31. Gambling With Your Life

Does Las Vegas increase your risk of suicide? A researcher embeds himself in the city where Americans are most likely to kill themselves.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Stephen J. Dubner?

  Freakonomics Radio is sponsored by Progressive. Whoever says saving money is hard doesn't know that new customers who bundle and save with Progressive save hundreds because switching your home and auto insurance is better than cutting down on the things you love, like those iced lattes that help you get ready to face the day. So switch your home and auto to Progressive and see if you could save and keep sipping away. Get your quote today at progressive.com. Progressive Casualty Insurance Company affiliates and other insurers. Not available in all states. Freakonomics Radio is sponsored by PNC Bank. Boring. Great word, bad rep. Yet, time and time again, here at Freakonomics, we find that when something culture-changing happens,

• 0:43Stephen J. Dubner?

  boring things like calculations and careful planning are usually behind it, which begs the question, why not apply it to other aspects of life, like banking, for example? Well, PNC Bank did since its inception, proving time and again that the best banking strategy isn't the exciting type, but the steady, reliable, definitely not YOLO type. PNC Bank. Brilliantly boring since 1865. Brilliantly boring since 1865 is a registered mark of the PNC Financial Services Group, Inc. PNC Bank, National Association, Member, FDIC. Freakonomics Radio is sponsored by hotels.com. Hotels.com helps you find and book the right

• 1:25Stephen J. Dubner?

  stay for work faster. With business preferences, save your travel must haves, like gym access or breakfast, just once, then get tailored results whenever you search for work travel. Plus, with a free membership, you can save up to 20% on hotels and earn rewards on every stay for future travel. Book now at hotels.com. Visit hotels.com for details.

• 1:54Stephen J. Dubner?

  Freakonomics Radio is sponsored by ChatGPT. ChatGPT Work is a new way to work in ChatGPT. ChatGPT Work can pull info from across your apps and connect to your tools to help you create finished work. You can even automate work in ChatGPT with the Scheduled Tasks feature, and the whole time you stay in control. Put ChatGPT to work on your most ambitious ideas and projects. Get started at chatgpt.com by selecting Work Mode, available on Plus and Pro plans.

• 2:31Speaker 01

  I'm Matt Ray, and I'm a sociologist at Temple University. And I study the sociology of race and ethnicity, and I study cultural sociology, and I study medical sociology and sort of the sociology of health and illness.

• 2:47Stephen J. Dubner?

  And lately, at least, or in part of what you study, I know you've been studying suicide as well, correct?

• 2:53Speaker 01

  I have. To sum up what I do in a word would be to say that I study losers. And I am interested in those who lose out on societal gains and out on opportunities. And it's another way of saying I'm interested in inequalities and stratification.

• 3:21Speaker 02

  From WNYC and APM, American Public Media, this is Freakonomics Radio, the podcast that explores the hidden side of everything. Here's your host, Stephen Dubner.

• 3:36Stephen J. Dubner?

  If you had to guess, would you say that more people in the US die from homicide or from suicide? I mean, homicide is certainly a lot noisier in the newspaper headlines, the cop shows on TV. But the fact is, there are more than twice as many suicides every year, about 36.5,000 suicides versus about 16.5,000 homicides. And more people kill themselves in the western states than in any other part of the country. The sociologist Matt Ray is studying this so-called suicide belt. He's also written a paper about one place out west that boasts the dubious distinction of having the highest suicide rate of any city in the country.

• 4:20Speaker 01

  I was living in Las Vegas, and I wanted to understand more about Las Vegas as a community. I just moved there and was struck by the exceedingly high suicide rate in Las Vegas. And so I wanted to know what's causing this. And more specifically, could it be something about the place that actually is effectively sort of suicidogenic? What's generating this high rate of suicide over such an extended period of time? Because as far back as I could go in the statistics for decades, I was seeing this consistently high rate. So it was a puzzle, really, more than anything else, just a curiosity that led me down this road.

• 5:02Stephen J. Dubner?

  Talk to me about the paper, what you found, what was particularly noteworthy and surprising to you.

• 5:08Speaker 01

  The suicide rate in Las Vegas is the highest of the large cities in the United States, and it's high by far. The suicide rate, and here, this is sort of adjusting for age, is, over the period, the most recent eight years for which we have data, 18.4 per 100,000 people. That number in itself is meaningless, but the next highest number is in Florida. That's 15.9, 15.5. The national average, which is perhaps the most meaningful comparison for that same period, was 9.5. So you're talking about a suicide rate in a city, and cities in the United States typically have low suicide rates compared to rural areas.

• 5:53Speaker 01

  You're talking about a city that has an average suicide rate, which is twice the national average.

• 5:58Stephen J. Dubner?

  And the US is not among the highest countries in the world in terms of suicide rate, not among the lowest either, although we actually do all right. But if we were looking at just Las Vegas, if all of the US were like Las Vegas, we would then be comparable to what countries in terms of suicide rate?

• 6:17Speaker 01

  We would be comparable to countries like Japan, which is recognized as having a high suicide rate, Austria, which is recognized as having a high suicide rate. But we wouldn't be as high as Hungary. We wouldn't be as high as Lithuania. We wouldn't be anywhere near as high as Russia. These are sort of the world leaders in suicide risk.

• 6:45Stephen J. Dubner?

  All right. So walk me through the paper a little bit, especially the way you tease apart different pieces of it. In other words, you looked at and wanted to tease apart the questions of whether it's people who live and stay in Las Vegas who kill themselves, whether it's people who live elsewhere and come to Las Vegas and kill themselves. If people who live in Las Vegas have a higher rate than others elsewhere, what happens when those people go elsewhere and so on? In other words, trying to separate, trying to tease out the effect of the place itself. So talk me through your intentions and then your results there.

• 7:15Speaker 01

  Right. So we really were, we really were interested in this question of what happens when you, you know, expose people to Las Vegas? Is there ways in which we can sort of determine if there's a place effect on suicide rates rather than sort of a people effect? That is, people sort of bringing their suicide risk with them to Las Vegas. We wanted to see instead if something happened to people who were exposed to Las Vegas. And that's true both for residents, people who live and die in Las Vegas, and visitors, that is, people who live elsewhere but die in Las Vegas. Remember, we're just looking at dead people here. We're just looking at death records because that's the data that we have.

• 7:56Stephen J. Dubner?

  And what you find then is that if you, if I live and stay in Las Vegas, I'm going to be more likely to kill myself. If I live elsewhere and travel to Las Vegas, I will be more likely to kill myself. But if I live in Las Vegas and leave, I will be less likely to kill myself. Is that right?

• 8:17Speaker 01

  That's correct. These are quite different size effects. If you, what we call the chronic exposure model, if you live and you're chronically exposed, live and die in Vegas, you're about 60% more likely than residents elsewhere in the United States to die by suicide. For the second model that you spoke of, the visitors coming to Las Vegas compared to people who are staying home, it's about 100% increase in suicide risk. And for the residents of Las Vegas who leave, they're, what we kind of think of as kind of reduced exposure model, or a hiatus model, you take a break from Vegas, your risk goes down about 20%.

• 8:55Stephen J. Dubner?

  So it sounds like if you live in Las Vegas, and there's some chance that you may be suicidal, if you are depressed and you may be suicidal.

• 9:03Speaker 01

  Get out of town.

• 9:04Stephen J. Dubner?

  So it really does, it really will help?

• 9:08Speaker 01

  Well, again, the overall risk here, this is important to keep in mind when we're using this particular measure, is really small.

• 9:16Stephen J. Dubner?

  But, but still, what you're saying is really interesting. You're saying that the people who are there do it more regularly than anywhere, any other city in the US, but also the people who don't live there and come there then do it more often. So I was going to ask you, does this mean that Las Vegas is suicidogenic, that it actually causes suicides? Or is it maybe that it's a suicide magnet? But it sounds as though, from what you're telling me, that it's very much both. Is that right?

