TABLE 2. Circumstances precipitating suicide deaths of non-Hispanic American Indian/Alaska Natives compared with non-Hispanic whites — National Violent Death Reporting System, 18 states,* 2003–2014.
| Circumstance | No. (%)† |
aOR (95% CI)§ | |
|---|---|---|---|
| AI/AN | White | ||
|
Total decedents
|
1,531 (100)
|
103,986 (100)
|
—
|
|
Cases with known circumstances¶,**
|
1,339 (87.5) |
93,403 (89.8) |
— |
|
Suicide event
| |||
| History of suicidal thoughts or plan†† |
111 (33.4) |
6,955 (32.7) |
—§§ |
| History of suicide attempts¶ |
308 (23.0) |
18,935 (20.3) |
1.0 (0.9–1.2) |
| Disclosed suicidal intent¶ |
457 (34.1) |
26,377 (28.2) |
1.3 (1.1–1.4) |
|
Interpersonal
| |||
| Intimate partner problem¶ |
524 (39.1) |
27,464 (29.4) |
1.2 (1.1–1.3) |
| Family relationship problem¶¶ |
83 (10.6) |
4,965 (8.8) |
—§§ |
| Victim of interpersonal violence within past month¶ |
21 (1.6) |
444 (0.5) |
—*** |
| Perpetrator of interpersonal violence within past month¶ |
91 (6.8) |
3,107 (3.3) |
2.0 (1.6–2.4) |
| Argument preceded death¶,¶¶ |
154 (19.7) |
6,102 (10.8) |
1.4 (1.2–1.7) |
|
Life stressor
| |||
| Victim in custody¶,** |
76 (5.0) |
2,458 (2.4) |
1.7 (1.4–2.2) |
| Released from institution within previous month¶,††† |
17 (4.6) |
1,885 (8.2) |
—*** |
| Criminal legal problem¶ |
201 (15.0) |
8,493 (9.1) |
1.5 (1.3–1.7) |
| Civil legal problem¶ |
34 (2.5) |
3,420 (3.7) |
—*** |
| Physical health problem¶ |
144 (10.6) |
21,655 (23.2) |
0.9 (0.7–1.0) |
| Job problem¶,§§§ |
92 (7.6) |
12,038 (13.2) |
0.5 (0.4–0.6) |
| Financial problem¶,§§§ |
76 (6.3) |
11,211 (12.3) |
0.5 (0.4–0.7) |
| School problem¶¶¶ |
36 (21.4) |
688 (22.0) |
—§§ |
| Eviction/Loss of home |
25 (1.9) |
2,525 (2.7) |
—§§ |
| Suicide of friend or family member¶ |
79 (5.9) |
1,797 (1.9) |
2.4 (1.9–3.1) |
| Death of friend or family member¶ |
118 (8.8) |
6,116 (6.6) |
1.7 (1.4–2.1) |
| Any crisis within past 2 weeks |
411 (30.7) |
26,815 (28.7) |
—§§ |
|
Mental health/Substance use
| |||
| Current mental health problem¶ |
371 (27.7) |
43,614 (46.7) |
0.4 (0.4–0.5) |
| Current depressed mood¶ |
489 (36.5) |
38,940 (41.7) |
0.9 (0.8–1.0) |
| Current mental health treatment¶ |
261 (19.5) |
31,987 (34.2) |
0.5 (0.4–0.5) |
| History of mental health treatment¶ |
311 (23.2) |
37,499 (40.2) |
0.4 (0.4–0.5) |
| Reported alcohol use in hours preceding death¶ |
651 (48.6) |
23,370 (25.0) |
2.7 (2.4–3.0) |
| Alcohol abuse problem¶ |
371 (27.7) |
17,242 (18.5) |
1.8 (1.6–2.1) |
| Substance abuse problem other than alcohol | 202 (15.1) | 14,365 (15.4) | —§§ |
Abbreviations: AI/AN = non-Hispanic American Indian/Alaska Native; aOR = adjusted odds ratio; CI = confidence interval; NVDRS = National Violent Death Reporting System; white = non-Hispanic white.
* Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin.
† Denominator includes only those suicides with ≥1 precipitating circumstances, unless otherwise noted. Sums of percentages in columns may exceed 100% because a suicide could have more than one precipitating circumstance.
§ Adjusted odds ratios measure the association between the decedent having the precipitating circumstance present and the race of the decedent being AI/AN. Each adjusted odds ratio used white as the reference group and controlled for age group and sex.
¶ Chi-squared test result for difference between AI/AN and white significant at p<0.05.
** Denominator includes all suicide decedents (1,531 AI/AN; 103,986 white).
†† Variable added to NVDRS in 2013; Denominator includes only decedents from 2013 and later with ≥1 known circumstances (332 AI/AN; 21,246 white).
§§ No significant difference was found between AI/AN and white for this incident characteristic, therefore no measure of association was calculated.
¶¶ Variable added to NVDRS in 2009; Denominator includes only decedents from 2009 and later with ≥1 known circumstances (780 AI/AN; 56,274 white).
*** Statistical reliability criteria for logistic regression not met because cell frequencies were less than the required minimum.
††† Variable added to NVDRS in 2013; Denominator includes all suicide decedents from 2013 and later (367 AI/AN; 22,959 white). Institution includes jail or other detention facility, hospital, psychiatric institution, supervised residential facility or nursing home.
§§§ Denominator includes only decedents ≥18 years with ≥1 known circumstance (1,213 AI/AN; 91,097 white).
¶¶¶ Denominator includes only decedents ≤18 years with ≥1 known circumstance (168 AI/AN; 3,125 white).