Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component
Abstract Background To date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge,...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Injury Epidemiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40621-022-00410-9 |
| _version_ | 1797836682703142912 |
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| author | Rachel Sayko Adams Jeri E. Forster Jaimie L. Gradus Claire A. Hoffmire Trisha A. Hostetter Mary Jo Larson Colin G. Walsh Lisa A. Brenner |
| author_facet | Rachel Sayko Adams Jeri E. Forster Jaimie L. Gradus Claire A. Hoffmire Trisha A. Hostetter Mary Jo Larson Colin G. Walsh Lisa A. Brenner |
| author_sort | Rachel Sayko Adams |
| collection | DOAJ |
| description | Abstract Background To date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge, the objectives of this study were to determine and compare postdeployment suicide rates and trends (percent change over time), and hazard rates for Army soldiers, by rank and component (measured at the end of the deployment). Methods Longitudinal cohort study of 860,930 Army soldiers returning from Afghanistan/Iraq deployment in fiscal years 2008–2014 from the Substance Use and Psychological Injury Combat study. Death by suicide was observed from the end of the first deployment in the study period through 2018 (i.e., the most recently available mortality data) for up to 11 years of follow-up. Analyses were conducted in 2021–2022. Results Adjusting for age, lowest-ranking Junior Enlisted (E1–E4) soldiers had a suicide rate 1.58 times higher than Senior Enlisted (E5–E9)/Warrant Officers (95% CI [1.24, 2.01]) and 2.41 times higher than Officers (95% CI [1.78, 3.29]). Suicide rates among lower-ranking enlisted soldiers remained elevated for 11 years postdeployment. Overall and annual postdeployment suicide rates did not differ significantly across components. Comparisons across rank and component for females were generally consistent with the full cohort results. Conclusions Lower-ranking enlisted soldiers had the highest rate of suicide, underscoring the importance of understanding rank as it relates to social determinants of health. For over a decade following Afghanistan/Iraq deployment, lower-enlisted rank during deployment was associated with an elevated rate of suicide; thereby suggesting that postdeployment prevention interventions targeting lower-ranking military members are warranted. |
| first_indexed | 2024-04-09T15:13:56Z |
| format | Article |
| id | doaj.art-65b68f8a264349f784aaa6aede962566 |
| institution | Directory Open Access Journal |
| issn | 2197-1714 |
| language | English |
| last_indexed | 2024-04-09T15:13:56Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Injury Epidemiology |
| spelling | doaj.art-65b68f8a264349f784aaa6aede9625662023-04-30T11:02:35ZengBMCInjury Epidemiology2197-17142022-12-019111010.1186/s40621-022-00410-9Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and componentRachel Sayko Adams0Jeri E. Forster1Jaimie L. Gradus2Claire A. Hoffmire3Trisha A. Hostetter4Mary Jo Larson5Colin G. Walsh6Lisa A. Brenner7Department of Health Law, Policy and Management, Boston University School of Public HealthVHA Rocky Mountain Mental Illness Research Education and Clinical CenterDepartment of Epidemiology, Boston University School of Public Health, Boston UniversityVHA Rocky Mountain Mental Illness Research Education and Clinical CenterVHA Rocky Mountain Mental Illness Research Education and Clinical CenterInstitute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis UniversityDepartments of Biomedical Informatics, Medicine, and Psychiatry, Vanderbilt University Medical CenterVHA Rocky Mountain Mental Illness Research Education and Clinical CenterAbstract Background To date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge, the objectives of this study were to determine and compare postdeployment suicide rates and trends (percent change over time), and hazard rates for Army soldiers, by rank and component (measured at the end of the deployment). Methods Longitudinal cohort study of 860,930 Army soldiers returning from Afghanistan/Iraq deployment in fiscal years 2008–2014 from the Substance Use and Psychological Injury Combat study. Death by suicide was observed from the end of the first deployment in the study period through 2018 (i.e., the most recently available mortality data) for up to 11 years of follow-up. Analyses were conducted in 2021–2022. Results Adjusting for age, lowest-ranking Junior Enlisted (E1–E4) soldiers had a suicide rate 1.58 times higher than Senior Enlisted (E5–E9)/Warrant Officers (95% CI [1.24, 2.01]) and 2.41 times higher than Officers (95% CI [1.78, 3.29]). Suicide rates among lower-ranking enlisted soldiers remained elevated for 11 years postdeployment. Overall and annual postdeployment suicide rates did not differ significantly across components. Comparisons across rank and component for females were generally consistent with the full cohort results. Conclusions Lower-ranking enlisted soldiers had the highest rate of suicide, underscoring the importance of understanding rank as it relates to social determinants of health. For over a decade following Afghanistan/Iraq deployment, lower-enlisted rank during deployment was associated with an elevated rate of suicide; thereby suggesting that postdeployment prevention interventions targeting lower-ranking military members are warranted.https://doi.org/10.1186/s40621-022-00410-9SuicideMilitaryVeteransDeployment |
| spellingShingle | Rachel Sayko Adams Jeri E. Forster Jaimie L. Gradus Claire A. Hoffmire Trisha A. Hostetter Mary Jo Larson Colin G. Walsh Lisa A. Brenner Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component Injury Epidemiology Suicide Military Veterans Deployment |
| title | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component |
| title_full | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component |
| title_fullStr | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component |
| title_full_unstemmed | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component |
| title_short | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component |
| title_sort | time dependent suicide rates among army soldiers returning from an afghanistan iraq deployment by military rank and component |
| topic | Suicide Military Veterans Deployment |
| url | https://doi.org/10.1186/s40621-022-00410-9 |
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