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Hicks BM, Vitro C, Johnson E, Sherman C, Heitzeg MM, Durbin CE, Verona E. Who bought a gun during the COVID-19 pandemic in the United States?: Associations with QAnon beliefs, right-wing political attitudes, intimate partner violence, antisocial behavior, suicidality, and mental health and substance use problems. PLoS One 2023; 18:e0290770. [PMID: 37643192 PMCID: PMC10464976 DOI: 10.1371/journal.pone.0290770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
There was a large spike in gun purchases and gun violence during the first year of the COVID-19 pandemic in the United States. We used an online U.S. national survey (N = 1036) to examine the characteristics of people who purchased a gun between March 2020 and October 2021 (n = 103) and compared them to non-gun owners (n = 763) and people who own a gun but did not purchase a gun during the COVID-19 pandemic (n = 170). Compared to non-gun owners, pandemic gun buyers were younger and more likely to be male, White race, and to affiliate with the Republican party. Compared to non-gun owners and pre-pandemic gun owners, pandemic gun buyers exhibited extreme elevations on a constellation of political (QAnon beliefs, pro-gun attitudes, Christian Nationalism, approval of former President Donald Trump, anti-vax beliefs, COVID-19 skepticism; mean Cohen's d = 1.15), behavioral (intimate partner violence, antisocial behavior; mean d = 1.38), mental health (suicidality, depression, anxiety, substance use; mean d = 1.21), and personality (desire for power, belief in a dangerous world, low agreeableness, low conscientiousness; mean d = 0.95) characteristics. In contrast, pre-pandemic gun owners only endorsed more pro-gun attitudes (d = 0.67), lower approval of President Joe Biden (d = -0.41) and were more likely to be male and affiliate with the Republican party relative to non-gun owners. Pandemic gun buyers represent an extreme group in terms of political and psychological characteristics including several risk-factors for violence and self-harm.
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Affiliation(s)
- Brian M. Hicks
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Catherine Vitro
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Elizabeth Johnson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Carter Sherman
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - C. Emily Durbin
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Edelyn Verona
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
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Sáenz-Aldea M, Zarrabeitia MT, García Blanco A, Santurtún A. Scrutinizing the Profile and Risk Factors of Suicide: A Perspective from a Case-Control Study Focused on a Northern Region of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15867. [PMID: 36497948 PMCID: PMC9741352 DOI: 10.3390/ijerph192315867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. A total of 135 cases were identified as suicides that occurred in a region of northern Spain between 2018 and 2020. Controls (three for each case) were matched by age, sex, and urban-rural areas. The information was collected retrospectively through electronic health record systems. A binary logistic regression analysis was performed to study the association between individual risk factors and suicide. Being male (78.5%), between 40 and 60 years of age, unmarried (70.9%), and unemployed (85%) were associated with suicide deaths. Although the existence of a previous self-harm attempt is presented as the most robust risk factor (OR 22.121 [8.997-54.389]), the presence of a psychiatric diagnosis (OR 12.583 [7.686-20.601]) and cancer (OR 3.729 [1.845-7.536]) also showed a significant relationship with suicide (p < 0.05). Defining and knowing the risk factors for suicide helps to better understand the profiles of those individuals who are vulnerable, and enables prevention actions to be taken in both social and medical spheres.
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Affiliation(s)
- María Sáenz-Aldea
- Family and Community Medicine, Davila Health Center, Health Service of Cantabria, Unit of Legal Medicine, University of Cantabria, 39005 Santander, Spain
| | - María T. Zarrabeitia
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, IDIVAL, 39005 Santander, Spain
| | - Ana García Blanco
- Pathology Service, Institute of Legal Medicine of Cantabria, Unit of Legal Medicine, University of Cantabria, 39005 Santander, Spain
| | - Ana Santurtún
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, IDIVAL, 39005 Santander, Spain
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Montgomery AE, Dichter ME, Blosnich JR. Gender Differences in the Predictors of Suicide-related Morbidity Among Veterans Reporting Current Housing Instability. Med Care 2021; 59:S36-S41. [PMID: 33438881 DOI: 10.1097/mlr.0000000000001422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Veterans experiencing housing instability are at increased risk of suicide. Research is needed to identify gender differences in the predictors of both suicidal ideation and suicide attempt, particularly among Veterans who are unstably housed. OBJECTIVES The objective of the present study was to explore whether correlates of suicide-related morbidity among unstably housed Veterans vary by gender and identify implications for improved care for these Veterans. METHODS The study cohort included 86,325 Veterans who reported current housing instability between October 1, 2013, and September 30, 2016. This cross-sectional study assessed differences in demographic and outcome variables by gender using χ2 analyses and a series of multiple logistic regressions predicting suicidal ideation and suicide attempt, stratified by gender. RESULTS Among unstably housed female Veterans, being younger than 40 years was associated with more than double the odds of having an indicator of suicidal ideation and >12 times the odds of having an indicator of a suicide attempt. The effect sizes associated with age were much less pronounced among unstably housed male Veterans. The presence of mental health and substance use conditions as well as a positive screen for military sexual trauma were associated with increased risk of suicide morbidity among both women and men. CONCLUSIONS Intervention and prevention among unstably housed Veterans may be complicated by unpredictable living situations; further research should explore tailored interventions to address the complex needs of unstably housed Veterans and how suicide prevention can be woven throughout.
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Affiliation(s)
- Ann E Montgomery
- US Department of Veterans Affairs (VA), National Center on Homelessness among Veterans, Philadelphia, PA.,Birmingham VA Medical Center.,University of Alabama at Birmingham, School of Public Health, Birmingham, AL
| | - Melissa E Dichter
- Temple University School of Social Work.,VA Center for Health Equity Research and Promotion, Philadelphia, PA
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA
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Boyer TL, Youk AO, Haas AP, Brown GR, Shipherd JC, Kauth MR, Jasuja GK, Blosnich JR. Suicide, Homicide, and All-Cause Mortality Among Transgender and Cisgender Patients in the Veterans Health Administration. LGBT Health 2021; 8:173-180. [PMID: 33544021 DOI: 10.1089/lgbt.2020.0235] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study examines the differences in suicide, homicide, and all-cause mortality between transgender and cisgender Veterans Health Administration (VHA) patients. Methods: VHA electronic medical record data from October 1, 1999 to December 31, 2016 were used to create a sample of transgender and cisgender patients (n = 32,441). Cox proportional hazard regression was used to evaluate differences in survival time (date of birth to death date/study end). Death data were from the National Death Index. Results: Transgender patients had more than twofold greater hazard of suicide than cisgender patients (adjusted hazard ratio [aHR] = 2.77, 95% confidence interval [CI] = 1.88-4.09), especially among younger (18-39 years) (aHR = 3.35, 95% CI = 1.30-8.60) and older (≥65 years) patients (aHR = 9.48, 95% CI = 3.88-23.19). Alternatively, transgender patients had an overall lower hazard of all-cause mortality (aHR = 0.90, 95% CI = 0.84-0.97) compared with cisgender patients, which was driven by patients 40-64 years old (aHR = 0.78, 95% CI = 0.72-0.86) and reversed by those 65 years and older (aHR = 1.17, 95% CI = 1.03-1.33). Conclusion: Transgender patients' hazard of suicide mortality was significantly greater than that of cisgender VHA patients.
