Abstract
Objectives: To characterize the events and examine suicide precursors among women and to examine gaps in surveillance.
Setting: A statewide study in North Carolina.
Methods: Suicides of women age 15 and older for the time period 1989–93, as identified from the Office of the Chief Medical Examiner, were included. All case files were reviewed by hand and telephone interviews were attempted with investigating law enforcement officials for every case in 1993.
Results: Altogether 882 suicides met the case definition, for an age adjusted rate that fluctuated between 5.53 and 7.26 per 100 000 women across the period. Interviews with law enforcement officials were completed for 135 of the 177 cases from 1993. White women had rates nearly three times those of racial minorities. Women under age 45 were proportionally more likely than older women to have recently experienced the breakup of an intimate relationship. Information about precursors was not as consistently reported as had been hoped. Medical examiner records were variable in completeness. Law enforcement interviews frequently did not yield information about the factors we had hoped to examine, probably because the investigations were conducted primarily to rule out homicide.
Conclusions: This study suggests somewhat different precursor patterns by age group. It also points to the need for reconsidering how suicide surveillance is accomplished as a strategy to guide intervention.
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Selected References
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- Bailey J. E., Kellermann A. L., Somes G. W., Banton J. G., Rivara F. P., Rushforth N. P. Risk factors for violent death of women in the home. Arch Intern Med. 1997 Apr 14;157(7):777–782. [PubMed] [Google Scholar]
- Bourque L. B., Kraus J. F., Cosand B. J. Attributes of suicide in females. Suicide Life Threat Behav. 1983 Summer;13(2):123–138. doi: 10.1111/j.1943-278x.1983.tb00010.x. [DOI] [PubMed] [Google Scholar]
- Burr J. A., McCall P. L., Powell-Griner E. Female labor force participation and suicide. Soc Sci Med. 1997 Jun;44(12):1847–1859. doi: 10.1016/s0277-9536(96)00294-8. [DOI] [PubMed] [Google Scholar]
- Dannenberg A. L., Baker S. P., Li G. Intentional and unintentional injuries in women. An overview. Ann Epidemiol. 1994 Mar;4(2):133–139. doi: 10.1016/1047-2797(94)90059-0. [DOI] [PubMed] [Google Scholar]
- Davidson J. R., Hughes D. C., George L. K., Blazer D. G. The association of sexual assault and attempted suicide within the community. Arch Gen Psychiatry. 1996 Jun;53(6):550–555. doi: 10.1001/archpsyc.1996.01830060096013. [DOI] [PubMed] [Google Scholar]
- Dudley M., Kelk N., Florio T., Waters B., Howard J., Taylor D. Coroners' records of rural and non-rural cases of youth suicide in New South Wales. Aust N Z J Psychiatry. 1998 Apr;32(2):242–251. doi: 10.3109/00048679809062735. [DOI] [PubMed] [Google Scholar]
- Durfee M. J., Gellert G. A., Tilton-Durfee D. Origins and clinical relevance of child death review teams. JAMA. 1992 Jun 17;267(23):3172–3175. [PubMed] [Google Scholar]
- Kaslow N. J., Thompson M. P., Meadows L. A., Jacobs D., Chance S., Gibb B., Bornstein H., Hollins L., Rashid A., Phillips K. Factors that mediate and moderate the link between partner abuse and suicidal behavior in African American women. J Consult Clin Psychol. 1998 Jun;66(3):533–540. doi: 10.1037//0022-006x.66.3.533. [DOI] [PubMed] [Google Scholar]
- Kingree J. B., Thompson M. P., Kaslow N. J. Risk factors for suicide attempts among low-income women with a history of alcohol problems. Addict Behav. 1999 Jul-Aug;24(4):583–587. doi: 10.1016/s0306-4603(98)00109-9. [DOI] [PubMed] [Google Scholar]
- Kposowa A. J. Marital status and suicide in the National Longitudinal Mortality Study. J Epidemiol Community Health. 2000 Apr;54(4):254–261. doi: 10.1136/jech.54.4.254. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Olson L., Huyler F., Lynch A. W., Fullerton L., Werenko D., Sklar D., Zumwalt R. Guns, alcohol, and intimate partner violence: the epidemiology of female suicide in New Mexico. Crisis. 1999;20(3):121–126. doi: 10.1027//0227-5910.20.3.121. [DOI] [PubMed] [Google Scholar]
- Schnitzer P. G., Runyan C. W. Injuries to women in the United States: an overview. Women Health. 1995;23(1):9–27. doi: 10.1300/J013v23n01_02. [DOI] [PubMed] [Google Scholar]
- Stepakoff S. Effects of sexual victimization on suicidal ideation and behavior in U.S. college women. Suicide Life Threat Behav. 1998 Spring;28(1):107–126. [PubMed] [Google Scholar]
- Thompson M. P., Kaslow N. J., Kingree J. B., Puett R., Thompson N. J., Meadows L. Partner abuse and posttraumatic stress disorder as risk factors for suicide attempts in a sample of low-income, inner-city women. J Trauma Stress. 1999 Jan;12(1):59–72. doi: 10.1023/A:1024742215337. [DOI] [PubMed] [Google Scholar]
- Wiederman M. W., Sansone R. A., Sansone L. A. History of trauma and attempted suicide among women in a primary care setting. Violence Vict. 1998 Spring;13(1):3–9. [PubMed] [Google Scholar]
- van de Voorde H., Hooft P., Mulkers U. On the influence of data source in aggregated data studies: a comparative study of suicide information based on death certificates and judicial files. J Epidemiol Community Health. 1993 Feb;47(1):73–75. doi: 10.1136/jech.47.1.73. [DOI] [PMC free article] [PubMed] [Google Scholar]