Associations between facility-level and community characteristics and firearm-related suicide rates

Recent research has evaluated Veteran-specific and local or regional factors affecting suicide rates in Veterans Health Administration Medical Centers (VAMCs) by comparing VAMCs with the states where they are located. The research design included firearm-related, and non-firearm-related suicide rates for VMACs for 2007-2009 obtained from the National Death Index and VA records. Rates for states were from the Web-based Injury Statistics and Query Reporting System. Data on firearm availability in states were from the Behavioral Risk Factor Surveillance System. Evidence for effects related to the state environments include significant correlations between VAMCs and the states in rates of overall, firearm-related, and non-firearm suicides and the proportion of firearm-related suicides, as well as correlations between overall and firearm-related rates in both VAMCs and States with firearm availability in the states. Regression models demonstrate that approximately half of the variance in suicide rates in VAMCs can be explained by the environments of the states. Rates of suicide among populations served by VAMCs depend upon factors related to the national Veteran population and to those of the states where they are located. For VAMCs, these findings demonstrate the value of community partnerships. From another perspective, using VAMCs as probes, they suggest that states can be characterized by environmental factors related to the risk of suicide, including but not limited to the availability of firearms.