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APHA Scientific Session and Event Listing

Recorded presentation

Catherine Barber, MPA¹, Deborah Azrael, PhD¹, Ellen Connorton, MSW, MPA², Renee M. Johnson, PhD, MPH¹, and Deborah Stone, MPH¹. (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) Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115

Introduction: Although the U.S. suicide rate declined steadily from 1994-2003, the suffocation suicide rate increased. Objectives: To identify groups in which suffocations increased, explore reasons, and identify characteristics that may aid prevention. Methods: Analyzed national vital statistics data, 1994-2003, and coroner/medical examiner and police report data from a pilot for the National Violent Death Reporting System. Results: Suffocation suicides increased among youths, middle-aged adults, both sexes, and whites. Shifts in weapon choice from firearms and poisons to suffocations may explain some of the increase but not all; there were declines in these methods in some groups, years, and states where suffocations did not rise and no decline in these methods in some groups where suffocations rose. Neither coding changes nor increased use of suffocation for self-stimulation are likely explanations, as unintentional and unknown-intent suffocations remained flat for all but infants and elders. 35-64 year-olds were the only group in which suicides did not fall; increased suffocations, little change in other methods, and declining elder suicides made 2003 the first year in which middle-aged suicide rates surpassed elders'. Among the middle-aged, suffocation and firearm victims were more likely than other victims to have experienced a crisis the day of the suicide and to test negative for antidepressants. Discussion: While declines in firearm and poisoning suicides have brought down total suicide rates, the problem of suffocations continues to call for primary and secondary prevention. Content analysis of pro-suicide websites suggests information about suffocation as quick and painless may contribute to its increase.

Learning Objectives:

• To precisely identify which demographic groups have been seen a rise in hanging suicides
• To list evidence supporting or refuting potential explanations for the rise in hangings
• To understand why reducing the easy availability of lethal means of suicide can prevent a subset of suicides
• To discuss alternate approaches to preventing suicides by means that, like hanging, are widely available.

Keywords: Suicide, Epidemiology

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation