Between 2000 and 2017, the suicide rate in the U.S. increased by 40%, with blue-collar workers in industries such as mining, oil and gas extraction, construction, agriculture, transportation, and warehousing most at risk, according to a new study from the Centers for Disease Control and Prevention.

The study used data from 32 states — including Pennsylvania and New Jersey — that participated in the 2016 National Violent Death Reporting System, which combined data from death certificates, coroner and medical examiner reports, and law enforcement reports. Researchers looked at the suicide rates by profession for 20,975 people, ages 16 to 64. They found that both male and female workers in construction, mining, oil, and gas had the highest suicide rates.

In 2018, Pennsylvania produced 6.2 trillion cubic feet of natural gas, mostly from the Marcellus Shale, making it the nation’s second-largest natural gas producer behind Texas, according to the U.S. Energy Information Administration. It also produced 49.9 million short tons of coal, ranking third in the country for coal production. And nearly 305,000 people currently work in the transportation and warehousing industry, representing 5.2% of the state’s workforce, according to the Pennsylvania Department of Labor and Industry.

Previous research indicated that suicide risk is associated with low-skilled work, lower education, and socioeconomic status, work-related access to lethal means, and job stress, which includes such factors as low job support and job insecurity.

“This is some of the first data that has taken such a systematic look at occupations,” said Gregory Brown, director of the Penn Center for the Prevention of Suicide. “A lot of these professions most at risk are male-dominated, like hunting, fishing, or steel. With those types of professions, you tend to have job instability, which can often lead to a lot of stress.”

Brown also said that within those industries, there’s no “easy access” to resources that might make a difference in addressing mental health. He said that when people work in a building, it’s much more likely that there’s a place where they can go when they need help.

“The other thing I suspect is that within these industries, there’s a macho culture,” Brown said. “Reaching out for help is often seen as a weakness. Men just don’t like to ask for help.”

Brown cited the military as an industry that has made changes in its culture surrounding mental health. A study showed that over the course of the wars in Iraq and Afghanistan, the use of mental-health services increased and stigma decreased. Brown said that because mental health is commonly discussed in the military now and health-care workers are aware of what to look for when helping members of the military, the situation has improved.

The CDC recommended that state and local health departments, employers, and professional associations in the industries most at risk focus resources on prevention. In May 2019, Gov. Tom Wolf announced a statewide suicide task force — which includes staff from multiple state agencies, General Assembly members, and Prevent Suicide PA — to develop a long-term strategy to reduce suicide in Pennsylvania. Since 1999, the state has seen a 34% increase in suicide rates.

“In employment settings like the ones in this study, that has yet to happen,” Brown said. “We don’t have a lot of data on what to do, or how to support people. We have almost no data on how to construct effective messages, and so men in their middle years, who have dramatically increased risk for suicide, don’t come in for mental-health care.”

If you or someone you know is thinking of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text TALK to the Crisis Text Line at 741741.