Natural Environment, Neighborhood Contexts, and Intra-Urban Suicidal Behavior

High suicide rates remain a critical public health challenge in the United States. Using census block group-level data, we examine spatial clustering of suicidal behavior in Salt Lake City (SLC), Utah, and identify key environmental and socioeconomic determinants. We find that green space and walkability are associated with lower suicidal behavior, likely by promoting stress relief, physical activity, and social interaction. In contrast, greater access to hotels is linked to higher risk, as these spaces may offer privacy that limits timely intervention. Neighborhoods with higher incomes and larger families showed greater resilience, consistent with reduced financial strain and stronger emotional support. Areas with higher labor force participation face increased risk, possibly reflecting pressures from job competition and wage stagnation. Contextual factors further moderate these effects. The protective effect of green space is weaker in neighborhoods with larger shares of non-Hispanic African American residents and in higher-income or larger-family areas, but stronger where the jobs-housing mix is higher. Spatial heterogeneity analyses reveal that mixed land use near downtown is associated with higher risk, likely because of traffic noise, waste, and crime. Meanwhile, higher proportions of non-Hispanic African American residents are associated with lower risk in eastern SLC, where these populations tend to live in higher-income neighborhoods with better living conditions. Overall, this study highlights the interplay of environmental, socioeconomic, and contextual factors underlying suicidal behavior and offers a comprehensive understanding of how physical settings and neighborhood characteristics shape vulnerability. These insights inform the development of more targeted and effective suicide prevention strategies.