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Affiliation(s)
- Taylor L Boyer
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
| | - Ada O Youk
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ann P Haas
- Department of Health Sciences, Lehman College, City University of New York, Bronx, New York, USA
| | - George R Brown
- Mountain Home VA Medical Center, Johnson City, Tennessee, USA.,Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Jillian C Shipherd
- Lesbian, Gay, Bisexual, and Transgender Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia, USA.,National Center for Post-traumatic Stress Disorder, VA Boston Healthcare System, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, Massachusetts, USA
| | - Michael R Kauth
- Lesbian, Gay, Bisexual, and Transgender Health Program, Office of Patient Care Services, Veterans Health Administration, Washington, District of Columbia, USA.,South Central Mental Illness Research, Education and Clinical Center, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.,Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA
| | - Guneet K Jasuja
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers VA Medical Center, Bedford, Massachusetts, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - John R Blosnich
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.,Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
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Copeland WE, Gaydosh L, Hill SN, Godwin J, Harris KM, Costello EJ, Shanahan L. Associations of Despair With Suicidality and Substance Misuse Among Young Adults. JAMA Netw Open 2020; 3:e208627. [PMID: 32573708 PMCID: PMC7312388 DOI: 10.1001/jamanetworkopen.2020.8627] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Deaths of despair is a term that has recently been used to describe the increases in premature mortality from suicides, drug overdoses (particularly from opiates), and alcohol-related liver disease among US adults. Despite the use of the term despair, its role in these causes of premature death has not been empirically tested. OBJECTIVE To test whether despair among young adults is associated with suicidal thoughts and behavior, alcohol misuse, and drug misuse. DESIGN, SETTING, AND PARTICIPANTS The Great Smoky Mountains Study is a Southeastern, mixed urban-rural population-based cohort study conducted from November 10, 1992, to September 22, 2015. A total of 1420 participants originally 9, 11, and 13 years of age were followed up 11 times to 30 years of age (11 230 person-observations). A total of 1154 of 1400 living participants (82.4%) were assessed at 30 years of age. Statistical analysis was performed from May 7, 2019, to April 10, 2020. EXPOSURES Participants were assessed with structured interviews for indicators of despair (eg, hopelessness, helplessness, low self-worth, and feeling unloved). Despair was assessed with items from structured interviews: the Child and Adolescent Psychiatric Assessment and the Young Adult Psychiatric Assessment. MAIN OUTCOMES AND MEASURES Structured interviews were used to assess suicidal thoughts and behavior, substance use, and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) alcohol use disorder and drug use disorder (including opioids) in young adulthood (2424 observations of 1266 individuals between 25 and 30 years of age). RESULTS This study included 1420 individuals (790 male individuals). During young adulthood (25 and 30 years of age), the 3-month weighted prevalence of any despair was 19.5% (476 of 2424 observations) with 7.6% of participants (201 of 2424 observations) reporting 2 or more despair items. In longitudinal, lagged models, despair scores (range, 0-3) were associated with more suicidal thoughts and behaviors (odds ratio [OR], 1.5; 95% CI, 1.1-2.0), illicit drug use (OR, 1.7; 95% CI, 1.2-2.5), and opioid use (OR, 1.9; 95% CI, 1.1-3.3) but not alcohol use disorder (OR, 0.8; 95% CI, 0.6-1.2). These associations persisted after accounting for sociodemographic factors (eg, poverty and educational level), lagged outcome status, and lagged depression status. The associations between despair and study outcomes were stronger in models accounting for long-term measures of despair extending back to childhood. There was no consistent pattern of moderation by sociodemographic factors. CONCLUSIONS AND RELEVANCE This study's findings suggest an empirical basis for longitudinal associations between despair and several, but not all, precursors of "deaths of despair" in rural Appalachia. Individual despair should be studied as a potential factor associated with morbidity and impairment in young adulthood.
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Affiliation(s)
- William E. Copeland
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont College of Medicine, Burlington
| | - Lauren Gaydosh
- Public Policy Studies, Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee
| | - Sherika N. Hill
- Department of Psychiatry, Duke University Medical Center, Durham, North Carolina
| | - Jennifer Godwin
- Center for Child and Family Policy, Duke University, Durham, North Carolina
| | - Kathleen Mullan Harris
- Carolina Population Center, Department of Sociology, University of North Carolina at Chapel Hill
| | - E. Jane Costello
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, Department of Psychology, University of Zürich, Zürich, Switzerland
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Bilsker D, Fogarty AS, Wakefield MA. Critical Issues in Men's Mental Health. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:590-596. [PMID: 29673272 PMCID: PMC6109879 DOI: 10.1177/0706743718766052] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This narrative review highlights key issues in men's mental health and identifies approaches to research, policy and practice that respond to men's styles of coping. Issues discussed are: 1) the high incidence of male suicide (80% of suicide deaths in Canada, with a peak in the mid-50 s age group) accompanied by low public awareness; 2) the perplexing nature of male depression, manifesting in forms that are poorly recognised by current diagnostic approaches and thus poorly treated; 3) the risky use of alcohol among men, again common and taking a huge toll on mental and physical health; 4) the characteristic ways in which men manage psychological suffering, the coping strengths to be recognised, and the gaps to be addressed; 5) the underutilization of mental health services by men, and the implication for clinical outcomes; and 6) male-specific approaches to service provision designed to improve men's accessing of care, with an emphasis on Canadian programs. The main conclusion is that a high proportion of men in Western society have acquired psychological coping strategies that are often dysfunctional. There is a need for men to learn more adaptive coping approaches long before they reach a crisis point. Recommendations are made to address men's mental health through: healthcare policy that facilitates access; research on tailoring interventions to men; population-level initiatives to improve the capacity of men to cope with psychological distress; and clinical practice that is sensitive to the expression of mental health problems in men and that responds in a relevant manner.
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Affiliation(s)
- Dan Bilsker
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Andrea S. Fogarty
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Matthew A. Wakefield
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
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Jordan HT, Stein CR, Li J, Cone JE, Stayner L, Hadler JL, Brackbill RM, Farfel MR. Mortality among rescue and recovery workers and community members exposed to the September 11, 2001 World Trade Center terrorist attacks, 2003-2014. ENVIRONMENTAL RESEARCH 2018; 163:270-279. [PMID: 29477875 DOI: 10.1016/j.envres.2018.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/05/2018] [Accepted: 01/09/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Multiple chronic health conditions have been associated with exposure to the September 11, 2001 World Trade Center (WTC) terrorist attacks (9/11). We assessed whether excess deaths occurred during 2003-2014 among persons directly exposed to 9/11, and examined associations of 9/11-related exposures with mortality risk. MATERIALS AND METHODS Deaths occurring in 2003-2014 among members of the World Trade Center Health Registry, a cohort of rescue/recovery workers and lower Manhattan community members who were exposed to 9/11, were identified via linkage to the National Death Index. Participants' overall levels of 9/11-related exposure were categorized as high, intermediate, or low. We calculated standardized mortality ratios (SMR) using New York City reference rates from 2003 to 2012. Proportional hazards were used to assess associations of 9/11-related exposures with mortality, accounting for age, sex, race/ethnicity and other potential confounders. RESULTS We identified 877 deaths among 29,280 rescue/recovery workers (3.0%) and 1694 deaths among 39,643 community members (4.3%) during 308,340 and 416,448 person-years of observation, respectively. The SMR for all causes of death was 0.69 [95% confidence interval (CI) 0.65-0.74] for rescue/recovery workers and 0.86 (95% CI 0.82-0.90) for community members. SMRs for diseases of the cardiovascular and respiratory systems were significantly lower than expected in both groups. SMRs for several other causes of death were significantly elevated, including suicide among rescue recovery workers (SMR 1.82, 95% CI 1.35-2.39), and brain malignancies (SMR 2.25, 95% CI 1.48-3.28) and non-Hodgkin's lymphoma (SMR 1.79, 95% CI 1.24-2.50) among community members. Compared to low exposure, both intermediate [adjusted hazard ratio (AHR) 1.36, 95% CI 1.10-1.67] and high (AHR 1.41, 95% CI 1.06-1.88) levels of 9/11-related exposure were significantly associated with all-cause mortality among rescue/recovery workers (p-value for trend 0.01). For community members, intermediate (AHR 1.13, 95% CI 1.01-1.27), but not high (AHR 1.14, 95% CI 0.94-1.39) exposure was significantly associated with all-cause mortality (p-value for trend 0.03). AHRs for associations of overall 9/11-related exposure with heart disease- and cancer-related mortality were similar in magnitude to those for all-cause mortality, but with 95% CIs crossing the null value. CONCLUSIONS Overall mortality was not elevated. Among specific causes of death that were significantly elevated, suicide among rescue/recovery workers is a plausible long-term consequence of 9/11 exposure, and is potentially preventable. Elevated mortality due to other causes, including non-Hodgkin's lymphoma and brain cancer, and small but statistically significant associations of 9/11-related exposures with all-cause mortality hazard warrant additional surveillance.
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Affiliation(s)
- Hannah T Jordan
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
| | - Cheryl R Stein
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
| | - Jiehui Li
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States.
| | - James E Cone
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
| | - Leslie Stayner
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois, 1603 W. Taylor Street, Chicago, Illinois 60612, United States
| | - James L Hadler
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
| | - Robert M Brackbill
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, United States
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Gunshot wounds resulting in hospitalization in the United States: 2004-2013. Injury 2017; 48:621-627. [PMID: 28173921 DOI: 10.1016/j.injury.2017.01.044] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/26/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The United States (US) leads all high income countries in gunshot wound (GSW) deaths. However, as a result of two decades of reduced federal support, study of GSW has been largely neglected. In this paper we describe the current state of GSW hospitalizations in the US using population-based data. PATIENTS AND METHODS We conducted an observational study of patients hospitalized for GSW in the National (Nationwide) Inpatient Sample (NIS) 2004 -2013. Our primary outcome is mortality after admission and we model its associations with gender, race, age, intent, severity of injury and weapon type, as well as providing temporal trends in hospital charges. RESULTS Each year approximately 30,000 patients are hospitalized for GSW, and 2500 die in hospital. Men are 9 times as likely to be hospitalized for GSW as women, but are less likely to die. Twice as many blacks are hospitalized for GSW as non-Hispanic whites. In-hospital mortality for blacks and non-Hispanic whites was similar when controlled for other factors. Most GSW (63%) are the result of assaults which overwhelmingly involve blacks; accidents are also common (23%) and more commonly involve non-Hispanic whites. Although suicide is much less common (8.3%), it accounts for 32% of all deaths; most of which are older non-Hispanic white males. Handguns are the most common weapon reported, and have the highest mortality rate (8.4%). During the study period, the annual rate of hospitalizations for GSW remained stable at 80 per 100,000 hospital admissions; median inflation-adjusted hospital charges have steadily increased by approximately 20% annually from $30,000 to $56,000 per hospitalization. The adjusted odds for mortality decreased over the study period. Although extensively reported, GSW inflicted by police and terrorists represent few hospitalizations and very few deaths. CONCLUSIONS The preponderance GSW hospitalizations resulting from assaults on young black males and suicides among older non-Hispanic white males have continued unabated over the last decade with escalating costs. As with other widespread threats to the public wellbeing, federally funded research is required if effective interventions are to be developed.
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Temporal Trends of Suicide Mortality in Mainland China: Results from the Age-Period-Cohort Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080784. [PMID: 27527195 PMCID: PMC4997470 DOI: 10.3390/ijerph13080784] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/27/2016] [Accepted: 08/01/2016] [Indexed: 11/16/2022]
Abstract
The aim of this study is to explore the long-term trends of suicide mortality in China. We implemented the age-period-cohort (APC) framework, using data from the Global Burden of Disease Study 2013. Our results showed that the net drift of suicide mortality was -4.727% (95% CI: -4.821% to -4.634%) per year for men and -6.633% (95% CI: -6.751% to -6.515%) per year for women, and the local drift values were below 0 in all age groups (p < 0.01 for all) for both sexes during the period of 1994-2013. Longitudinal age curves indicated that, in the same birth cohort, suicide death risk increased rapidly to peak at the life stage of 20-24 years old and 15-24 years old for men and women, respectively, and then showed a decelerated decline, followed by a rise thereafter after 54 years old for men and a slight one after 69 years old for women. The estimated period and cohort RRs were found to show similar monotonic downward patterns (significantly with p < 0.01 for all) for both sexes, with more quickly decreasing for women than for men during the whole period. The decreasing trend of suicide was likely to be related to the economic rapid growth, improvements in health care, enhancement on the level of education, and increasing awareness of suicide among the public in China. In addition, fast urbanization and the effective control of pesticides and rodenticides might be the special reasons behind these trends we observed in this study.
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Mortality from Unspecified Unintentional Injury among Individuals Aged 65 Years and Older by U.S. State, 1999-2013. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080763. [PMID: 27472356 PMCID: PMC4997449 DOI: 10.3390/ijerph13080763] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/17/2016] [Accepted: 07/22/2016] [Indexed: 11/24/2022]
Abstract
Introduction: Recent changes in unspecified unintentional injury mortality for the elderly by U.S. state remain unreported. This study aims to examine U.S. state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013; Methods: Using mortality rates from the U.S. CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for older adults aged 65+ from 1999 to 2013 by state. Specifically, the proportion of unintentional injury deaths with unspecified external cause in the data was considered. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013; Results: Of the 36 U.S. states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. Twenty-nine of the 36 states showed reductions in the proportion of unspecified unintentional injury cause, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. As unspecified unintentional injury mortality decreased, mortality from falls in 28 states and poisoning in 3 states increased significantly. Mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states also decreased; Conclusions: The proportion of unintentional injuries among older adults with unspecified cause decreased significantly for many states in the United States from 1999 to 2013. The reduced proportion of unspecified injury has implications for research and practice. It should be considered in state-level trend analysis during 1999–2013. It also suggests comparisons between states for specific injury mortality should be conducted with caution, as large differences in unspecified injury mortality across states and over time could create bias for specified injury mortality comparisons.
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11
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Wang Z, Yu C, Wang J, Bao J, Gao X, Xiang H. Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983-2012. Int J Equity Health 2016; 15:107. [PMID: 27412030 PMCID: PMC4944259 DOI: 10.1186/s12939-016-0400-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/06/2016] [Indexed: 11/16/2022] Open
Abstract
Background Previous studies suggested that the racial differences in U.S. suicide rates are decreasing, particularly for African Americans, but the cause behind the temporal variations has yet to be determined. This study aims to investigate the long-term trends in suicide mortality in the U.S. between 1983 and 2012 and to examine age-, period-, and cohort-specific effects by gender and race. Method Suicide mortality data were collected from the Web-based Injury Statistics Query and Reporting System (WISQARS) and analyzed with the Joinpoint regression and age-period-cohort (APC) analysis. Results We found that although age-standardized rate of suicide in white males, white females, black males, and black females all changed at different degrees, the overall situation almost has not changed since these changes offset each other. By APC analysis, while the age effect on suicide demonstrate an obvious difference between white males and females (with the peak at 75 to 79 for white males and 45 to 54 for white females), young black people are predominantly susceptible to suicide (risk peaks in early 20s for black males and late 20s for black females). Cohort effects all showed a descending trend, except that in white males and females which showed an obvious increase peaked in around cohort 1960. There was a similar period effect trend between different genders in the same race group, but between the races, differences were found in the period before 1990 and after 2000. Conclusion We confirmed that the distinction in age-specific suicide rate patterns does exist by gender and by race after controlling for period and cohort effects, which suggested that minorities’ age patterns of suicide may have been masked up by the white people in the whole population. The differences of period effects and cohort effects between white and black Americans were likely to be mainly explained by the difference in race susceptibility to economic depression.
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Affiliation(s)
- Zhenkun Wang
- School of Public Health, Wuhan University, Wuhan, 430071, China.,Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH, 43210, USA
| | - Chuanhua Yu
- School of Public Health, Wuhan University, Wuhan, 430071, China. .,Global Health Institute, Wuhan University, Wuhan, 430071, China.
| | - Jinyao Wang
- School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Junzhe Bao
- School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Xudong Gao
- School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Huiyun Xiang
- Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH, 43210, USA. .,College of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
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Newcomer AR, Roth KB, Kellam SG, Wang W, Ialongo NS, Hart SR, Wagner BM, Wilcox HC. Higher Childhood Peer Reports of Social Preference Mediates the Impact of the Good Behavior Game on Suicide Attempt. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:145-56. [PMID: 26297498 PMCID: PMC4720573 DOI: 10.1007/s11121-015-0593-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The Good Behavior Game (GBG) is a universal classroom-based preventive intervention directed at reducing early aggressive, disruptive behavior and improving children's social adaptation into the classroom. The GBG is one of the few universal preventive interventions delivered in early elementary school that has been shown to reduce the risk for future suicide attempts. This paper addresses one potential mechanism by which the GBG lowers the risk of later suicide attempt. In this study, we tested whether the GBG, by facilitating social adaptation into the classroom early on, including the level of social preference by classmates, thereby lowers future risk of suicide attempts. The measure of social adaptation is based on first and second grade peer reports of social preference ("which children do you like best?"; "which children don't you like?"). As part of the hypothesized meditational model, we examined the longitudinal association between childhood peer social preference and the risk of future suicide attempt, which has not previously been examined. Data were from an epidemiologically based randomized prevention trial, which tested the GBG among two consecutive cohorts of first grade children in 19 public schools and 41 classrooms. Results indicated that peer social preference partially mediated the relationship between the GBG and the associated reduction of risk for later suicide attempts by adulthood, specifically among children characterized by their first grade teacher as highly aggressive, disruptive. These results suggest that positive childhood peer relations may partially explain the GBG-associated reduction of risk for suicide attempts and may be an important and malleable protective factor for future suicide attempt.
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Affiliation(s)
- Alison R Newcomer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway Room 921, Baltimore, MD, 21287, USA
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Kimberly B Roth
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sheppard G Kellam
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shelley R Hart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Barry M Wagner
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Holly C Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway Room 921, Baltimore, MD, 21287, USA.
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Olfson M, Wang S, Blanco C. National trends in hospital-treated self-harm events among middle-aged adults. Gen Hosp Psychiatry 2015; 37:613-9. [PMID: 26380873 DOI: 10.1016/j.genhosppsych.2015.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 08/19/2015] [Accepted: 08/20/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess national trends in hospital-treated self-harm events focusing on adults aged 45-64years. METHOD Healthcare Cost and Utilization Project data from 2001 (N=7,452,727) to 2011 (N=7,893,587) were used to assess national trends in hospital stays for suicide and self-inflicted injury among youth (0-24years), young adults (35-44years), middle-aged adults (45-64years) and older adults (≥65years). RESULTS Among middle-aged adults, hospital-treated self-harm events increased from 5.1 (2001) to 7.1 (2011) per 10,000 population (OR=1.4, 95% CI=1.2, 1.6). This increase was larger than corresponding changes among youth (5.2-4.9) (interaction P=.0003), young adults (10.0-10.6) (interaction P=.006) or older adults (2.2-2.4) (interaction P=.07). Among middle-aged adults, hospital-treated self-harm events per 100 hospital discharges significantly increased (OR=1.4, 95% CI=1.3, 1.6), but there was not a significant increase in self-harm discharges per 100 mental disorder discharges (OR=1.2, 95% CI=1.0, 1.4). CONCLUSIONS Between 2001 and 2011, there was a disproportionate national increase in hospital-treated self-harm events among middle-aged adults that mirrored national trends in suicide. Because the increase was largely accounted for by an overall increase in mental health hospitalizations of middle-aged adults, the rising rate of hospital-treated self-harm events may reflect broader population-based mental health challenges facing US middle-aged adults.
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Affiliation(s)
- Mark Olfson
- New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Shuai Wang
- New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Carlos Blanco
- New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
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Hempstead KA, Phillips JA. Rising suicide among adults aged 40-64 years: the role of job and financial circumstances. Am J Prev Med 2015; 48:491-500. [PMID: 25736978 DOI: 10.1016/j.amepre.2014.11.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 10/27/2014] [Accepted: 11/13/2014] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Suicide rates among middle-aged men and women in the U.S. have been increasing since 1999, with a sharp escalation since 2007. PURPOSE To examine whether suicides with circumstances related to economic crises increased disproportionately among the middle-aged between 2005 and 2010. METHODS This study used the National Violent Death Reporting System (NVDRS) in 2014 to explore trends and patterns in circumstance and method among adults aged 40-64 years. RESULTS Suicide circumstances varied considerably by age, with those related to job, financial, and legal problems most common among individuals aged 40-64 years. Between 2005 and 2010, the proportion of suicides where these circumstances were present increased among this age group, from 32.9% to 37.5% of completed suicides (p<0.05). Further, suffocation is a method more likely to be used in suicides related to job, economic, or legal factors, and its use increased disproportionately among the middle-aged. The number of suicides using suffocation increased 59.5% among those aged 40-64 years between 2005 and 2010, compared with 18.0% for those aged 15-39 years and 27.2% for those aged >65 years (p<0.05). CONCLUSIONS The growth in the importance of external circumstances and increased use of suffocation jointly pose a challenge for prevention efforts designed for middle-aged adults. Suffocation is a suicide method that is highly lethal, requires relatively little planning, and is readily available. Efforts that target employers and workplaces as important stakeholders in the prevention of suicide and link the unemployed to mental health resources are warranted.
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Affiliation(s)
- Katherine A Hempstead
- Robert Wood Johnson Foundation, Princeton; Center for State Health Policy, Health Care Policy and Aging Research, New Brunswick, New Jersey.
| | - Julie A Phillips
- Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey
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Abstract
Suicide is a public health problem affecting people across the lifespan. It is currently the 10th leading cause of death, with rates having remained relatively flat for the past century. This article summarizes the problem of suicide and suicidal behavior along with suicide prevention efforts in the United States. Part 1 provides an overview of the epidemiology of suicide, including groups most at risk of suicide and suicidal behavior. Part 2 provides a review of common risk factors, organized by developmental life stage. A brief discussion of the lesser well-researched area of protective factors follows. Part 3 provides an overview of suicide prevention today, including the major types of prevention strategies, their successes, including means restriction, quality improvement in behavioral services, and comprehensive programs; and limitations to date, such as a lack of evidence for impact on actual deaths or behavior, small sample sizes, and low base rates. Finally, part 4 discusses challenges and future directions with an eye toward the great many opportunities that exist for prevention.
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Affiliation(s)
- Deborah M Stone
- Division of Violence Prevention (DVP), National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Alex E Crosby
- Division of Violence Prevention (DVP), National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Blosnich JR, Gordon AJ, Bossarte RM. Suicidal ideation and mental distress among adults with military service history: results from 5 U.S. states, 2010. Am J Public Health 2014; 104 Suppl 4:S595-602. [PMID: 25100426 DOI: 10.2105/ajph.2014.302064] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association of military service history with past-year suicidal ideation and past-30-days mental distress in a probability-based sample of adults. METHODS We gathered 2010 Behavioral Risk Factor Surveillance System data from 5 states that asked about past-year suicidal ideation. Military service was defined as current or former active-duty service or National Guard or Reserves service. We stratified analyses into 18 to 39 years, 40 to 64 years, and 65 years and older age groups and used multiple logistic regression analyses, adjusted for demographic confounders, to discern the association of military service history with past-year suicidal ideation and past-30-days mental distress. RESULTS Among the 26,736 respondents, 13.1% indicated military service history. After adjusting for several confounders, we found military history status among those aged 40 to 64 years was associated with both past-year suicidal ideation and past-30-days mental distress. We found no significant associations among the younger or older age groups. CONCLUSIONS Differences in suicidal ideation between military and nonmilitary individuals may occur in midlife. Future research should examine the possibility of cohort effects, service era effects, or both.
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Affiliation(s)
- John R Blosnich
- At the time of the study, John R. Blosnich and Adam J. Gordon were with the US Department of Veterans Affairs Center for Health Equity Research and Promotion, Pittsburgh, PA. John R. Blosnich was also with the Department of Psychiatry, University of Rochester, NY. Adam J. Gordon was also with the School of Medicine, University of Pittsburgh. Robert M. Bossarte was with the VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, NY, and the Department of Psychiatry, University of Rochester
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Phillips JA. A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States. Soc Sci Med 2014; 114:151-60. [DOI: 10.1016/j.socscimed.2014.05.038] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/15/2022]
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Phillips JA, Nugent CN. Suicide and the Great Recession of 2007-2009: the role of economic factors in the 50 U.S. states. Soc Sci Med 2014; 116:22-31. [PMID: 24973571 DOI: 10.1016/j.socscimed.2014.06.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 06/09/2014] [Accepted: 06/12/2014] [Indexed: 12/15/2022]
Abstract
After several decades of decline, U.S. suicide rates have risen since 2005, a trend driven largely by increases among those aged 45-64 that began in 1999. A prominent explanation for this pattern relates to deteriorating economic conditions, especially the sharp rise in unemployment associated with the Great Recession of 2007-2009. We pool data from 1997 to 2010 on the 50 U.S. states to examine the role of economic factors in producing the recent rise in suicide rates. Unlike prior studies, we examine trends in the total suicide rate and in the rate disaggregated by sex, age group and time period and include a number of important confounding factors in a multivariate analysis. We find a strong positive association between unemployment rates and total suicide rates over time within states. The association appears stronger in states that had higher female labor force participation rates over the period, suggesting that the Great Recession may generate greater levels of anomie in this context. Once we consider contextual factors such as female labor force participation, we find that rising unemployment had a similar adverse effect on male and female suicide rates. A positive effect of unemployment on temporal variation in middle-aged suicide exists but not for other age groups. Other economic characteristics, such as percent of manufacturing jobs and per capita income, are not associated with temporal variation in suicide rates within states but are associated with variation between states in suicide rates. The findings suggest that the following may be important components of effective prevention strategies: 1) specifically targeting employers and workplaces as important stakeholders in the prevention of suicide, 2) disseminating information about health risks tied to un/employment, and 3) linking the unemployed to mental health resources.
