September 10, 2024 was World Suicide Prevention Day. According to the World Health Organization,

“Every year 726,000 people take their own life and there are many more people who make suicide attempts.”

When I was five years old my mid-life father took an overdose of sleeping pills after he had become increasingly depressed because he couldn’t support his family doing the work he loved. Fortunately, he survived, but our lives were never the same. I grew up wondering what happened to my father, when it would happen to me, and what I could do to prevent it happening to other families.

Although females, as well as males, can die by suicide, males at every age are at higher risk than are females. Yet rarely is suicide discussed as a health issue for boys and men.

World Suicide Prevention Day (WSPD) was established in 2003 by the International Association for Suicide Prevention in conjunction with the World Health Organization (WHO). On September 10^th each year they focus attention on the issues, reduce stigma and raise awareness among organizations, governments, and the public, giving a singular message that suicides are preventable.

The triennial theme for World Suicide Prevention Day for 2024-2026 is “Changing the Narrative on Suicide” with the call to action “Start the Conversation”. This theme aims to raise awareness about the importance of reducing stigma and encouraging open conversations to prevent suicides. Changing the narrative on suicide is about transforming how we perceive this complex issue and shifting from a culture of silence and stigma to one of openness, understanding, and support.

The call to action encourages everyone to start the conversation on suicide and suicide prevention. Every conversation, no matter how small, contributes to a supportive and understanding society. By initiating these vital conversations, we can break down barriers, raise awareness, and create better cultures of support.

I have been writing a series of articles—”Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide.” In Part 1, I shared statistics from the National Institute of Mental Health, comparing the suicide rates for males and females at various ages:

Even during our youth where suicide rates are relatively low, males are still more likely to die by suicide than are females. It is also clear to me as my wife and I move into our 80s, that males and females face many challenges as we age, but it is older males who more often end their lives by suicide with rates 8 to 17 times higher rates than for females.   

In Part 2, I discussed the evolutionary roots of male/female differences and quoted Dr. Roy Baumeister,  one of the world’s leading social scientists. Understanding his work can better help us understand a lot about why men are the way they are and specifically why men are the risk-taking gender.

In his groundbreaking book, Is There Anything Good About Men? How Cultures Flourish By Exploiting Men, he says,

“If evolutionary theory is right about anything, it’s right about reproduction. Nature will most favor traits that lead to success at reproducing. But for thousands of years, men and women have faced vastly different odds and problems in reproducing. On this basic task, women faced good odds of success, whereas men were born to face looming failure.”

Men not only take greater risks than women, but also are less resilient and more prone to feelings of failure when they don’t feel they can offer something of value to those they love.

In Part 3, I show that suicide is the most prevalent form of violence and is the cause of more death than either war or homicide. We don’t often think of suicide as a form of violence or depression as an underlying cause of violence, but they are intimately related. The World Health Organization (WHO) produced an in-depth analysis of violence and published the information under the title, “The World Report on Violence and Health.” The report is the result of 3 years of work, during which WHO drew on the knowledge of more than 160 experts from more than 70 countries.

            The report detailed estimated global-related deaths as follows:

These numbers vary in different years and rates of violent deaths also vary according by country and within each country with different groups. But clearly violence from suicide accounts for nearly as many deaths as war-related violence and homicides combined. All forms of violence are tragic and many have come to believe that violence is simply a part of human nature. But this is not true.

Violence of all kinds can be understood and prevented.

“Violence thrives in the absence of democracy, respect for human rights and good governance,”

said Nelson Mandela. We often talk about how a ‘culture of violence’ can take root. This is indeed true—as a South African who has lived through apartheid and is living through its aftermath, I have seen and experience it. No country, no city, no community is immune. But neither are we powerless against it.”

As we approach another presidential election in the United States, most everyone is aware of the threat to democracy we are facing and the conflicts that divide our country.

In Part 4, I offered guidance for all those who are ready to see the truth about the times in which we live and how we can live, love, and work, for good in the world.

For most of my professional life I believed that treating depression and preventing suicide involved helping individuals, couples, and families. A new perspective opened for me in 1993 at a men’s leadership conference in Indianapolis, Indiana. I’ve written a number of articles about my experience over the years, including my most recent, “Transformations: The End of the U.S. and the World as We Know It and The Truth About Our Collective Future.”

I said that an old kind of masculinity was on the way out. My colleague Riane Eisler describes two competing systems that humans have been engaging with that she calls the dominator system and the partnership system. Throughout the world emotionally wounded men who ascend to power have chosen a dominator approach to asserting power.

            The old dominator systems were ruled by frightened men who came to believe that the only way to survive was to rule by force. Historian Ruth Ben-Ghiat describes these men in her book, Strongmen: Mussolini to the Present. She says,

“For ours is the age of authoritarian rulers: self-proclaimed saviors of the nation who evade accountability while robbing their people of truth, treasure, and the protections of democracy.”

            Among the seventeen protagonists in her book she includes: Adolph Hitler, Saddam Hussein, Benito Mussolini, Vladamir Putin, and Donald J. Trump. Pulitzer-Prize winning journalist Anne Applebaum describes the way modern-day autocrats support each other in her book, Autocracy Inc.: The Dictators Who Want to Run the World.

