It may be time to change the benchmark for discussion of public health problems in the U.S.


For quite a while, the annual number of fatalities from auto accidents has been a kind of shorthand for health issues that are big and important.

Starting in 2009, though, suicides surpassed deaths from crashes. In 2010, there were about 38,000 suicides compared with about 35,000 deaths from motor vehicle crashes.

In a new analysis, the Centers for Disease Control and Prevention zeroed in on suicide data for middle-aged people, 35-64, because that’s where the increase in suicides has been the most dramatic. (Among younger and older people the rates didn’t change much.)

The suicide rate for people 35-64 rose to 17.6 per 100,000 people in 2010 from 13.7 per 100,000 in 1999. That’s an increase of 28 percent.

Why are the rates up so much?

The CDC researchers say that possible factors include the recent economic downturn, an increase in drug overdoses and a so-called cohort effect for baby boomers. As teens, baby boomers were more likely to commit suicide than teens of previous generations. It may be that the tendency followed them as they aged.


How people commit suicide has changed, too. Use of firearms and poison rose, but the biggest increase was for suffocation, mostly due to hanging.

“This increasing trend is particularly troubling because a large proportion of suicide attempts by suffocation result in death, suggesting a need for increased public awareness of suicide risk factors and research of potential suicide prevention strategies to reduce suffocation deaths,” the CDC researchers wrote.

* Text by SCOTT HENSLEY, May 2, 2013

The findings appear in the latest issue of Morbidity & Mortality Weekly Report.

The Pentagon announced Friday it will spend $1 billion to add 14 interceptors to a West Coast-based missile defense system, responding to what it called faster-than-anticipated North Korean progress on nuclear weapons and missiles.



Threats will only “further isolate” North Korea, Carney says

Citing a “series of irresponsible and reckless provocations” by Pyongyang, Defense Secretary Chuck Hagel said he is determined to ensure protection of the U.S. homeland and stay ahead of the North Korean missile threat.

“We will strengthen our homeland defense, maintain our commitment to our allies and partners, and make clear to the world that the United States stands firm against aggression,” Hagel told a Pentagon news conference.

The Pentagon intends to add the 14 interceptors to 26 already in place at Fort Greely, Alaska. That will expand the system’s ability to shoot down long-range missiles in flight before they could reach U.S. territory. In addition to those at Greely, the U.S. also has four missile interceptors at Vandenberg Air Force Base, Calif.

Defense Secretary Chuck Hagel speaks during a news conference at the Pentagon, Friday, March 15, 2013. / AP Photo/Cliff Owen

James Miller, the undersecretary of defense for policy, said the project would cost about $1 billion. CBS News correspondent David Martin reported that how much added security that will buy is subject to debate, since the interceptors have an uneven test record.

“The reason we’re advancing our program here for homeland security is to not take any chances, is to stay ahead of the threat and to assure any contingency,” Hagel said.

The Pentagon announced on March 15, 2013 it will spend $1 billion to add 14 interceptors to a West Coast-based missile defense system, responding to what it called faster-than-anticipated North Korean progress on nuclear weapons and missiles.

Martin also reported that U.S. intelligence does not believe North Korea yet has a nuclear-armed missile capable of reaching the U.S. But a photo of a mobile intercontinental ballistic missile in a military parade last year heightened concerns they are working hard to develop one.


Former Defense Secretary Robert Gates once said North Korea could have an ICBM (intercontinental ballistic missile) by 2016, added Martin, but the extra interceptor missiles to shoot it down won’t all be in place until 2017.

Miller and Hagel said the U.S. will conduct environmental studies on three additional potential locations for interceptors in the United States, including on the East Coast, as required by Congress. Hagel said no decision on a particular site has been made, but the studies would shorten the timeline should a decision be made.

Miller said that would provide options for building an interceptor base on the East Coast or adding more interceptors in Alaska, should either approach become necessary due to further future increases in the threat from Iran and North Korea.

The threat of a missile strike from North Korea was the rationale for building the missile defense sites in Alaska and California during the administration of President George W. Bush. Technical difficulties with the interceptors slowed the pace at which they were installed at Greely and Vandenberg.