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Affiliation(s)
- Julie A Phillips
- Department of Sociology and Institute for Health, Health Care Policy and Aging Research (IHHCPAR), Rutgers University, 112 Paterson Street, New Brunswick, NJ 08901, USA.
| | - Colleen N Nugent
- Department of Sociology and Institute for Health, Health Care Policy and Aging Research (IHHCPAR), Rutgers University, 112 Paterson Street, New Brunswick, NJ 08901, USA.
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Mohammadi M, Moradi T, Bottai M, Reutfors J, Cao Y, Smedby KE. Risk and predictors of attempted and completed suicide in patients with hematological malignancies. Psychooncology 2014; 23:1276-82. [DOI: 10.1002/pon.3561] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 03/28/2014] [Accepted: 03/29/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Mohammad Mohammadi
- Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Tahereh Moradi
- Institute of Environmental Medicine, Division of Epidemiology; Karolinska Institutet; Stockholm Sweden
- Center for Epidemiology and Social Medicine, Health Care Services; Stockholm County Council; Sweden
| | - Matteo Bottai
- Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Johan Reutfors
- Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
| | - Yang Cao
- Unit of Biostatistics, Division of Epidemiology, Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Karin E. Smedby
- Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet; Karolinska University Hospital; Stockholm Sweden
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Chen M, Kwaku AB, Chen Y, Huang X, Tan H, Wen SW. Gender and regional disparities of tuberculosis in Hunan, China. Int J Equity Health 2014; 13:32. [PMID: 24767610 PMCID: PMC4013307 DOI: 10.1186/1475-9276-13-32] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 04/22/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. METHODS We obtained data from the 2005-2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province were divided into four regions according to quartiles based on the 2007 per capita GDP. Index of Disparity (ID) and Relative Index of Inequality (RII) were used to measure the disparities of TB incidence in relation to gender and region. Bootstrap technique was used to increase the precision. RESULTS The average annual incidence of TB was 111.75 per 100,000 in males and 43.44 per 100 000 in females in Hunan. The gender disparity was stable, with ID from 42.34 in 2005 to 43.92 in 2009. For regional disparity, ID, RII (mean) and RII (ratio) decreased significantly from 2005 to 2009 in males (P < 0.05) but remained stable among the female population. CONCLUSIONS As interventions such as introduction of the New Rural Cooperative Scheme put in place to reduce health disparities in China, regional disparity in relation to incidence of TB decreased significantly, but the gender disparity remains in the Hunan province.
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Affiliation(s)
| | | | | | | | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan 410008, P, R, China.
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Liu RT, Kraines MA, Puzia ME, Massing-Schaffer M, Kleiman EM. Sociodemographic predictors of suicide means in a population-based surveillance system: findings from the National Violent Death Reporting system. J Affect Disord 2013; 151:449-454. [PMID: 23845386 DOI: 10.1016/j.jad.2013.06.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 06/14/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multivariate studies of specific suicide means are relatively rare, given the logistical challenges associated with the low base rate of suicide in the general population. Thus, information on individual characteristics associated with specific suicide means remains relatively wanting. The current study provided the largest examination to date of sociodemographic characteristics associated with different means of lethality among suicide decedents, using data from a multi-state population-based surveillance system. METHODS Multivariate logistic regression was used with data for 20,577 suicide decedents in the National Violent Death Reporting System from 2003 to 2005. RESULTS Firearm decedents were more likely male, elderly, non-Hispanic white, married, veterans, and born in the U.S. Hanging and suffocation decedents were more likely male, young, racial/ethnic minorities, never married, non-veterans, and foreign-born. Decedents that jumped from heights were more likely female, older, non-Hispanic black, never married, non-veterans, and foreign-born. Decedents who used sharp instruments were more likely older, never married, and foreign-born. Self-poisoned decedents were more likely female, middle-age, non-Hispanic white, and not married. Regarding specific poisons, alcohol was more likely to be used by middle-age decedents; gas by males, elderly, and married individuals; over-the-counter drugs by females, adolescents, and foreign-born decedents; prescription drugs by females, middle-aged, and U.S. born individuals; and street drugs by males and racial/ethnic minorities. LIMITATIONS The data were drawn from 18 states and so cannot be regarded as nationally representative. CONCLUSIONS Substantial sociodemographic variability exists across different suicide means. Recognition of this variability may help to tailor prevention efforts involving means restriction.
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Affiliation(s)
- Richard T Liu
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA.
| | - Morganne A Kraines
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Megan E Puzia
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Maya Massing-Schaffer
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Evan M Kleiman
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Bando DH, Brunoni AR, Fernandes TG, Benseñor IM, Lotufo PA. Suicide rates and trends in São Paulo, Brazil, according to gender, age and demographic aspects: a joinpoint regression analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 34:286-93. [PMID: 23429774 DOI: 10.1016/j.rbp.2012.02.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 03/14/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate suicide rates and trends in São Paulo by sex, age-strata, and methods. METHODS Data was collected from State registry from 1996 to 2009. Population was estimated using the National Census. We utilized joinpoint regression analysis to explore temporal trends. We also evaluated marital status, ethnicity, birthplace and methods for suicide. RESULTS In the period analyzed, 6,002 suicides were accrued with a rate of 4.6 per 100,000 (7.5 in men and 2.0 in women); the male-to-female ratio was around 3.7. Trends for men presented a significant decline of 5.3% per year from 1996 to 2002, and a significant increase of 2.5% from 2002 onwards. Women did not present significant changes. For men, the elderly (> 65 years) had a significant reduction of 2.3% per year, while younger men (25-44 years) presented a significant increase of 8.6% from 2004 onwards. Women did not present significant trend changes according to age. Leading suicide methods were hanging and poisoning for men and women, respectively. Other analyses showed an increased suicide risk ratio for singles and foreigners. CONCLUSIONS Specific epidemiological trends for suicide in the city of São Paulo that warrant further investigation were identified. High-risk groups - such as immigrants - could benefit from targeted strategies of suicide prevention.
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Affiliation(s)
- Daniel H Bando
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Baker SP, Hu G, Wilcox HC, Baker TD. Increase in suicide by hanging/suffocation in the U.S., 2000-2010. Am J Prev Med 2013; 44:146-9. [PMID: 23332330 PMCID: PMC3553495 DOI: 10.1016/j.amepre.2012.10.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 10/16/2012] [Accepted: 10/18/2012] [Indexed: 12/24/2022]
Abstract
BACKGROUND Recently, suicide exceeded motor vehicle crashes as the leading cause of injury death in the U.S. However, details of this change in suicide methods and the relationship to individual demographics, such as age and societal influences, have not been reported. PURPOSE To determine the characteristics of the changes in suicide rates between 2000 and 2010. METHODS Data came from CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS™). Line charts were plotted to reveal changes in suicide rates by firearm, poisoning, and hanging/suffocation (ICD-10 codes: X72-X74, X60-X69, and X70). The measure of change used is the percentage change in suicide rate between 2000 and 2010. RESULTS The overall suicide rate increased from 10.4 to 12.1 per 100,000 population between 2000 and 2010, a 16% increase. The majority of the increase was attributable to suicide by hanging/suffocation (52%) and by poisoning (19%). Subgroup analysis showed: (1) suicide by hanging/suffocation increased by 104% among those aged 45-59 years and rose steadily in all age groups except those aged ≥70 years; (2) the largest increase in suicide by poisoning (85%) occurred among those aged 60-69 years; and (3) suicide by firearm decreased by 24% among those aged 15-24 years but increased by 22% among those aged 45-59 years. The case fatality rates for suicide by hanging/suffocation during 2000-2010 ranged from 69% to 84%, close to those for suicide by firearm. Analyses were conducted in 2012. CONCLUSIONS Substantial increases in suicide by hanging/suffocation and poisoning merit attention from policymakers and call for innovations and changes in suicide prevention approaches.
