Suicide rates are up alarmingly among middle-aged Americans, according to the latest federal government statistics.

They show a 28 percent rise in suicide rates for people aged 35 to 64 between 1999 and 2010.  Rates for children and younger adults, and people over 65, didn’t change much over the same time, the Centers for Disease Control and Prevention reports.

“Most suicide research and prevention efforts have focused historically on youth and the elderly. This report’s findings suggest that efforts should also address the needs of middle-aged persons,” CDC researchers wrote in the agency’s weekly report in death and disease.

The CDC didn’t look at why suicides might be up. Other reports have shown a link between bad economic times and suicides, although the American Association for Suicidology denies this. The National Bureau of Economic Research says the U.S. experienced a recession from 2007 to 2009.

But the association says unemployment and home foreclosures -- both of which soared during this time and both of which remain high -- do lead to more suicides.

“The findings in this report suggest it is important for suicide prevention strategies to address the types of stressors that middle-aged Americans might be facing and that can contribute to suicide risk,” said Linda Degutis, director of CDC’s National Center for Injury Prevention and Control.

The CDC had already noted a worrying trend for suicides. “Suicide deaths have surpassed deaths from motor vehicle crashes in recent years in the United States. In 2010 there were 33,687 deaths from motor vehicle crashes and 38,364 suicides,” the CDC’s Nimesh Patel and Scott Kegler wrote in their report.

They teased out the data by age and sex and found a clear trend for people who usually are at the height of career and family responsibilities -- those aged 35 to 64. “Annual suicide rates for this age group increased 28 percent over this period (from 13.7 suicides per 100,000 people in 1999 to 17.6 per 100,000 in 2010), with particularly high increases among non-Hispanic whites and American Indians and /Alaska Natives,” they wrote.

They also found an increase in three methods of committing suicide: hanging or suffocation, poisoning and guns.

Men are far more likely than women to commit suicide, but suicide rates rose more for women than for men. Suicide rates increased 32 percent for women and 27 percent for men, CDC said.

“The greatest increases in suicide rates were among people aged 50 to 54 years (48 percent) and 55 to 59 years (49 percent),” the CDC said.

The American Association for Suicidology says economic recessions don’t normally affect suicide rates.

“Although US suicide rates did increase slightly during the years of the Great Depression, reaching a peak rate of 17.4/100,000 in 1933, subsequent US recessions have not been found to lead to increased national rates of suicide in the period of or immediately following each recession,” the group says.

The latest numbers suggest suicide rates for middle-aged Americans now surpass the peak during the Depression. And there’s another possible explanation.

“There is a clear and direct relationship between rates of unemployment and suicide,” the suicidology group says in its statement.

“The peak rate of suicide in 1933 occurred one year after the total US unemployment rate reached 25 percent of the labor force. Similar findings have been documented internationally. At the individual level, unemployed individuals have between two and four times the suicide rate of those employed.”

The group also raises concern about the home foreclosure rate. “More than a million people recently have lost their homes, about as many as did in the Great Depression when the population was about half what it is today. For most Americans, our homes are our primary investment and the locus of our identities and social support systems. When combined with the loss of job, home loss has been found to be one of the most common economic strains associated with suicides.”

According to the Bureau of Labor Statistics, unemployment peaked at 10 percent in 2009. It’s been above 5 percent since 2008 and is currently around 7.6 percent. Home foreclosures have also soared.

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Losing your job can give you a heart attack – quite literally.

Duke University researchers have found that unemployment significantly raises the risk of a heart attack. And that risk goes up with each job loss and with increasing time spent unemployed, according to a study published in the Archives of Internal Medicine.

In fact, one job loss raised the risk of a heart attack by 35 percent, while four job losses raised the risk by 63 percent. The unemployed were at greatest risk of a heart attack within the year following a layoff or firing.

“Looking at a lifetime of exposure to a social stressor such as unemployment – the number of times a person has lost a job or the amount of time they’re without a job – there’s an independent association with heart attacks,” says the study’s lead author Matthew E. Dupre, an assistant professor of at Duke and a senior fellow at the university’s Center for the Study of Aging.

Dupre says he and his colleagues were somewhat surprised by their results, since they took into account known  and suspected risk factors, like high blood pressure and loss of health insurance.

“The fact that the associations remained largely unchanged despite accounting for more than a dozen suspected risk factors was somewhat unexpected,” he says. “Changes in income, health insurance, health behaviors, physical health status, and the like had little impact on the risks related to unemployment. Instead, we found that the risks associated with multiple job losses were of the magnitude of other established risk factors, such as smoking, hypertension, and diabetes.”

For the new study, the researchers scrutinized the health and work histories of 13,451 adults aged 51 to 64. Detailed histories covered a full 18 years, during which study volunteers suffered a total of 1061 heart attacks.

At the outset, 14 percent of the volunteers were unemployed. During the course of the study 69.7 percent lost one or more jobs.

Heart experts said that the study adds to the mounting evidence that certain kinds of stressors can ramp up the risk of a cardiovascular event.

“This is adding to what we know with regards to the triggers of cardiovascular events,” says Dr. John Schindler, an assistant professor of medicine at the University of Pittsburgh Medical Center. “Many years ago we thought of this as a random process. Now we see there are real triggers, whether environmental or perceived stress.”

Recent studies have turned up numerous emotional triggers, including frustration, depression, and anxiety, Schindler says. “And all of those go along with unemployment,” he adds.

So, what is it about job loss that might raise the risk of a heart attack?

“There are likely multiple mechanisms which link significant socioeconomic stress, including becoming unemployed, to an increased risk of cardiovascular events,” says Dr. Eliot Corday Professor of Cardiovascular Medicine and Science at the University of California, Los Angeles, Eliot Corday Professor of Cardiovascular Medicine and Science at the University of California, Los Angeles, and co-director of the UCLA preventive cardiology program. “These include sustained activation of the part of the nervous system involved with stress and stress-related hormones, decrements in heart healthy behaviors, avoiding preventive health visits and measures, and not seeking prompt medical attention when there are early warning signs.”

What the study shows, experts say, is that you need to pay extra attention to your heart in times of stress, such as job loss.

“My conclusion is that we should always be focused on our hearts since cardiovascular disease is potentially such a potentially deadly disease,” Schindler says. “But since we’re at greater risk the first year we lose a job, at that time we should be even more diligent about cardiovascular health.”

Future research could examine whether emotional support could help reduce risk.

“Whether the cardiovascular risk related to unemployment and multiple job losses could also be reduced by psychological support or enhanced social resources will require further study,” Fonarow says.

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