Trends in suicide rates by race and ethnicity among members of the United States Army.
Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was co...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0280217 |
| _version_ | 1827924243287900160 |
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| author | Lisa A Brenner Jeri E Forster Colin G Walsh Kelly A Stearns-Yoder Mary Jo Larson Trisha A Hostetter Claire A Hoffmire Jaimie L Gradus Rachel Sayko Adams |
| author_facet | Lisa A Brenner Jeri E Forster Colin G Walsh Kelly A Stearns-Yoder Mary Jo Larson Trisha A Hostetter Claire A Hoffmire Jaimie L Gradus Rachel Sayko Adams |
| author_sort | Lisa A Brenner |
| collection | DOAJ |
| description | Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological Injury Combat Study (SUPIC). Demographic (e.g., race and ethnicity) and military data from the Department of Defense compiled within SUPIC, as well as Department of Veterans Affairs data were linked with National Death Index records (through 2018) to identify deaths by suicide including those that occurred after military service. The cohort included 860,930 Army Service members (Active Duty, National Guard, and Reserve). Age-adjusted (using the direct standardization method) and age-specific suicide rates per 100,000 person years were calculated and rate ratios (RR) were used for comparisons. Trends were evaluated using hazard rates over time since the end of individuals' index deployments. Among those aged 18-29 at the end of their index deployment, the suicide rate for American Indian/Alaskan Native (AI/AN) individuals was 1.51 times higher (95% confidence interval [CI]: 1.03, 2.14) compared to White non-Hispanic individuals (WNH), and lower for Hispanic and Black non-Hispanic (BNH) than for WNH individuals (RR = 0.65 [95% CI: 0.55, 0.77] and RR = 0.71 [95% CI: 0.61, 0.82], respectively). However, analyses revealed increasing trends in hazard rates post-deployment (≤ 6.5 years) within groups of Hispanic and BNH individuals (Average Annual Percent Change [APC]: 12.1% [95% CI: 1.3%, 24.1%] and 11.4% [95% CI: 6.9%, 16.0%], respectively) with a smaller, increase for WNH individuals (APC: 3.1%; 95% CI: 0.1%, 6.1%). Findings highlight key subgroups at risk for post-deployment suicide (i.e., WNH, AI/AN and younger individuals), as well as heterogeneous trends overtime, with rates and trends varying within race and ethnic groups by age groups. Post-deployment suicide prevention efforts that address culturally relevant factors and social determinants of health associated with health inequities are needed. |
| first_indexed | 2024-03-13T05:09:02Z |
| format | Article |
| id | doaj.art-84ed4c3aca2a4069b94e727f2bff253f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-13T05:09:02Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-84ed4c3aca2a4069b94e727f2bff253f2023-06-16T05:31:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e028021710.1371/journal.pone.0280217Trends in suicide rates by race and ethnicity among members of the United States Army.Lisa A BrennerJeri E ForsterColin G WalshKelly A Stearns-YoderMary Jo LarsonTrisha A HostetterClaire A HoffmireJaimie L GradusRachel Sayko AdamsEfforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological Injury Combat Study (SUPIC). Demographic (e.g., race and ethnicity) and military data from the Department of Defense compiled within SUPIC, as well as Department of Veterans Affairs data were linked with National Death Index records (through 2018) to identify deaths by suicide including those that occurred after military service. The cohort included 860,930 Army Service members (Active Duty, National Guard, and Reserve). Age-adjusted (using the direct standardization method) and age-specific suicide rates per 100,000 person years were calculated and rate ratios (RR) were used for comparisons. Trends were evaluated using hazard rates over time since the end of individuals' index deployments. Among those aged 18-29 at the end of their index deployment, the suicide rate for American Indian/Alaskan Native (AI/AN) individuals was 1.51 times higher (95% confidence interval [CI]: 1.03, 2.14) compared to White non-Hispanic individuals (WNH), and lower for Hispanic and Black non-Hispanic (BNH) than for WNH individuals (RR = 0.65 [95% CI: 0.55, 0.77] and RR = 0.71 [95% CI: 0.61, 0.82], respectively). However, analyses revealed increasing trends in hazard rates post-deployment (≤ 6.5 years) within groups of Hispanic and BNH individuals (Average Annual Percent Change [APC]: 12.1% [95% CI: 1.3%, 24.1%] and 11.4% [95% CI: 6.9%, 16.0%], respectively) with a smaller, increase for WNH individuals (APC: 3.1%; 95% CI: 0.1%, 6.1%). Findings highlight key subgroups at risk for post-deployment suicide (i.e., WNH, AI/AN and younger individuals), as well as heterogeneous trends overtime, with rates and trends varying within race and ethnic groups by age groups. Post-deployment suicide prevention efforts that address culturally relevant factors and social determinants of health associated with health inequities are needed.https://doi.org/10.1371/journal.pone.0280217 |
| spellingShingle | Lisa A Brenner Jeri E Forster Colin G Walsh Kelly A Stearns-Yoder Mary Jo Larson Trisha A Hostetter Claire A Hoffmire Jaimie L Gradus Rachel Sayko Adams Trends in suicide rates by race and ethnicity among members of the United States Army. PLoS ONE |
| title | Trends in suicide rates by race and ethnicity among members of the United States Army. |
| title_full | Trends in suicide rates by race and ethnicity among members of the United States Army. |
| title_fullStr | Trends in suicide rates by race and ethnicity among members of the United States Army. |
| title_full_unstemmed | Trends in suicide rates by race and ethnicity among members of the United States Army. |
| title_short | Trends in suicide rates by race and ethnicity among members of the United States Army. |
| title_sort | trends in suicide rates by race and ethnicity among members of the united states army |
| url | https://doi.org/10.1371/journal.pone.0280217 |
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