said that the deaths of Spade and Bourdain could cause a ripple effect across the country, especially among young people.
"I often think of it as suicide contagion. Particularly dependent on how the media highlights those individuals' lives, it can sometimes trigger thoughts of suicide or a suicide attempt among individuals," she said.
The CDC recommends a variety of options to prevent suicide. The Center suggests that states provide financial support to those in need, that healthcare systems strengthen access to care, and that communities work together to support and educate.
Levine, agreeing with those CDC recommendations, says hope is a powerful force. "I think where there's hope, there's an opportunity for recovery and an opportunity for life," she said.
She also recommends statewide resources, like preventsuicidePA.org or texting PA to 741741.
Pennsylvania Governor Tom Wolf has also spoken out about the study.
“We all know people who may be suffering and may not know where to turn for mental health services,” Wolf said in a Friday press release. “Each of us can take the step to reach out to a friend if they are in need and let them know that help is available. There are numerous caring organizations and resources here to help and support and I want to be sure that information is readily known.”
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741.
90.5 WESA's Maria Scapellato contributed to this story.