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Affiliation(s)
- Susan P Baker
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
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Phillips JA, Nugent CN. Antidepressant use and method of suicide in the United States: variation by age and sex, 1998-2007. Arch Suicide Res 2013; 17:360-72. [PMID: 24224670 DOI: 10.1080/13811118.2013.785373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examines the association between antidepressant use and suicide rates, by sex, age, and method of suicide, between 1998 and 2007 in the United States. Overall suicide rates for the young and elderly declined but rates for the middle-aged increased. All age groups experienced increases in antidepressant use. The elderly exhibited the largest increase in antidepressant usage and biggest declines in suicide rates. Firearm suicides for men and women declined but suicide by drug poisoning rose, particularly for women. For young males and elderly males and females, better treatment of severe depression may have contributed to declining suicide rates. However, rising rates of prescription drug use are associated with higher levels of suicide by drug poisoning.
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Affiliation(s)
- Julie A Phillips
- a Department of Sociology , Rutgers, The State University of New Jersey , Piscataway , New Jersey , USA
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Muazzam S, Swahn MH, Alamgir H, Nasrullah M. Differences in poisoning mortality in the United States, 2003-2007: epidemiology of poisoning deaths classified as unintentional, suicide or homicide. West J Emerg Med 2012; 13:230-8. [PMID: 22900120 PMCID: PMC3415827 DOI: 10.5811/westjem.2012.3.11762] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Poisoning, specifically unintentional poisoning, is a major public health problem in the United States (U.S.). Published literature that presents epidemiology of all forms of poisoning mortalities (i.e., unintentional, suicide, homicide) together is limited. This report presents data and summarizes the evidence on poisoning mortality by demographic and geographic characteristics to describe the burden of poisoning mortality and the differences among sub-populations in the U.S. for a 5-year period. METHODS Using mortality data from the Center for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System, we presented the age-specific and age-adjusted unintentional and intentional (suicide, homicide) poisoning mortality rates by sex, age, race, and state of residence for the most recent years (2003-2007) of available data. Annual percentage changes in deaths and rates were calculated, and linear regression using natural log were used for time-trend analysis. RESULTS There were 121,367 (rate=8.18 per 100,000) unintentional poisoning deaths. Overall, the unintentional poisoning mortality rate increased by 46.9%, from 6.7 per 100,000 in 2003 to 9.8 per100.000 in 2007, with the highest mortality rate among those aged 40-59 (rate=15.36), males (rate=11.02) and whites (rate=8.68). New Mexico (rate=18.2) had the highest rate. Unintentional poisoning mortality rate increased significantly among both sexes, and all racial groups except blacks (p<0.05 time-related trend for rate). Among a total of 29,469 (rate=1.97) suicidal poisoning deaths, the rate increased by 9.9%, from 1.9 per 100,000 in 2003 to 2.1 per 100,000 in 2007, with the highest rate among those aged 40-59 (rate=3.92), males (rate=2.20) and whites (rate=2.24). Nevada (rate=3.9) had the highest rate. Mortality rate increased significantly among females and whites only (p<0.05 time-related trend for rate). There were 463 (rate=0.03) homicidal poisoning deaths and the rate remained the same during 2003-2007. The highest rates were among aged 0-19 (rate=0.05), males (rate=0.04) and blacks (rate=0.06). CONCLUSION Prevention efforts for poisoning mortalities, especially unintentional poisoning, should be developed, implemented and strengthened. Differences exist in poisoning mortality by age, sex, location, and these findings underscore the urgency of addressing this public health burden as this epidemic continues to grow in the U.S.
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Abstract
Suicide is second to only accidental death as the leading cause of mortality in young men across the world. Although suicide rates for young men have fallen in some high-income and middle-income countries since the 1990s, wider mortality measures indicate that rates remain high in specific regions, ethnic groups, and socioeconomic groups within those nations where rates have fallen, and that young men account for a substantial proportion of the economic cost of suicide. High-lethality methods of suicide are preferred by young men: hanging and firearms in high-income countries, pesticide poisoning in the Indian subcontinent, and charcoal-burning in east Asia. Risk factors for young men include psychiatric illness, substance misuse, lower socioeconomic status, rural residence, and single marital status. Population-level factors include unemployment, social deprivation, and media reporting of suicide. Few interventions to reduce suicides in young men have been assessed. Efforts to change help-seeking behaviour and to restrict access to frequently used methods hold the most promise.
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Affiliation(s)
- Alexandra Pitman
- University College London Mental Health Sciences Unit, London, UK.
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Blow FC, Bohnert ASB, Ilgen MA, Ignacio R, McCarthy JF, Valenstein MM, Knox KL. Suicide mortality among patients treated by the Veterans Health Administration from 2000 to 2007. Am J Public Health 2012; 102 Suppl 1:S98-104. [PMID: 22390612 DOI: 10.2105/ajph.2011.300441] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to examine rates of suicide among individuals receiving health care services in Veterans Health Administration (VHA) facilities over an 8-year period. METHODS We included annual cohorts of all individuals who received VHA health care services from fiscal year (FY) 2000 through FY 2007 (October 1, 1999-September 30, 2007; N = 8,855,655). Vital status and cause of death were obtained from the National Death Index. RESULTS Suicide was more common among VHA patients than members of the general US population. The overall rates of suicide among VHA patients decreased slightly but significantly from 2000 to 2007 (P < .001). Male veterans between the ages of 30 and 64 years were at the highest risk of suicide. CONCLUSIONS VHA health care system patients are at elevated risk for suicide and are appropriate for suicide reduction services, although the rate of suicide has decreased in recent years for this group. Comprehensive approaches to suicide prevention in the VHA focus not only on recent returnees from Iraq and Afghanistan but also on middle-aged and older Veterans.
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Affiliation(s)
- Frederic C Blow
- Department of Veterans Affairs, Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC) and Health Services Research and Development Center of Excellence, Ann Arbor, MI, USA.
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Goldenberg SL. Men’s Health Initiative of British Columbia: Connecting the Dots. Urol Clin North Am 2012; 39:37-51. [DOI: 10.1016/j.ucl.2011.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Wexler L, Silveira ML, Bertone-Johnson E. Factors associated with Alaska Native fatal and nonfatal suicidal behaviors 2001-2009: trends and implications for prevention. Arch Suicide Res 2012; 16:273-86. [PMID: 23137218 DOI: 10.1080/13811118.2013.722051] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Suicide rates among American Indian and Alaska Native (AI/AN) young people are significantly higher than other ethnic groups in the United States. Not only are there great differences when comparing AI/AN rates and those of other Americans, some tribal groups have very low rates of suicide while other Native communities have much higher rates. Despite this obvious variability, there is little research to help understand the factors associated with these differences. The current study considers the correlates of suicidal behavior in one rural Alaska Native region that suffers disproportionately from suicide. The analysis describes suicide behavior between the years 2001-2009, and considers the characteristics associated with both suicide deaths and nonfatal suicidal behavior. In multivariate analyses we identified gender, method of suicide and history of previous attempt as significant predictors of fatal suicide behavior, similar to results obtained from analyses on the same community's data from the previous decade. This descriptive study can offer some insights to shape prevention efforts in this and other rural, tribal communities.
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Affiliation(s)
- Lisa Wexler
- Community Health Education, Department of Public Health, School of Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts 01003, USA.
