Firearm Suicide in the Veteran Population: Findings from the National Violent Death Reporting System

Suicide remains a serious public health problem and reducing suicide is a national imperative. In a recent groundbreaking study, Kaplan and colleagues showed that veterans were twice as likely as non-veterans to complete suicide. Equally ominous, of the veterans who completed suicide, 84 percent used firearms compared to 55 percent of non-veterans. Limited knowledge exists regarding the characteristics of firearm suicide among veterans in the general population. Earlier veteran suicide studies focused mainly on males, Vietnam-era, and Veterans Health Administration patient populations. The purpose of this study was to describe the prevalence and factors associated with firearm suicide among female and male veterans in general population. Analysis of 18,555 suicide decedents in the 2003-05 National Violent Death Reporting System was performed. The main outcome measure was suicide by firearm versus other methods. The results showed that male and female veteran suicide decedents were, respectively, 1.37 (95% Confidence Interval [CI] =1.25-2.51) and 1.50 (95% CI =1.01-2.22) times more likely to use firearms compared to non-veterans after adjusting for potential confounding factors. Furthermore, among male veterans, those who were older, married, white, lived in western and southern regions, and had physical health problems were more likely to use a firearm to complete suicide. History of suicide attempts and having been diagnosed with mental health problems were associated with a lower risk of completing suicide with a firearm. None of these factors were associated with firearm suicide among female veterans. Clinical and policy implications of these findings will be discussed.