“Nowadays, autocracies are underpinned by sophisticated networks composed across multiple regimes…The autocrats are rewriting the rules of world trade and governance as their propagandists pound home the same messages about the weakness of democracy and the evil of America.”

            At MenAlive I have been supporting men and their families to embrace the partnership system and have recently created a way for organizations and individuals to belief in these ideas and practices to stay connected. You can learn more at our website, MoonshotforMankind.org and get news you can use on our substack, substack.com/@moonshotformankind.

            If you’d like to read more articles on men’s mental, emotional, and relational health, you can subscribe for free at https://menalive.com/email-newsletter/.

Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind.

Suicide does not just occur in high-income countries but is a global phenomenon in all regions of the world. In fact, close to three quarters (73%) of global suicides occurred in low- and middle-income countries in 2021.

By BWH Communications | Harvard Gazette

Three biomarkers in blood can better predict the risk of major cardiovascular events in women decades earlier than previous tests, giving them more time to address their risk with lifestyle changes and therapeutics, according to research from Brigham and Women’s Hospital, a Harvard affiliate.

In a landmark study of 27,939 initially healthy American women, the researchers used a single measure of low-density lipoprotein cholesterol (LDL-C), or “bad cholesterol”; high-sensitivity C-reactive protein (hsCRP), a marker of vascular inflammation; and lipoprotein(a), a genetically determined lipid fraction, to predict risk over a 30-year follow-up period.

The findings were presented at the European Society of Cardiology Congress in London and published simultaneously in the New England Journal of Medicine.

Waiting until women are in their 60s and 70s to initiate heart attack and stroke prevention is a prescription for failure.

–Julie Buring, principal investigator of the Women’s Health Study

A wake-up call for women

Heart disease is the leading cause of death for women in the U.S., with 44 percent living with some form of heart disease. In 2021, it was responsible for the deaths of 310,661 women — or about 1 in every 5 female deaths — yet only about half of U.S. women recognize that heart disease is their No. 1 killer, according to the American Heart Association and the Centers for Disease Control and Prevention.

To assess each marker as well as the combined effect of elevated levels of two or all three, the research team divided participants into five quintiles, ranging from those with the highest to the lowest levels of the markers. Researchers found that, compared to women with the lowest levels of individual markers:

• Women with the highest levels of hsCRP had a 70 percent greater risk of a major cardiovascular event;
• Women with the highest levels of LDL-C had a 36 percent greater risk;
• Women with the highest levels of Lp(a) had a 33 percent greater risk.

While hsCRP was the strongest of the three biomarkers, all were very important. More markers meant greater risk; women who had elevated levels of all three markers were 2.6 times likelier to have a major adverse cardiovascular event. This association was even stronger for stroke — women with the most elevated levels were 3.7 times likelier to have a stroke over the next 30 years.

“These data should be a wake-up call for women,” said co-author Julie Buring, principal investigator of the Women’s Health Study and an epidemiologist in the Brigham’s Division of Preventive Medicine. “Waiting until women are in their 60s and 70s to initiate heart attack and stroke prevention is a prescription for failure.”

At the time the participants were enrolled in the cohort, their mean age was 54.7 years; 25 percent had hypertension, 12 percent were current smokers, 2.5 percent had diabetes, and 14.4 percent had a parental history of myocardial infarction before 65 years of age. Nearly all were white, with good access to healthcare and medical information.

Reducing risk

Each of the three risk factors is modifiable with a combination of lifestyle changes and drug therapy. Multiple randomized trials have demonstrated that lowering cholesterol and lowering inflammation both significantly reduce risks of heart attack and stroke. Further, several new drugs that markedly reduce Lp(a) as well as second-generation anti-inflammatory agents are being tested to see if they too can lower rates of clinical events.

The new data strongly support earlier and more aggressive use of targeted preventive interventions, particularly among women for whom cardiovascular disease remains underdiagnosed and undertreated.

“Doctors cannot treat what they don’t measure,” said lead author Paul Ridker, director of the Center for Cardiovascular Disease Prevention at BWH. “To provide the best care for our patients, we need universal screening for inflammation, cholesterol, and lipoprotein(a), and we need it now.

“While we still need to focus on lifestyle essentials like diet, exercise, and smoking cessation, the future of prevention is clearly going to include combination therapies that target inflammation and Lp(a) in addition to cholesterol,” he added.

The research team analyzed data from the Women’s Health Study, funded by the U.S. National Institutes of Health through research grants to preventive cardiology investigators in the Division of Preventive Medicine at the Brigham. The trial began in 1993 and has followed female health professionals aged 45 years and older ever since. Participants had their hsCRP, LDL-C, and Lp(a) levels tested in a blood sample obtained when they enrolled in the study. The primary endpoint was a first major adverse cardiovascular event — heart attack, coronary revascularization, stroke, or death from cardiovascular causes.

Disclosures: Ridker has received research grant support to the Brigham and Women’s Hospital and/or served as a consultant to entities developing preventive strategies and treatments that target inflammation, cholesterol, and lipoprotein(a), including Novo Nordisk, Novartis, Pfizer, Agepha, and Kowa. Full disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Supported by grants (HL043851, HL080467, and HL099355) from the National Heart, Lung, and Blood Institute and grants (CA047988 and CA182913) from the National Cancer Institute, National Institutes of Health.

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This story is reprinted with permission from The Harvard Gazette.

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