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Elger CE, Hoppe C. What is Depression in Epilepsy? Front Neurol 2011; 2:79. [PMID: 22162974 PMCID: PMC3232452 DOI: 10.3389/fneur.2011.00079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 11/21/2011] [Indexed: 12/02/2022] Open
Affiliation(s)
- Christian E Elger
- Department of Epileptology, University of Bonn Medical Centre Bonn, Germany
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McKenzie K, Fingerhut L, Walker S, Harrison A, Harrison JE. Classifying external causes of injury: history, current approaches, and future directions. Epidemiol Rev 2011; 34:4-16. [PMID: 22045696 DOI: 10.1093/epirev/mxr014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International Classification of Diseases (ICD) is used to categorize diseases, injuries, and external causes of injury, and it is a key epidemiologic tool enabling storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification system remains current, and work is now under way to develop the next revision, ICD-11. It has been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of the development of external causes classification and outline the external cause structure. They discuss approaches to manage ICD-10 deficiencies and outline the ICD-11 revision approach regarding the development of, rationale for, and implications of proposed changes to the chapter. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation, and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.
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Affiliation(s)
- Kirsten McKenzie
- National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia 4059.
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Hoppe C, Elger CE. Depression in epilepsy: a critical review from a clinical perspective. Nat Rev Neurol 2011; 7:462-72. [PMID: 21750525 DOI: 10.1038/nrneurol.2011.104] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Crosby AE, Buckner AV, Taylor BD. Addressing Self-Directed Violence Prevention for Preventive Medicine Practitioners. Am J Lifestyle Med 2011. [DOI: 10.1177/1559827611410020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article summarizes the field of self-directed violence and its prevention focusing on suicidal behavior. Then it describes ways in which health care practitioners, especially preventive medicine specialists, can play a role in preventing these injuries whether they practice in clinical or community based settings. A review of the importance of suicidal behavior as a public health problem, its epidemiology, and prevention approaches are discussed. Suicidal behavior results from an interaction of risk factors but much is known about these factors and many of the injuries due to this phenomenon are preventable. Prevention of suicidal behavior requires collaboration from many sectors, including health care practitioners. Preventive medicine specialists can address this problem that affects individuals, families, and communities by taking an active part as practitioners, researchers, advocates, and through education.
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Affiliation(s)
- Alex E. Crosby
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (AEC)
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine (AB, BDT), Atlanta, Georgia
| | - Ayanna V. Buckner
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (AEC)
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine (AB, BDT), Atlanta, Georgia
| | - Beverly D. Taylor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (AEC)
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine (AB, BDT), Atlanta, Georgia
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Im JS, Choi SH, Hong D, Seo HJ, Park S, Hong JP. Proximal risk factors and suicide methods among suicide completers from national suicide mortality data 2004-2006 in Korea. Compr Psychiatry 2011; 52:231-7. [PMID: 21497215 DOI: 10.1016/j.comppsych.2010.07.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 05/25/2010] [Accepted: 07/16/2010] [Indexed: 11/26/2022] Open
Abstract
This study was conducted to examine differences in proximal risk factors and suicide methods by sex and age in the national suicide mortality data in Korea. Data were collected from the National Police Agency and the National Statistical Office of Korea on suicide completers from 2004 to 2006. The 31,711 suicide case records were used to analyze suicide rates, methods, and proximal risk factors by sex and age. Suicide rate increased with age, especially in men. The most common proximal risk factor for suicide was medical illness in both sexes. The most common proximal risk factor for subjects younger than 30 years was found to be a conflict in relationships with family members, partner, or friends. Medical illness was found to increase in prevalence as a risk factor with age. Hanging/Suffocation was the most common suicide method used by both sexes. The use of drug/pesticide poisoning to suicide increased with age. A fall from height or hanging/suffocation was more popular in the younger age groups. Because proximal risk factors and suicide methods varied with sex and age, different suicide prevention measures are required after consideration of both of these parameters.
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Affiliation(s)
- Jeong-Soo Im
- Department of Preventive Medicine, Gachon Medical School, Incheon, Korea
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Abstract
BACKGROUND Recent epidemiological studies highlight that within Muslim-dominated Middle Eastern countries suicide rates are high or are increasing among young females. This paper discusses the most important reasons behind this trend. METHODS The literature review started using the PubMed (http://www.ncbi.nlm.nih.gov) search engine, applying four keywords: suicide, young females, Middle East, and Muslim. The search strategy was complemented by hand-searching selected journals or by looking at the reference list of the retrieved papers. RESULTS All retrieved papers confirm a higher rate of suicide or attempted suicide among young Muslim females in the Middle East. Furthermore, the method chosen for suicide, psychiatric disorders, marriage, and masculine role are among the most important interrelated reasons that increase the likelihood of a young female being a victim of suicide. CONCLUSIONS Higher suicide rates among young Middle Eastern Muslim females must be considered an important issue, and their root causes should be dealt with properly and without delay.
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Affiliation(s)
- Mohsen Rezaeian
- Social Medicine Department, Rafsanjan Medical School, Rafsanjan, Iran.
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Reversed urban-rural differences in breast cancer mortality (China, 2002-2008). Breast Cancer Res Treat 2010; 126:231-4. [PMID: 21120600 DOI: 10.1007/s10549-010-1276-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 11/17/2010] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to examine the urban-rural difference in breast cancer mortality between 2002 and 2008 in China. A longitudinal analysis of mortality data was performed. Mortality data were extracted from Chinese Health Statistics Yearbook. Linear regression was used to examine the statistical significance of linear trend in mortality rates. The percent change in rates was used to measure the linear trend, which was calculated as regression coefficient × 100 × 6 divided by the rate of 2002. Between 2002 and 2008, the mortality from breast cancer increased by 201% among urban women (P < 0.05) while among rural women the rate did not show the significant increase, thus resulting in a reversed urban-rural difference (from -2.3/100,000 population in 2002 to 3.6 in 2008). Subgroup analysis showed that the reversed urban-rural difference was completely due to substantial increases among urban women aged 55-59 years and aged 75 years and above. In addition, significant decreases of breast cancer mortality were observed in urban women aged 35-49 years and in rural women aged 35-39 years (P < 0.05). The reversed urban-rural difference in breast cancer mortality during 2002-2008 is primarily caused by the increases among elderly urban women. Further studies are needed to understand the increases and to develop cost-effective interventions for elderly urban women in China.
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Spiller HA, Appana S, Brock GN. Epidemiological trends of suicide and attempted suicide by poisoning in the US: 2000-2008. Leg Med (Tokyo) 2010; 12:177-83. [PMID: 20547089 DOI: 10.1016/j.legalmed.2010.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 04/07/2010] [Accepted: 04/20/2010] [Indexed: 01/21/2023]
Abstract
UNLABELLED In the US the suicide rate on a population basis has risen and fallen over time between approximately 10 and 12 per 100,000 population. The recent trend toward an increased rate has been paralleled by an increase in emergency department visits for attempted suicide. The purpose of this study was to examine trends in suspected suicide (SS) cases reported to the National Poison Data System (NPDS), over a 9-year period (2000-2008). METHODS Data were obtained from NPDS, for all human patients between the years 2000 and 2008 with the reason for poisoning exposure recorded as "Intentional - Suspected Suicide" (ISS). Additionally, population sizes were obtained from the US Census Bureau as single annual counts by age and sex bands for the 2000-2008. RESULTS There were 1,672,324 human exposures reported to substances with the reason of SS. Sixty-five percent (1,084,669) were female. The average age of a patient was 30 years with the age groups 13-19 and 20-29 years reporting the highest SS events, 26.4% and 25.7%, respectively. From 2000 to 2008, the estimated rate of SS increased from 72.6 to 82.8 per 1000 human exposure cases. On a population basis, the estimated rate of SS increased from 55.8 to 67.9 per 100,000 population (p for trend <0.001). The relative risk of human exposures for reason of SS compared to human exposures for any other reason being reported to the NPDS is 1.13 (95% CI: [1.122-1.135], p < 0.001) for every 10 years. The relative risk for females vs. males was 1.82 for having SS as a reason for exposure (p < 0.001). However, females were also 0.82 times less likely to experience a severe medical outcome (SMO) compared to males (95% CI: [0.81-0.83], p < 0.001). We noted an increasing risk of a SMO or fatality increasing with age. CONCLUSIONS Based on the total human exposure cases reported to the NPDS, there was a suggested trend of an increase in SS rates of 13% in the next 10 years. There was a greater incidence of SS in females and younger age groups. However, the odds of a SMO or fatality were higher for males and increased with increasing age.
