Codesigning a public health approach to preventing firearm-related suicide deaths with rural communities

Pollock, Nathaniel J.; Wilson, Margo; Karaivanov, Yordan; Power, Nicole; Reccord, Charlene

doi:10.1503/cmaj.77311

Cited by 2 publications

(4 citation statements)

References 11 publications

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“…Elderly men may be especially vulnerable after the onset of diseases associated with chronic pain such as arthritis and cancer, neurodegenerative diseases that impair cognitive function such as dementia, and social risks related to isolation and grief (Price and Khubchandani 2021 ; Betz et al 2018 ; Morgan et al 2019 ). Those in rural areas may experience additional risks related to increased access to firearms, especially for hunting (Kaufman et al 2021 ; Wexler et al 2022 ; Pollock et al 2020 ), though we did not examine rurality in this study.…”

Section: Discussionmentioning

confidence: 97%

Fatal and non-fatal firearm-related injuries in Canada, 2016–2020: a population-based study using three administrative databases

et al. 2023

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Background Firearms are a substantial cause of injury-related morbidity and mortality in Canada and globally, though evidence from contexts other than the USA is relatively limited. We examined deaths, hospitalizations and emergency department (ED) visits due to firearm-related injuries in Canada to identify population groups at increased risk of fatal and non-fatal outcomes. Methods We conducted a population-based study using three national administrative databases on deaths, hospitalizations, and ED visits. ICD-10 codes were used to identify firearm-related injuries from January 1, 2016, through December 31, 2020. Fatal and non-fatal firearm injuries were classified as suicide/self-harm, homicide/assault, unintentional, undetermined or legal intervention injuries. We analyzed the data with counts, rates and proportions, stratified by sex, age group, province/territory, and year. Results Over the 5-year period, we identified 4005 deaths, 3169 hospitalizations, and 2847 ED visits related to firearm injuries in various jurisdictions in Canada. Males comprised the majority of fatal and non-fatal injury cases. The highest rates of fatal and non-fatal firearm injuries were among 20- to 34-year-olds. The leading cause of fatal firearm injuries was self-harm (72.3%). For non-fatal firearm hospitalizations and ED visits, assault (48.8%) and unintentional injuries (62.8%) were the leading causes of injury. Rates varied by province and territory. Conclusions Our results showed that males comprised the majority of fatal and non-fatal firearm injuries in Canada. The rates of both fatal and non-fatal firearm injuries were highest among the 20- to 34-year-old age group. This comprehensive overview of the epidemiology of firearm injuries in Canada provides baseline data for ongoing surveillance and policy evaluation related to public health interventions.

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Section: Discussionmentioning

confidence: 97%

Fatal and non-fatal firearm-related injuries in Canada, 2016–2020: a population-based study using three administrative databases

et al. 2023

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“…Public health and clinical interventions need to account for place-based differences in both community strengths and suicide risks. To do so, rural stakeholders need to be collaborators in the planning, design, and implementation of interventions 74 and must have a role in "rural proofing" 85 evidence-based preventative strategies. Achieving a nuanced and effective approach to rural suicide prevention will also be determined by the extent to which resources are distributed equitably to the communities that are most impacted by suicide.…”

Section: Discussionmentioning

confidence: 99%

“…Although our study found that there were many similarities between rural and urban people who died by suicide, the differences between these groups underscore the need for clinical and population-based approaches to suicide prevention that account for place-based differences. 74 Given the prominence of firearms as a prevalent suicide method in rural communities, there may be value in developing interventions to promote the safe storage of guns, 10,75-77 especially when people with access are in distress or at elevated risk. Rural "means safety" 77 initiatives would be complemented by community-based interventions 43 and clinical care focused on problematic alcohol use and engaging atrisk men in follow-up care.…”

Section: Suicide Prevention In Rural Communitiesmentioning

confidence: 99%

“…A key challenge for suicide prevention in rural communities is to ensure that interventions are developed and implemented in a manner that fits local contexts. 74 Mixed methods research may be particularly useful in understanding the social and cultural factors that influence the relationships between gender, suicide methods, and alcohol in rural communities.…”

Section: Suicide Prevention In Rural Communitiesmentioning

confidence: 99%

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Rural–Urban Differences in Suicide Mortality: An Observational Study in Newfoundland and Labrador, Canada: Différences de la Mortalité Par Suicide en Milieu Rural-Urbain: Une Étude Observationnelle à Terre-Neuve et Labrador, Canada

Reccord¹,

Power²,

Hatfield

et al. 2021

Can J Psychiatry

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Background: Suicide rates are higher in rural compared to urban areas. Although this pattern appears to be driven by higher rates among men, there is limited evidence about the characteristics of rural people who die by suicide in Canada. The objective of this study was to examine the demographics, manner of death, and social and clinical antecedents of people who died by suicide in rural areas compared to urban areas. Methods: We conducted an observational study of all suicide deaths that occurred among Newfoundland and Labrador residents between 1997 and 2016 using a linked data set derived from a comprehensive review of provincial medical examiner records. We used t tests and χ2 to assess associations between rural/urban status and variables related to demographics, circumstances, and manner of death, as well as social and medical history. Logistic regression was utilized to assess the independent contribution of any variable found to be significant in univariate analysis. Results: Rural people who died by suicide accounted for 54.8% of all deaths over a 20-year period. Overall, 81.6% of people who died were male. Compared to urban, rural people who died by suicide were younger, more likely to use firearms or hanging, and had a higher mean blood alcohol content at the time of death (27.69 vs. 22.95 mmol/L). Rural people were also less likely to have had a known history of a prior suicide attempt, psychiatric disorder, alcohol or substance abuse, or chronic pain. Discussion: The demographic and clinical differences between rural and urban people who died by suicide underscore the need for suicide prevention approaches that account for place-based differences. A key challenge for suicide prevention in rural communities is to ensure that interventions are developed and implemented in a manner that fits local contexts.

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Codesigning a public health approach to preventing firearm-related suicide deaths with rural communities

Cited by 2 publications

References 11 publications

Fatal and non-fatal firearm-related injuries in Canada, 2016–2020: a population-based study using three administrative databases

Fatal and non-fatal firearm-related injuries in Canada, 2016–2020: a population-based study using three administrative databases

Rural–Urban Differences in Suicide Mortality: An Observational Study in Newfoundland and Labrador, Canada: Différences de la Mortalité Par Suicide en Milieu Rural-Urbain: Une Étude Observationnelle à Terre-Neuve et Labrador, Canada

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