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Acknowledging limits in data sequence continuity, we constructed the Suicide Trends and Archival Comparative Knowledgebase (STACK), harmonizing data from 1900\u20132021. Coupling visualizations with Joinpoint regressions, we examine the contemporary suicide crisis in historical perspective. Data reveal patterns that both support and challenge prevailing understandings of suicide risk, trends, and drivers. Overall, we document a cyclical, dampening, and downward-trending pattern of suicide over 120 y, contrasting sharply with trends in other causes of death. However, this trend is offset by a sharp rise and unique patterning for persons under 35, beginning in the mid-to-late 1950s. The contemporary \u201cyouth crisis\u201d spans a broader age range and begins much earlier than typically acknowledged. Each successive generation faces risk at younger ages, accompanied by a startling rise in suicide by hanging since the 1980s among both males and females. Despite ongoing concerns about rural populations and the elderly, living in large metropolitan areas (versus suburban and rural areas) and being older have recently emerged as protective factors. While analyses by race or rurality remain limited to the last half century because of data availability, the long-term temporal, geographic, and sociodemographic complexity of suicide mortality trends offers critical insights and intriguing avenues for next-generation research, treatment, and prevention efforts.<\/jats:p>","DOI":"10.1073\/pnas.2519951123","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T19:05:09Z","timestamp":1777316709000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":1,"title":["A century of suicide: Insights from long-term data in the United States"],"prefix":"10.1073","volume":"123","author":[{"given":"Nina","family":"de Lacy","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Utah","place":["Salt Lake City"]},{"name":"Huntsman Mental Health Institute, University of Utah Health Hospitals & Clinics","place":["Salt Lake City"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai-yin","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Utah","place":["Salt Lake City"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Collins","sequence":"additional","affiliation":[{"name":"School of Environment, Society, and Sustainability, University of Utah","place":["Salt Lake City"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4541-5966","authenticated-orcid":false,"given":"David","family":"Danks","sequence":"additional","affiliation":[{"name":"Corcoran Department of Philosophy, and School of Data Science, University of Virginia","place":["Charlottesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando A.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Matheson Center for Health Care Studies, University of Utah","place":["Salt Lake City"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-3705","authenticated-orcid":false,"given":"Ken R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Family and Consumer Studies, University of Utah","place":["Salt Lake City"]},{"name":"Huntsman Cancer Institute, University of Utah Health Hospitals & Clinics","place":["Salt Lake City"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3690-5878","authenticated-orcid":false,"given":"Bernice A.","family":"Pescosolido","sequence":"additional","affiliation":[{"name":"Department of Sociology, Indiana University","place":["Bloomington"]},{"name":"Irsay Institute, IU Research, Indiana University","place":["Bloomington"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_3_4_1_2","volume-title":"Suicide: A Study in Sociology","author":"Durkheim E.","year":"1897","unstructured":"E. 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