“Our policy is to stay ahead of the threat — and to continue to ensure that we are ahead of any potential future Iranian or North Korean ICBM capability,” Miller said in a speech Tuesday at the Atlantic Council.


Miller noted that last December, North Korea launched a satellite into space, demonstrating its mastery of some of the same technologies required for development of an intercontinental ballistic missile.

“Our concern about Pyongyang’s potential ICBM capability is compounded by the regime’s focus on developing nuclear weapons,” he said. “North Korea’s third nuclear test last month is obviously a serious concern for all nations.”

North Korea recently threatened to reduce Seoul to a “sea of fire” and stage pre-emptive nuclear attacks on Washington.

“North Korea’s shrill public pronouncements underscore the need for the U.S. to continue to take prudent steps to defeat any future North Korean ICBM,” Miller said in his speech Tuesday.

In this handout image provided by the German Bundeswehr armed forces a patriot missile is fired during the Operation Red Arrow exercise on October 15, 2008 in Crete, Greece. Germany’s cabinet agreed on Thursday to send Patriot missiles and up to 400 soldiers to Turkey to act as a deterrent against any spread of the conflict in Syria across the border. (Photo by Peter Mueller/Bundeswehr via Getty Images)* CBS (March 15, 2013)

Ted Genoways was just 31 when he took over as editor of The Virginia Quarterly Review in 2003, determined to propel the storied but old-fashioned literary magazine at the University of Virginia into the 21st century. Three years later he made good on his promise. The tiny journal won two National Magazine Awards and six nominations — up against perennial glamour titles like The New Yorker, Harper’s Magazine and Vanity Fair — and Mr. Genoways was hailed in national literary circles for his spunk and vision.

But by this summer, things had gone dangerously south. Mr. Genoways had become alienated from his small staff, some of whose members repeatedly complained to the university president’s office about his absences and his attitude. His initially warm relationship with the university’s English department — whose renowned creative writing division includes novelists and poets like Ann Beattie, John Casey, Rita Dove and Deborah Eisenberg — had cooled after he sought a position there and was summarily rejected.

Then on July 30, the review’s managing editor, Kevin Morrissey, took a gun to a coal tower on the outskirts of town and killed himself, an act that some of Mr. Morrissey’s friends and family attributed partly to stress in the workplace — even going so far as to lay that stress publicly at Mr. Genoways’s door.
Now the 85-year-old review is in limbo. University officials have canceled the winter issue and closed the offices until an investigation into the staff’s complaints is complete. Mr. Genoways is fighting for his job, his reputation, his $134,000-a-year salary and his legacy as the editor who helped put the review on the literary map far beyond the “academical village” founded by Thomas Jefferson, where William Faulkner, a pipe between his teeth and a Tyrolean hat on his head, once strolled as writer-in-residence.

“I was hired to steward an old and valuable institution,” said Mr. Genoways, his hands folded in his lap during an interview last week. “Until anyone tells me otherwise, I still see myself in that role.”
His fate could hinge on the results of the investigation, which may be completed by the end of the month. In announcing it on Aug. 19, the university’s new president, Teresa A. Sullivan, said in a statement, “The review will, I hope, provide a factual basis for understanding this workplace and deciding what corrective actions, if any, the university should undertake.”

In the last few weeks, returning faculty and staff members — still reeling from the violent killing of a female university lacrosse player in the spring — have been shocked to arrive back on campus and watch the aftermath of Mr. Morrissey’s death playing out on blogs and in the national media. The Hook, a newsweekly here, ran a cover article on Aug. 18 reporting that the 52-year-old Mr. Morrissey had asked the university to intervene in the workplace situation in the months and weeks before his suicide, but his pleas had not been addressed in time.

