Suicides Among American Indian or Alaska Native Persons — National Violent Death Reporting System, United States, 2015–2020

Stone, Deborah M.; Trinh, Eva; Zhou, Hong; Welder, Laura; Horn, Pamela End Of; Fowler, Katherine A.; Ivey-Stephenson, Asha Z.

doi:10.15585/mmwr.mm7137a1

Cited by 20 publications

(17 citation statements)

References 6 publications

(11 reference statements)

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“…Since the findings are based on claims data, it is important to note that these data were captured when children interacted with the health care system, meaning that these encounters can be used as opportunities to engage youth in follow-up services and potentially prevent future suicide-related events. This is particularly important for American Indian or Alaska Native young people, as the rate of suicide-related mortality is highest among American Indian or Alaska Native persons …”

Section: Discussionmentioning

confidence: 99%

“…This is particularly important for American Indian or Alaska Native young people, as the rate of suiciderelated mortality is highest among American Indian or Alaska Native persons. 5 Suicide attempt and intentional self-harm encounters increased during the pandemic for children and adolescents in all racial and ethnic groups except American Indian or Alaska Native. A potential implication could be that the policy initiatives aimed toward preventing suicide among American Indian or Alaska Native communities is having their intended intent, but more research is warranted to determine why the pandemic did not seem to impact this group as much as others in this particular way.…”

Section: Supplemental Contentmentioning

confidence: 99%

“…American Indian and Alaska Native persons experienced higher suicide-related mortality compared to the general US population prior to the pandemic. 5 We examined racial and ethnic differences in tion System (T-MSIS). The study sample included all individuals aged 3 to 17 years from all 50 states, Washington, DC, Puerto Rico, and the US Virgin Islands who were enrolled in Medicaid or CHIP for at least 6 consecutive months in the year.…”

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confidence: 99%

“…This is particularly true for American Indian or Alaska Native youth. American Indian and Alaska Native persons experienced higher suicide-related mortality compared to the general US population prior to the pandemic . We examined racial and ethnic differences in encounters related to suicidal behaviors among a national sample of children and adolescents covered under Medicaid or Children’s Health Insurance Program (CHIP) during the first year of the pandemic.…”

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confidence: 99%

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Racial and Ethnic Differences in Encounters Related to Suicidal Behavior Among Children and Adolescents With Medicaid Coverage During the COVID-19 Pandemic

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Section: Supplemental Contentmentioning

confidence: 99%

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Racial and Ethnic Differences in Encounters Related to Suicidal Behavior Among Children and Adolescents With Medicaid Coverage During the COVID-19 Pandemic

et al. 2023

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“…In the US, the risk of external causes of deaths varies across sociodemographic characteristics . Although deaths due to firearms and poisoning are increasing nationally, the trends for suicide, homicide, and unintentional injury may differ by age, sex, and race and ethnicity . During the past 2 decades, deaths due to drug overdose have emerged as a major public health concern and had been an important contributor to plateauing US life expectancy before the COVID-19 pandemic .…”

Section: Introductionmentioning

confidence: 99%

Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

et al. 2023

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ImportanceAlthough deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood.ObjectiveTo examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined as poisonings (eg, drug overdose), firearms, and all other injuries, including motor vehicle injuries and falls. Given the repercussions of the COVID-19 pandemic, US death rates for 2019 and 2020 were also compared.Design, Setting, and ParticipantsSerial cross-sectional study using national death certificate data obtained from the National Center for Health Statistics and including all external causes of 3 813 894 deaths among individuals aged 20 years or older from January 1, 1999, to December 31, 2020. Data analysis was conducted from January 20, 2022, to February 5, 2023.ExposuresAge, sex, and race and ethnicity.Main Outcomes and MeasuresTrends in age-standardized mortality rates and average annual percentage change (AAPC) in rates calculated by intent (suicide, homicide, unintentional, and undetermined), age, sex, and race and ethnicity for each external cause.ResultsBetween 1999 and 2020, there were 3 813 894 deaths due to external causes in the US. From 1999 to 2020, poisoning death rates increased annually (AAPC, 7.0%; 95% CI, 5.4%-8.7%). From 2014 to 2020, poisoning death rates increased the most among men (APC, 10.8%; 95% CI, 7.7%-14.0%). During the study period, poisoning death rates increased in all the racial and ethnic groups examined; the most rapid increase was among American Indian and Alaska Native individuals (AAPC, 9.2%; 95% CI, 7.4%-10.9%). During the study period, death rates for unintentional poisoning had the most rapid rate of increase (AAPC, 8.1%; 95% CI, 7.4%-8.9%). From 1999 to 2020, firearm death rates increased (AAPC, 1.1%; 95% CI, 0.7%-1.5%). From 2013 to 2020, firearm mortality increased by an average of 4.7% annually (95% CI, 2.9%-6.5%) among individuals aged 20 to 39 years. From 2014 to 2020, mortality from firearm homicides increased by an average of 6.9% annually (95% CI, 3.5%-10.4%). From 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, and homicide due to firearms and all other injuries.Conclusions and RelevanceResults of this cross-sectional study suggest that from 1999 to 2020, death rates due to poisonings, firearms, and all other injuries increased substantially in the US. The rapid increase in deaths due to unintentional poisonings and firearm homicides is a national emergency that requires urgent public health interventions at the local and national levels.

