Dataset Information

Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System.

ABSTRACT: We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012-2015; N = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poison ingestion (20%). Sexual minorities were more likely than heterosexuals to be younger, female, and Black/African American. Multivariate sex-stratified analyses in the overall sample showed that strong sexual orientation differences in lethal methods existed among men but not among women. However, when we compared sex differences in lethal methods among sexual minorities only, we found that lesbian/bisexual women, as compared to gay/bisexual men, were more likely to use a firearm or drug or poison ingestion than hanging. Findings suggest that the higher rate of suicide mortality among sexual minorities is likely driven by hanging, a method of suicide that is not particularly amenable to lethal method restricted-access prevention approaches. Future research directions, clinical training recommendations, and intervention opportunities are discussed.

SUBMITTER: Clark KA

PROVIDER: S-EPMC7937759 | biostudies-literature | 2022 Apr-Jun

REPOSITORIES: biostudies-literature

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Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System.

Clark Kirsty A KA Mays Vickie M VM Arah Onyebuchi A OA Kheifets Leeka I LI Cochran Susan D SD

Archives of suicide research : official journal of the International Academy for Suicide Research 20200908 2

We examined sexual orientation and sex differences in seven methods of suicide among adult suicides reported in the United States National Violent Death Reporting System (2012-2015; <i>N</i> = 59,075). Overall, most sexual minorities (i.e., lesbians, gay men, bisexuals) identified in the dataset used hanging (38%) followed by firearm (30%) and drug or poison ingestion (20%). Sexual minorities were more likely than heterosexuals to be younger, female, and Black/African American. Multivariate sex- ...[more]

PMID: 32897837

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Project description:Background:More than 25 million adults in the United States have chronic pain. Chronic pain has been associated with suicidality, but previous studies primarily examined nonfatal suicidal behaviors rather than suicide deaths associated with chronic pain or the characteristics of such deaths. Objective:To estimate the prevalence of chronic pain among suicide decedents in a large multistate sample and to characterize suicide decedents with and without chronic pain. Design:Retrospective analysis of National Violent Death Reporting System (NVDRS) data. The NVDRS links death certificate, coroner or medical examiner, and law enforcement data collected by investigators, who often interview informants who knew the decedent to gather information on precipitating circumstances surrounding the suicide. Information is abstracted by using standard coding guidance developed by the Centers for Disease Control and Prevention. Setting:18 states participating in the NVDRS. Participants:Suicide decedents with and without chronic pain who died during 1 January 2003 to 31 December 2014. Measurements:Demographic characteristics, mechanism of death, toxicology results, precipitating circumstances (mental health, substance use, interpersonal problems, life stressors), and suicide planning and intent. Results:Of 123 181 suicide decedents included in the study, 10 789 (8.8%) had evidence of chronic pain, and the percentage increased from 7.4% in 2003 to 10.2% in 2014. More than half (53.6%) of suicide decedents with chronic pain died of firearm-related injuries and 16.2% by opioid overdose. Limitation:The results probably underrepresent the true percentage of suicide decedents who had chronic pain, given the nature of the data and how they were captured. Conclusion:Chronic pain may be an important contributor to suicide. Access to quality, comprehensive pain care and adherence to clinical guidelines may help improve pain management and patient safety. Primary Funding Source:None.

Project description:BackgroundThe rate of suicide in the US has increased substantially in the past two decades, and new insights are needed to support prevention efforts. The National Violent Death Reporting System (NVDRS), the nation's most comprehensive registry of suicide mortality, has qualitative text narratives that describe salient circumstances of these deaths. These texts have great potential for providing novel insights about suicide risk but may be subject to information bias.ObjectiveTo examine the relationship between decedent characteristics and the presence and length of NVDRS text narratives (separately for coroner/medical examiner (C/ME) and law enforcement (LE) reports) among 233,108 suicide and undetermined deaths from 2003-2017.MethodsGeneralized estimating equations (GEE) logistic and quasi-Poisson modeling was used to examine variation in the narratives (proportion of missing texts and character length of the non-missing texts, respectively) as a function of decedent age, sex, race/ethnicity, education, marital status, military history, and homeless status. Models adjusted for site, year, location of death, and autopsy status.ResultsThe frequency of missing narratives was higher for LE vs. C/ME texts (19.8% vs. 5.2%). Decedent characteristics were not consistently associated with missing text across the two types of narratives (i.e., Black decedents were more likely to be missing the LE narrative but less likely to be missing the C/ME narrative relative to non-Hispanic whites). Conditional on having a narrative, C/ME were significantly longer than LE (822.44 vs. 780.68 characters). Decedents who were older, male, had less education and some racial/ethnic minority groups had shorter narratives (both C/ME and LE) than younger, female, more educated, and non-Hispanic white decedents.ConclusionDecedent characteristics are significantly related to the presence and length of narrative texts for suicide and undetermined deaths in the NVDRS. Findings can inform future research using these data to identify novel determinants of suicide mortality.

Dataset Information

Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System.

Publications

Sexual Orientation Differences in Lethal Methods Used in Suicide: Findings From the National Violent Death Reporting System.

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