• 9:42Speaker 01

  That's what I believe. I can't answer that definitively. I don't have solid evidence on all sides of this question. But yeah, that's the explanation that I think is most compelling, that there's a chance that suicide rates are higher in Vegas, in part because suicide rates are higher. That is, people are aware of this as a kind of more frequent option in Vegas. There's a little bit of a, perhaps a Golden Gate Bridge effect, where people also are recognizing Las Vegas as a kind of suicide destination. Now, I'll point out that in absolute numbers, the number of people who are doing this is really quite small.

• 10:22Speaker 01

  We're talking about 25 or 30 people a year who are visitors to Las Vegas who kill themselves there. But still, that, that sounds like a small number, but that's still a much higher number than we see in other cities.

• 10:52Stephen J. Dubner?

  Coming up, what is it about Las Vegas that leads to such a high suicide rate? We'll also tell you why, if you live in New York, like I do, suicide isn't at the top of your worry list. Here's a hint: you might want to leave the cream cheese off your next bagel.

• 11:31Stephen J. Dubner?

  Freakonomics Radio is sponsored by Granola. You know that moment when a meeting ends and someone says, "Let's circle back on this next week," and everyone nods but no one writes it down? Then next week rolls around and it's radio silence? That's why Granola exists. Granola is an AI-powered notepad built for the way real people actually meet. You take rough notes like you normally would, and in the background, Granola securely transcribes the meeting. Then it turns everything into clean, structured, actually useful notes when the meeting ends. And the best part? Granola works through your device's audio, which means it integrates seamlessly into the video conferencing tools you already use. No setup, no awkward bots. It's just your normal meeting with superpowers. If meetings are eating up your day, Granola is a no-brainer. You can try it totally free.

• 12:16Stephen J. Dubner?

  Just head to granola.ai/freakonomics. That's granola.ai/freakonomics to get your time back. Try it for free at granola.ai/freakonomics.

• 12:34Stephen J. Dubner?

  Freakonomics Radio is sponsored by Quince. You know those pieces in your closet that you find yourself wearing on repeat? The sweater that goes with everything? The perfect pair of pants? Or the tee you somehow always reach for first? Those are the pieces that make getting dressed easy, and that's what Quince does best. Quince focuses on high-quality wardrobe staples made with premium materials like 100% Mongolian cashmere, organic cotton, and merino wool. The styles are timeless, versatile, and designed to become the dependable pieces you reach for day after day. And it's not just clothing. Quince brings that same approach to everything they make, from hotel-quality bedding and bath to kitchen essentials and thoughtfully designed furniture. Find your next fall favorites at Quince.

• 13:17Stephen J. Dubner?

  Download the Quince app for app-exclusive offers or go to quince.com/freak. Get free shipping on your order and 365-day returns. Now available in Canada and the UK, too. That's Q-U-I-N-C-E.com/freak.

• 13:39Stephen J. Dubner?

  Freakonomics Radio is sponsored by Progressive. Whoever says saving money is hard doesn't know that new customers who bundle and save with Progressive save hundreds because switching your home and auto insurance is better than cutting down on the things you love, like those iced lattes that help you get ready to face the day. So, switch your home and auto to Progressive and see if you could save and keep sipping away. Get your quote today at progressive.com. Progressive Casualty Insurance Company affiliates and other insurers. Not available in all states.

• 14:13Speaker 02

  From WNYC and APM, American Public Media, this is Freakonomics Radio. Here's your host, Stephen Dubner.

• 14:21Stephen J. Dubner?

  Matt Ray is a sociologist who studies, among other things, suicide. He says there are a lot of factors that contribute to Las Vegas having a suicide rate that's nearly double the national rate. For starters, it's grown quickly, really quickly, from about 127,000 people in 1960 to nearly 2 million today. And that kind of boom can make it hard to build strong government institutions. And that, says Ray, can translate into a lack of services like psychiatric counseling. There's also a high rate of drug and alcohol use in Vegas, and of course, there's the gambling culture. But, Ray says, that's not all.

