A grim new study from the Centers for Disease Control and Prevention about spiking U.S. suicide rates obscures the role guns often play in the deaths, a prominent public health expert says.

Over the last 15 years, the CDC study shows, suicides have increased 24 percent. The percentage of suicides involving guns — long cited as one of the most widely used methods of self harm, and unquestionably the most lethal — has declined. Suffocation and poisoning, as a percentage of suicides, have increased.

But public health experts say the CDC’s emphasis on comparative rates misses a bigger story: More Americans are killing themselves with guns, with the absolute number of gun suicides rising by 4,735 from 1999 to 2014.

“The report makes it sound as though the use of guns went down, but that’s not actually the case,” says Cathy Barber, a researcher at the Harvard Injury Control Research Center and co-founder of the National Center for Suicide Prevention Training. While the percentage of all suicides that involve guns has gone down compared to other methods, the rise in the overall number of deaths means that gun suicides are also up.

In 1999, there were 16,599 suicides completed with a firearm. In 2014, gun suicides totaled 21,334.

Suicide rates rose for men and women in all age groups except those 75 and over, with rates for middle-aged adults experiencing the biggest increase, according to the CDC report, which was released Friday.

White men experienced a dramatic spike in total suicides, and used guns to kill themselves more than any other method. There were seven more suicides per every 100,000 white male deaths in 2014 than in 1999. Half of those “new” suicides were carried out with a gun.

Suicides among women also increased. Though poisoning replaced firearms as the most common method in 2014, the overall use of guns by women in suicides rose in absolute terms as more American women killed themselves than ever before.

“Firearms are important both as a leading method and as a contributor to the increase in suicides,” Barber says. Even with the relative percentage decrease, more than half of male suicides are completed with a firearm, as are roughly a third of female suicides, a trend that seems likely to remain consistent should rates continue to rise.

There’s also a strong body of research that shows that more guns lead to more suicide, across all regions of the country. And guns, more than any other method, are most likely to lead to a successful suicide attempt.

“There’s just no other method of committing suicide that’s as lethal as using a firearm,” Dr. Liza Gold, a professor of psychiatry at Georgetown University, told The Trace in November. “Even if someone then tried to overdose on pills or hang themselves, it’s more likely that their method would fail or someone would intervene in time.”

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