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Trends in Adolescent Suicide by Method in the US, 1999-2020

Ormiston,

Lawrence,

Sulley

et al. 2024

JAMA Netw Open

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ImportanceAdolescent suicide in the US is a major public health problem, yet temporal trends in suicide methods by demographics are understudied.ObjectiveTo examine national trends in suicide mortality by method (firearm, poisoning, hanging and asphyxiation, and all other means) from 1999 to 2020 by demographic characteristics.Design, Setting, and ParticipantsThis serial cross-sectional study used national death certificate data of adolescent (aged 10-19 years) suicide decedents compiled by the National Center for Health Statistics from January 1, 1999, to December 31, 2020. Data analysis was performed from April 1, 2023, to July 9, 2023.ExposuresAge, sex, and race and ethnicity.Main Outcomes and MeasuresTrends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated by age, sex, and race and ethnicity for each suicide method.ResultsThis study assessed data from 47 217 adolescent suicide decedents. From 1999 to 2020, suicide by firearm (AAPC, 1.0; 95% CI, 0.1-1.9), poisoning (AAPC, 2.7; 95% CI, 1.0-4.4), hanging and asphyxiation (AAPC, 2.4; 95% CI, 0.2-4.6), and other means (AAPC, 2.9; 95% CI, 1.2-4.6) increased. Rapidly increasing rates were observed among female adolescents for poisoning (AAPC, 4.5; 95% CI, 2.3-6.7) and hanging and asphyxiation (AAPC, 5.9; 95% CI, 5.0-6.8) suicides. From 2007 to 2020, firearm suicides sharply increased among female (annual percent change [APC], 7.8; 95% CI, 6.0-9.5) and male (APC, 5.3; 95% CI, 4.3-6.3) adolescents. Firearm suicide rates increased among Black adolescents from 2012 to 2020 (APC, 14.5; 95% CI, 9.7-19.5), Asian and Pacific Islander adolescents from 2008 to 2020 (APC, 12.0; 95% CI, 9.7-14.5), American Indian and Alaska Native adolescents from 2014 to 2020 (APC, 10.6; 95% CI, 2.6-19.3), and Hispanic or Latino adolescents from 2011 to 2020 (APC, 10.2; 95% CI, 6.3-13.8). During the study period, Black adolescents had the highest average increase in hanging and asphyxiation suicides (AAPC, 4.2; 95% CI, 3.2-5.2). From 2011 to 2020, poisoning suicide deaths increased (APC, 12.6; 95% CI, 8.5-16.7) among female adolescents.Conclusions and RelevanceSuicide rates increased across all methods from 1999 to 2020. Differences were noted by sex, age, and race and ethnicity. Increasing suicide rates among racial and ethnic minoritized youth are especially concerning, and effective prevention strategies are urgently needed.

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Suicides Among American Indian or Alaska Native Persons — National Violent Death Reporting System, United States, 2015–2020

Cited by 20 publications

References 6 publications

Racial and Ethnic Differences in Encounters Related to Suicidal Behavior Among Children and Adolescents With Medicaid Coverage During the COVID-19 Pandemic

Racial and Ethnic Differences in Encounters Related to Suicidal Behavior Among Children and Adolescents With Medicaid Coverage During the COVID-19 Pandemic

Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

Trends in Adolescent Suicide by Method in the US, 1999-2020

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