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Affiliation(s)
- Henry A Spiller
- Kentucky Regional Poison Control Center, Louisville, KY, USA.
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Phillips JA, Robin AV, Nugent CN, Idler EL. Understanding recent changes in suicide rates among the middle-aged: period or cohort effects? Public Health Rep 2010; 125:680-8. [PMID: 20873284 DOI: 10.1177/003335491012500510] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We examined trends in suicide rates for U.S. residents aged 40 to 59 years from 1979 to 2005 and explored alternative explanations for the notable increase in such deaths from 1999 to 2005. METHODS We obtained information on suicide deaths from the National Center for Health Statistics and population data from the U.S. Census Bureau. Age- and gender-specific suicide rates were computed and trends therein analyzed using linear regression techniques. RESULTS Following a period of stability or decline, suicide rates have climbed since 1988 for males aged 40-49 years, and since 1999 for females aged 40-59 years and males aged 50-59 years. A crossover in rates for 40- to 49-year-old vs. 50- to 59-year-old males and females occurred in the early 1990s, and the younger groups now have higher suicide rates. The post-1999 increase has been particularly dramatic for those who are unmarried and those without a college degree. CONCLUSIONS The timing of the post-1999 increase coincides with the complete replacement of the U.S. population's middle-age strata by the postwar baby boom cohorts, whose youngest members turned 40 years of age by 2005. These cohorts, born between 1945 and 1964, also had notably high suicide rates during their adolescent years. Cohort replacement may explain the crossover in rates among the younger and older middle-aged groups. However, there is evidence for a period effect operating between 1999 and 2005, one that was apparently specific to less-protected members of the baby boom cohort.
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Affiliation(s)
- Julie A Phillips
- Department of Sociology, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
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Hu G, Baker T, Baker SP. Comparing road traffic mortality rates from police-reported data and death registration data in China. Bull World Health Organ 2010; 89:41-5. [PMID: 21346889 DOI: 10.2471/blt.10.080317] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 08/27/2010] [Accepted: 09/03/2010] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To compare death rates from road traffic injuries in China in 2002-2007 when derived from police-reported data versus death registration data. METHODS In China, police-recorded data are obtained from police records by means of a standardized, closed-ended data collection form; these data are published in the China statistical yearbook of communication and transportation. Official death registration data, on the other hand, are obtained from death certificates completed by physicians and are published in the China health statistics yearbook. We searched both sources for data on road traffic deaths in 2002-2007, used the χ(2) test to compare the mortality rates obtained, and performed linear regression to look for statistically significant trends in road traffic mortality over the period. FINDINGS For 2002-2007, the rate of death from road traffic injuries based on death registration data was about twice as high as the rate reported by the police. Linear regression showed a significant decrease of 27% (95% confidence interval, CI: 35-19) in the death rate over the period according to police sources but no significant change according to death registration data. CONCLUSION The widely-cited recent drop in road traffic mortality in China, based on police-reported data, may not reflect a genuine decrease. The quality of the data obtained from police reports, which drives decision-making by the Government of China and international organizations, needs to be investigated, monitored and improved.
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Affiliation(s)
- Guoqing Hu
- School of Public Health, Central South University, Changsha, China.
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Bagley SC, Munjas B, Shekelle P. A systematic review of suicide prevention programs for military or veterans. Suicide Life Threat Behav 2010; 40:257-65. [PMID: 20560747 DOI: 10.1521/suli.2010.40.3.257] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Military personnel and veterans have important suicide risk factors. After a systematic review of the literature on suicide prevention, seven (five in the U.S.) studies of military personnel were identified containing interventions that may reduce the risk of suicide. The effectiveness of the individual components was not assessed, and problems in methodology or reporting of data were common. Overall, multifaceted interventions for active duty military personnel are supported by consistent evidence, although of very mixed quality, and in some cases during intervals of declines in suicide rates in the general population. There were insufficient studies of U.S. Veterans to reach conclusions.
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Affiliation(s)
- Steven C Bagley
- Department of Veteran Affairs, Psychiatry, Palo Alto, CA 94304, USA.
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Abstract
About 35,000 people commit suicide every year in the United States. Almost all are seriously, but treatably, mentally ill. Most come to the attention of a physician, in an emergency room, primary practice setting, or psychiatric hospital or office, during the days, weeks or months before they die. Since 1995, suicide has been the second most commonly reported of all Joint Commission hospital sentinel events (not just psychiatric events). Suicide is involved in the majority of psychiatric malpractice lawsuits. It takes life from patients, parents from children, children from families, and valuable people from society. Suicide is a terrible way to lose a relative or friend, leaving much greater damage than most natural or accidental death. This paper discusses four points to be considered by those who want to improve this situation: 1) Suicide is rarely "voluntary" in any clinical sense of the term; 2) A great many suicides are preventable once a clinician becomes involved; 3) Suicide is worth preventing; 4) There are practical approaches to prevention that work.
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Bittner JG, Hawkins ML, Atteberry LR, Ferdinand CH, Medeiros RS. Impact of Traumatic Suicide Methods on a Level I Trauma Center. Am Surg 2010. [DOI: 10.1177/000313481007600211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Suicide is a major, preventable public health issue. Although firearm-related mechanisms commonly result in death, nonfirearm methods cause significant morbidity and healthcare expenditures. The goal of this study is to compare risk factors and outcomes of firearm and nonfirearm traumatic suicide methods. This retrospective cohort study identified 146 patients who attempted traumatic suicide between 2002 and 2007 at a Level I trauma center. Overall, mean age was 40.2 years, 83 per cent were male, 74 per cent were white, and mean Injury Severity Score (ISS) was 12.7. Most individuals (53%) attempted suicide by firearms and 25 per cent died (84% firearm, 16% nonfirearm techniques). Subjects were more likely to die if they were older than 60 years-old, presented with an ISS greater than 16, or used a firearm. On average, patients using a firearm were older and had a higher ISS and mortality rate compared with those using nonfirearm methods. There was no statistical difference between cohorts with regard to gender, ethnicity, positive drug and alcohol screens, requirement for operation, intensive care unit admission, and hospital length of stay. Nonfirearm traumatic suicide prevention strategies aimed at select individuals may decrease overall attempts, reduce mechanism-related mortality, and potentially impact healthcare expenditures.
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Affiliation(s)
- James G. Bittner
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Michael L. Hawkins
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Linda R. Atteberry
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Colville H. Ferdinand
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Regina S. Medeiros
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
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Mullany B, Barlow A, Goklish N, Larzelere-Hinton F, Cwik M, Craig M, Walkup JT. Toward understanding suicide among youths: results from the White Mountain Apache tribally mandated suicide surveillance system, 2001-2006. Am J Public Health 2009; 99:1840-8. [PMID: 19696377 PMCID: PMC2741522 DOI: 10.2105/ajph.2008.154880] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2009] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined suicide and suicide attempt rates, patterns, and risk factors among White Mountain Apache youths (aged < 25 years) from 2001 to 2006 as the first phase of a community-based participatory research process to design and evaluate suicide prevention interventions. METHODS Apache paraprofessionals gathered data as part of a tribally mandated suicide surveillance system. We compared findings to other North American populations. RESULTS Between 2001 and 2006, 61% of Apache suicides occurred among youths younger than 25 years. Annual rates among those aged 15 to 24 years were highest: 128.5 per 100 000, 13 times the US all-races rate and 7 times the American Indian and Alaska Native rate. The annual suicide attempt incidence rate in this age group was 3.5%. The male-to-female ratio was 5:1 for suicide and approximately 1:1 for suicide attempts. Hanging was the most common suicide method, and third most common attempt method. The most frequently cited attempt precipitants were family or intimate partner conflict. CONCLUSIONS An innovative tribal surveillance system identified high suicide and attempt rates and unique patterns and risk factors of suicidal behavior among Apache youths. Findings are guiding targeted suicide prevention programs.
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Affiliation(s)
- Britta Mullany
- Johns Hopkins Center for American Indian Health, 621 N Washington St., Baltimore, MD 21205, USA.
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