Recorded presentation

Catherine W. Barber, MPA¹, NVISS Workgroup², Deborah Azrael, PhD¹, Jenny Hochstadt, MSc¹, Deborah Kacanek, ScD¹, Mallory O'Brien, PhD¹, and David Hemenway, PhD¹. (1) Harvard Injury Control Research Center, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, 617-432-1143, cbarber@hsph.harvard.edu, (2) Various institutions, 677 Huntington Avenue, Boston, MA 02115

Introduction: Suicide claims 30,000 lives annually in the US. Victims range from a teenager who takes his life on impulse after arguing with parents to a person with endstage lung cancer taking his life after deliberation. Better understanding the precipitants of suicide will aid prevention activities. Objective: To describe the role of health problems as a precipitating factor in suicide. Methods: Coroner/medical examiner, police, and death certificate data were linked and analyzed from four states and two counties participating in a pilot for the National Violent Death Reporting System. Results: Data were reported on 1,614 suicide victims. Circumstances that may have played a precipitating role were abstracted. Most frequently noted were problems with mental health (42%), intimate partners (31%), health (24%), and alcohol (24%). Most victims had more than one circumstance endorsed (mean: 3.4). Only 6% of victims had just “health” or “health” plus “depressed mood” endorsed. Health problems more often appeared in tandem with other problems. Review of incident narratives indicated that only 12% of health problems were explicitly noted as terminal; many were chronic conditions, back pain, or injuries. Among all victims, the book Final Exit was mentioned in 15 incident narratives. Although marketed as a how-to manual for the terminally ill and not for those with mental illness, only 7 of the 15 victims were noted as having health problems; most had multiple problems such as mental illness or relationship break-ups. Conclusions: Suicides, even health-related suicides, appear to be infrequently associated with a single problem type. Health problems are most frequently “bundled” with other life problems.

Learning Objectives: Participants will be able to

• Describe a new source of data on suicide victims.
• Describe the prevalence of health problems noted in the records of suicide victims as well as the frequency with which these apear singly vs. with other precipitating problems.
• Explain how better understanding precipitating factors will assist in developing public health approaches to suicide prevention

Keywords: Suicide, Surveillance

Related Web page: www.nviss.org

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation