Suicide deaths in the United States increased to almost 50,000 last year, according to provisional data from the Centers for Disease Control and Prevention (CDC).

The CDC estimated suicide deaths rose by 2.6% from the previous year, The New York Times reports. The overall suicide rate (the number of suicides per 100,000 people) increased by about 35% over the last two decades. The highest increase in the number of deaths by suicide last year was among people 65 and older. The number of suicide deaths decreased by 8% among people ages 10 to 24.

The increase in suicides can be attributed to many factors, experts say. These include easy access to guns, economic uncertainty, substance use, social isolation, difficulty in accessing mental health care and stigma around seeking help. The longer-term consequences of the pandemic may also play a role, according to Robin Lee of the National Center for Injury Prevention and Control.