• 15:01Speaker 01

  I'll add that there's one more feature here of Las Vegas, which I think it bears mentioning, and that is what I kind of think of as a sort of frontier culture mentality among residents, and I think even among visitors, that Las Vegas is just this sort of place of total license, you know, it's the Wild West, it's an open frontier for all kinds of immorality and exploration of vice, and the entire self-branding of Las Vegas as this place where that is not only tolerated but actually sanctioned, you know, the what

• 15:40Speaker 01

  happens in Vegas stays in Vegas kind of mentality produces, I think, a kind of sort of libertarian ethos of go it alone, do it yourself, help-seeking in this framework is perhaps not kind of accepted or valorized the way it is in other parts of the country. These kinds of cultural arguments are always very hard to make, they always sound deeply unscientific, but in a lot of ways, I think it's exactly where a lot of the explanatory power comes from, is understanding the culture and the values underlying people's behavioral sets.

• 16:25Stephen J. Dubner?

  Let me ask you this, Matt, do you feel as a scholar, you know, I mean, look, you have what sounds to be a very nice job at a very nice university in a very nice city, teaching sociology at Temple in Philadelphia, and you study suicide, and you study, as you put it, losers, you know, people who, whose lives don't turn out the way they wanted them to turn out, and then kind of need to ask themselves, what do I do about it? And some of them kill themselves. In terms of that, do you feel that suicide is an underrated problem in our society and in any society?

• 17:03Speaker 01

  Underrated. Well, I think that we're kind of schizophrenic about suicide, which is that we have both devoted intellectuals and scholars and public health officials and sociologists and especially psychiatrists and psychologists have devoted so much ink to thinking and talking, exploring suicide, that it's hard to say that it's underexamined. We also tend to be obsessed with suicides in pop culture. I can't even begin to list the number of films, the number of TV shows whose plot points turn on suicides. And so it's kind of a hot-button issue.

• 17:48Speaker 01

  But I think it's true, equally true, that most of the time, we ignore the suicides that are happening in our midst. I certainly feel that's the case in Las Vegas, where every year or year and a half, a reporter, enterprising reporter at one of the Las Vegas newspapers discovers the suicide problem in Las Vegas, and we get a kind of rash of stories. And then we go back to not thinking about it. And so to the extent that we have this kind of look but don't see relationship with suicide, it is kind of under the radar.

• 18:27Stephen J. Dubner?

  Why do you think we have that relationship as a sociologist or as a human being? We know it exists, it's existed throughout history. The numbers are large. I mean, you talk about how predominant suicide is in pop culture, let's say in TV shows or films, but I'll tell you, without having done any looking into this at all, I'd bet a lot of money that murder is much more prominently featured in TV and on film than suicide, and yet murder takes fewer than half the number of lives of suicide every year.

• 19:02Speaker 01

  Great point. We do seem to be far more focused on that form of violence than the lethal, self-directed violence that is suicide. And I think that there's a way in which the...

• 19:22Speaker 01

  The need for justice that we feel when a homicide occurs motivates us to take a greater collective interest in it. A crime has occurred, the most heinous kind of crime has occurred, a life has been taken, someone did it, that person is bad, we need to identify that person and we need to bring about some justice and some retribution. Those ingredients are really missing. They're really missing with suicide. We see it as tragedy. We see

• 19:59Speaker 01

  it as loss. It's deeply saddening and depressing and grim, very, very grim. And so I think it doesn't mobilize people in the same way that homicide does, or even in some ways accidents.

• 20:19Stephen J. Dubner?

  Let me ask you one more question. I'd love, you mentioned it, and I think we're looking into it, so I'd love to know if you have any insight. What is the story with Hungary? Why such a, over a long period of history, why does Hungary have such a high suicide rate?

• 20:37Speaker 01

  I have no idea. You know, I would rather talk about New York.

• 20:42Stephen J. Dubner?

  Well, give me New York, then. Why New York relatively low compared to Vegas?

• 20:49Speaker 01

  You are absolutely right. Las Vegas has this high suicide rate. New York has the lowest. There are some urban counties in New Jersey that are lower, but the five borough area in New York has extraordinarily low suicide rates. You know, if you live in New York, you, an interesting thing is that you're more likely to die of a heart attack than elsewhere in the United States. So the particular place-based risk...

