Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

Shepard, Donald S.; Gurewich, Deborah; Lwin, Aung K.; Reed, Gerald A.; Silverman, Morton M.

doi:10.1111/sltb.12225

Cited by 340 publications

(232 citation statements)

References 22 publications

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“…The increase has been manifested across multiple demographic groups ( 3 ). One study, after adjusting for underreporting, estimated the 2013 U.S. national cost of suicide and suicide attempts at $93.5 billion ( 5 ). …”

Section: Introductionmentioning

confidence: 99%

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015

Ivey-Stephenson

Crosby

Jack

et al. 2017

MMWR Surveill. Summ.

248

186

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Problem/ConditionSuicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts.Reporting Period2001–2015.Description of SystemMortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60–X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001–2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme. ResultsSuicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons aged 35–64 years. For mechanism of death, greater increases in rates of suicide by firearms and hanging/suffocation occurred across all urbanization levels; rates of suicide by firearms in nonmetropolitan/rural counties were almost two times that of rates in larger metropolitan counties. InterpretationSuicide rates in nonmetropolitan/rural counties are consistently higher than suicide rates in metropolitan counties. These trends also are observed by sex, race/ethnicity, age group, and mechanism of death.Public Health ActionInterventions to prevent suicides should be ongoing, particularly in rural areas. Comprehensive suicide prevention efforts might include leveraging protective factors and providing innovative prevention strategies that increase access to health care and mental health care in rural communities. In addition, distribution of socioeconomic factors varies in different communities and needs to be better understood in the context of suicide prevention.

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Section: Introductionmentioning

confidence: 99%

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015

Ivey-Stephenson

Crosby

Jack

et al. 2017

MMWR Surveill. Summ.

248

186

View full text Add to dashboard Cite

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“…In 2013, it was estimated that the suicides and attempted suicides by females in the U.S. cost $413 million in direct medical costs and $9976 million in indirect costs [1]. Suicide was the 10th leading cause of death in the U.S. in 2013 and the second leading cause of death for those ages 15-24 [2].…”

Section: Introductionmentioning

confidence: 99%

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001–2013

Price

Khubchandani

2016

J Immigrant Minority Health

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Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African-American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.

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“…The lifetime prevalence of suicide attempts among adults and adolescents is approximately 1.9 to 8.7% and 3.1 to 8.8% respectively (Nock et al, 2008). Both NSSI and suicide attempts are associated with numerous negative life outcomes and have significant economic and social consequences (Goldman-Mellor et al, 2014; Plener, Schumacher, Munz, & Groschwitz, 2015; Shepard, Gurewich, Lwin, Reed, & Silverman, 2016). …”

Section: Introductionmentioning

confidence: 99%

Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort

Coppersmith

Nada-Raja

Beautrais

2017

Journal of Affective Disorders

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Background Non-suicidal self-injury (NSSI) and suicide attempts are related, but distinct behaviors. The primary aim of the current study was to identify factors that distinguish those with different lifetime histories of self-injury. A secondary aim was to test whether lifetime history of self-injury at age 26 predicted current suicide ideation at age 32. Methods Participants were 26 year olds from a large birth cohort with a lifetime history of no self-injury (n = 466), a lifetime history of NSSI (n = 191), or a lifetime history of NSSI and a suicide attempt (NSSI+SA; n = 52). They were compared on a history of psychiatric disorders, 12-month suicide ideation, lifetime history of childhood sexual abuse, and lifetime exposure to suicide. Results An anxiety disorder, a substance dependence disorder, suicide ideation, and a history of childhood sexual abuse distinguished the NSSI+SA and NSSI only groups. Longitudinal results demonstrated that a history of NSSI predicted future suicide ideation after adjusting for other selected risk factors. Limitations The majority of analyses are cross-sectional which limits inferences about causality. The retrospective self-report for lifetime behavior could be subject to reporting biases. Conclusions Adults with a history of NSSI and adults with a history of NSSI and a suicide attempt are clinically distinct groups that are both at risk of future suicide ideation. Identifying and treating NSSI could be a key preventive factor in reducing subsequent suicide risk.

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Suicide and Suicidal Attempts in the United States: Costs and Policy Implications

Cited by 340 publications

References 22 publications

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death — United States, 2001–2015

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001–2013

Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort

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