Suicidal attempts and death rates in the United States from 2007 to 2014

1. Suicide attempts in males, persons older than 65 years, and persons in rural areas were most likely to result in death.

2. The most common method of suicidal attempt involved drug poisoning, but the most lethal involved firearms, drowning, and hanging.

Evidence Rating Level: 3 (Average)

Study Rundown: Suicide was the 10^th leading cause of death in the United States in 2017. This cross-sectional study analyzed suicide-related deaths and attempts that resulted in an emergency department visit or hospitalization in the United States from 2007 to 2014. Females were more likely to commit suicidal attempts, but less likely to result in death. Suicidal acts were more fatal among males and those greater than 65 years old. Rural populations had a higher rate of suicidal attempts and deaths than urban populations. A majority of attempts involved drug poisoning with a lower death rate. Most deaths were due to firearms, drowning, and hanging.

This study only included suicidal acts that resulted in death or treatment in a hospital but excluded attempts that did not result in a hospital visit. The rates of suicide and methods could vary if nonfatal suicide attempts that did not result in an ED visit were included. Since suicide is a preventable cause of death, the general public and health care providers should be aware of populations that are at a higher risk of suicide and have resources available for those at risk.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016

In-Depth [cross-sectional study]: This cross-sectional study obtained data on suicidal deaths and attempts that resulted in an ED visit or hospitalization in the United States from 2007 to 2014 from 3 databases. Persons younger than 5 years were excluded from this study. A total of 3,657,886 suicidal acts were identified during this study period. 8.5% were fatal and 46.5% of nonfatal suicidal attempts resulted in hospitalization. Compared to females, males were less likely to engage in suicidal attempts. Despite this, males were 4 times more likely to die due to attempted suicide, most commonly by firearms or hanging. Suicide attempts were more common among persons younger than 25 years (fatality rate 1 in 32) but resulted in fewer deaths than those 65 years or older (fatality rate 1 in 3). Adults aged 65 years or older were 5 times more likely to use a lethal method of death, with 1 in 4 involving a firearm. By region, suicide attempts were lowest in the West, but had the highest death rate. Rural populations had a 22.1% higher suicidal attempt rate and a 33.1% higher death rate than those in urban areas. Suicidal attempts in the West and rural areas were twice as likely to involve a firearm. The most lethal suicidal methods involved firearms (89.6% death rate), drowning (56.4% death rate), and hanging (52.7% death rate). The least lethal methods involved cutting or piercing (0.7% death rate), poisoning with nondrug substance (1.1% death rate), and poisoning with drugs (1.9% death rate). The most common method of suicidal acts (about 80%) involved drug poisoning or cutting.

Image: PD

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