• 21:18Speaker 01

  Of death for New Yorkers is not suicide. It's a myocardial infarction. And so this speaks to the issue of sort of how place and health or mortality are related, which is one of the issues I'm trying to get at in this study. In fact, the basic model for our Vegas paper was taken from a study in 1999 about the increase in heart attack risk that visitors to New York experience. People who visit New York see their risk for heart attack go up about 6%. And residents of New York have a heart attack risk that is about 12% greater than elsewhere.

• 21:56Stephen J. Dubner?

  So if you-

• 21:57Speaker 01

  You should get out of New York because if you're a New Yorker and you leave New York, Stephen, your risk of dying by heart attack will drop by about 7%.

• 22:07Stephen J. Dubner?

  If I'm personally not at a lot of risk for a heart attack, then I can probably afford the added risk of heart attack by staying in New York. If, however, I'm slightly more tending towards suicide, I gotta stay out of Las Vegas.

• 22:20Speaker 01

  That's exactly right.

• 22:21Stephen J. Dubner?

  And Hungary, don't even-

• 22:23Speaker 01

  Cancel that flight. Do not go if you're on the fence.

• 22:40Stephen J. Dubner?

  Freakonomics Radio is going to Hungary and lots of other places, too. It'll all be part of an hour-long episode about suicide that airs on finer public radio stations this June. There'll be four more hours of radio, too. You'll hear from Romanian witches, Harvard dropouts, and a couple of prostitutes. Oh, yeah, a bunch of economists, too.

• 23:07Speaker 02

  Freakonomics Radio is a co-production of WNYC, APM, American Public Media, and Dubner Productions. Our staff includes Susie Lechtenberg, Beray Lamb, Chris Neary, and Colin Campbell. Our engineer is David Herman. Subscribe to this podcast on iTunes and you'll get the next episode in your sleep. You can find more audio at FreakonomicsRadio.com. And as always, if you want to read more about the hidden side of everything, go to Freakonomics.com.

• 23:55Stephen J. Dubner?

  Freakonomics Radio is sponsored by Ozempic. Innovation happens through rethinking what's possible. And when it comes to GLP-1s, Ozempic pill does just that. Learn more about Ozempic semaglutide tablets, 4 and 9mg, by calling 1-833-OZEMPIC or visit Ozempic.com to view the medication guide and ask your doctor what's possible with FDA-approved Ozempic pill.

• 24:26Stephen J. Dubner?

  Freakonomics Radio is sponsored by Southern Company. The world and its energy needs are always changing. Southern Company's commitment to meeting this demand stays the same. That's because Southern Company believes energy is more than a utility, it's what powers possibilities. So they are looking ahead and investing $80 billion in infrastructure upgrades and are committed to fueling growth in ways that benefit all customers so that reliable and affordable energy is accessible for generations to come. Go to southerncompany.com to learn more. Southern Company, building the future of energy.

• 25:05Speaker 03

  This podcast is supported by Nurtac ODT, remagu pant. We know you didn't ask for an interruption, but migraine doesn't wait for the right moment to interrupt either. It just barges in, takes your time, and throws everything off. So when migraine takes your time, take Nurtac. It's for the acute treatment of migraine with or without aura in adults. Nurtac can provide pain relief in two hours, which can last up to two days. Ask your healthcare provider if Nurtac is right for you, because your time is for you, not migraine. Don't take if allergic to Nurtac ODT. Allergic reactions can occur even days after use. Get help right away for trouble breathing, rash, swelling of face, mouth, tongue, or throat. High blood pressure and Raynaud's syndrome can occur. Get help for high blood pressure, numbness, coolness, pain, or color changes in fingers

• 25:50Speaker 03

  and toes. Common side effect is nausea. For full prescribing information, call 1-833-4-NURTC or visit nurtc.com. All right, back to your podcast, playlist, or whatever's keeping you going today.

• 26:04Speaker 04

  This episode is brought to you by Charles Schwab. Is there a right time to sell a stock? Are you taking the right risks with your portfolio? Financial decisions can be tricky, and often your own cognitive and emotional biases can lead you astray. Financial Decoder, an original podcast from Charles Schwab, can help. Join host Mark Reapy as he offers practical solutions to help overcome the cognitive and emotional biases that may affect your investing decisions. Listen at schwab.com/financialdecoder.