Socioeconomic and circumstance differences in means of suicide among U.S. adults: Evidence from the National Violent Death Reporting System.

BACKGROUND

Suicide is a major public health problem. To our knowledge, few studies have examined how multiple sociodemographic and circumstance factors are associated with a comprehensive set of International Classification of Diseases, Tenth Revision (ICD-10)-defined suicide means; therefore, we evaluated these associations in a national sample of U.S. adults.

METHODS

Data were obtained from the U.S. National Violent Death Reporting System from 2003 to 2023. Adults aged ≥18 years who were assigned an ICD-10 cause of death code that corresponds to a suicide means were included (N = 391,250). Suicide means were categorized as firearm, asphyxiation, medication poisoning, non-medication poisoning, non-firearm weapon, jumping, and motor vehicle. Multinomial logistic regression was used to regress suicide means by socioeconomic and circumstance factors, using firearm suicide as the reference outcome.

RESULTS

Firearms were the most common suicide method (52.6%), followed by asphyxiation (26.9%) and medication poisoning (11.1%). In general, suicide by firearm was relatively less likely among those in older age groups, higher education levels, racial-ethnic minorities, females, and those with mental health and substance abuse history. In contrast, suicide by firearm was generally more likely among those who were married, military history, employed in the workforce, financial hardship, and those with physical health and relationship problems.

CONCLUSIONS

We identified sociodemographic and circumstance factors that may be at higher risk of suicide via different means of suicide. These results may identify high risk individuals and guide clinical practice, screening guidelines, and policies based on which suicide means may be more likely.