Carol Wood, a spokeswoman for the university, said that mediation had been discussed with Mr. Morrissey and was planned.
Many of Mr. Genoways’s contributing writers have spoken out publicly on his behalf, attesting to his character and professionalism. But his support within the university appears to be more limited. Since Mr. Morrissey died, Mr. Genoways said, “I’ve only heard from one faculty member regularly.”
From its founding as “a great serious publication wherein shall be reflected the calm thought of the best men,” The Virginia Quarterly Review has kept its offices on the stately grounds of the university. Its home at the Jeffersonian center of the University, at 1 West Range, is steps from the iconic Rotunda and the preserved and showcased room at 13 West Range where Edgar Allan Poe lived as a young student.
When Mr. Genoways was brought on as editor, he replaced Staige Blackford, who had served as editor of the review for 28 years and was days away from retiring when he was killed in a car crash. Over the decades Mr. Blackford had nurtured relationships with the members of the faculty, many of whom frequently wrote for the magazine. Mr. Genoways began his time as editor by doing the same, inviting professors to meetings and asking for their input on the magazine’s design.

Lisa Russ Spaar, a professor in the English department who knew Mr. Genoways when he was a graduate student at Virginia — earning his M.F.A. in poetry writing — said that he initially dazzled the literary world on campus with his energy and passion.
“I do think that Ted was very interested in making V.Q.R. more competitive,” she said. “He wanted to move it from being a reader’s-reader kind of quarterly to being something that was bold and took risks.”
But after Mr. Genoways was denied a position in the department, his relationship with the faculty became strained, a situation that some faculty members saw as a missed opportunity.
“There are certain ways in which the journal can draw on the kind of contacts and expertise and advice that the faculty of a university can provide,” said Jahan Ramazani, a professor of English. “And in turn, the faculty can benefit from a relationship with V.Q.R.”
Mr. Genoways’s relationship with the members of his staff was deteriorating as well. Beginning last fall, they said, he was showing up in the office only a few days a week for a few hours a day. He was lax about returning their phone calls. He began transferring more editing duties to them.
“Ted was rarely in the office, he would rarely answer e-mails to us and he would not tell us about major decisions,” said Sheila McMillen, an editor who has been placed on paid leave while the university conducts its investigation. “When we would attempt to talk to him, he would get angry and extremely defensive.”

John Casteen IV, a friend of Mr. Genoways’s who is a volunteer on the magazine’s poetry board — and a son of the former university president, John Casteen III, who hired Mr. Genoways — was skeptical.

“The description of Ted’s behavior is totally inconsistent with anything I ever saw when I was in the office,” said the younger Mr. Casteen, who has contributed articles on poetry to the review.

Mr. Genoways acknowledged that the office dynamics had grown tense, but said that he had successfully argued for pay raises to compensate for the staff’s increased work. While he was spending more time out of the office, he said, he was busy working from home.
“They may have seen me working on V.Q.R. less,” he said. “But in the last year to year and a half the amount of work I’ve done on V.Q.R. has been at times overwhelming.”
Mr. Genoways also said he was increasingly worried about the magazine’s finances. The endowments, heavily invested in the stock market, have suffered, he said, and a fund of about $800,000 had been spent down by more than half as Mr. Genoways invested in the kind of long-form journalism and color photography that contributed to its rise in the magazine world.

The staff members began to grumble over the editorial direction of the magazine. It was too dark, too gritty, too morose, they said, with too many articles about war and conflict and death. Mr. Genoways, who frequently sent reporters to Iraq and Afghanistan, made no apologies for the content.
“If the subject matter was dark, to me it was never presented in an air of despair,” he said, acknowledging that the magazine’s subscription numbers, which now hover around 2,400, were falling about the same time. “So were everybody else’s in the country. I didn’t see those things as related.”
Molly Minturn, an associate editor, insisted that Mr. Genoways had created a “toxic work environment” that the university did not do enough to repair. Mr. Morrissey, described by his co-workers as a gentle person who never graduated from college, read voraciously and organized his life around work, seemed to have been affected the most by the tension.

By July, Mr. Morrissey, who struggled with depression, appeared to be despondent over his interactions with Mr. Genoways, Ms. Minturn said. After she told university officials that month that she feared Mr. Morrissey would harm himself, they did not act quickly, she said.
“The issue here is the way V.Q.R. was managed, and the questions that remain unanswered,” Ms. Minturn said. “I’m hoping that this investigation will answer them.”

By JULIE BOSMAN (September 10, 2010)