Suicide Mortality Among American Indians and Alaska Natives, 1999–2009

Herne, Mose; Bartholomew, Michael L.; Weahkee, Rose L.

doi:10.2105/ajph.2014.301929

Cited by 81 publications

(52 citation statements)

References 21 publications

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“…45 These results underscore the need for suicide prevention initiatives in American Indian and Alaska Native communities. In 1 recent report, a multitiered suicide prevention program among the Apache of Arizona, which included efforts to increase identification, coping skills, and resilience of at-risk young people, coincided with a 23% decrease in suicide among 15-to 24-year-olds.…”

Section: Figurementioning

confidence: 97%

Suicide After Deliberate Self-Harm in Adolescents and Young Adults

et al. 2018

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OBJECTIVES:Among adolescents and young adults with nonfatal self-harm, our objective is to identify risk factors for repeated nonfatal self-harm and suicide death over the following year. METHODS:A national cohort of patients in the Medicaid program, aged 12 to 24 years (n = 32 395), was followed for up to 1 year after self-harm. Cause of death information was obtained from the National Death Index. Repeat self-harm per 1000 person-years and suicide deaths per 100 000 person-years were determined. Hazard ratios (HRs) of repeat self-harm and suicide were estimated by Cox proportional hazard models. Suicide standardized mortality rate ratios were derived by comparison with demographically matched general population controls. RESULTS:The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents (46.0, 95% confidence interval [CI]: 29.9-67.9) than young adults (19.2, 95% CI: 12.7-28.0). Hazards of suicide after self-harm were significantly higher for American Indians and Alaskan natives than non-Hispanic white patients (HR: 4.69, 95% CI: 2.41-9.13) and for self-harm patients who initially used violent methods (HR: 18.04, 95% CI: 9.92-32.80), especially firearms (HR: 35.73, 95% CI: 15.42-82.79), compared with nonviolent self-harm methods (1.00, reference). The hazards of repeat self-harm were higher for female subjects than male subjects (HR: 1.25, 95% CI: 1.18-1.33); patients with personality disorders (HR: 1.55, 95% CI: 1.42-1.69); and patients whose initial self-harm was treated in an inpatient setting (HR: 1.65, 95% CI: 1.49-1.83) compared with an emergency department (HR: 0.62, 95% CI: 0.55-0.69) or outpatient (1.00, reference) setting. CONCLUSIONS:After nonfatal self-harm, adolescents and young adults were at markedly elevated risk of suicide. Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk underscoring the importance of follow-up care to help ensure their safety.abstract

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Section: Figurementioning

confidence: 97%

Suicide After Deliberate Self-Harm in Adolescents and Young Adults

et al. 2018

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“…46 Native Americans and Alaska Natives have a suicide rate nearly 50% higher than Whites, at 21.2 and 14.2 per 100,000 respectively, with the highest rate occurring in Alaska. 47 However, certain cultural factors (eg, loss of identity) and socioeconomic factors (eg, unemployment) are associated with increased rates of suicide and suicidal ideation. 47,48 Among US males aged 10-35 years, non-Hispanic White males have suicide as the second leading cause of death, ranking higher than homicide, while among Black and Hispanic males in this age group, homicide leads suicide consistently.…”

Section: Mental Healthmentioning

confidence: 99%

“…47 However, certain cultural factors (eg, loss of identity) and socioeconomic factors (eg, unemployment) are associated with increased rates of suicide and suicidal ideation. 47,48 Among US males aged 10-35 years, non-Hispanic White males have suicide as the second leading cause of death, ranking higher than homicide, while among Black and Hispanic males in this age group, homicide leads suicide consistently. 49,50 Thus, data indicate that the expression of violence differs according to race.…”

Section: Mental Healthmentioning

confidence: 99%

Review: Increasing Awareness and Education on Health Disparities for Health Care Providers

Nesbitt

Palomarez

2016

Ethn Dis

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The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient’s cultural background to promote healthy behaviors. Ethn Dis. 2016;26(2):181-190; doi:10.18865/ed.26.2.181

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“…A regional analysis of suicide from 1999 to 2009 among Alaska Native and American Indian populations showed particularly high rates among Alaska Native communities and suicide rate among people younger than 44 years was 5 times the suicide rate of White Americans in the United States. 3 In Nunavut, the northernmost territory of Canada, around 65% of suicides among the Inuit population between 1999 and 2014 occurred among people aged 10 to 24 years. 4 …”

Section: Introductionmentioning

confidence: 99%