Suicides Among American Indian/Alaska Natives - National Violent Death Reporting System, 18 States, 2003-2014

Rachel A Leavitt, Allison Ertl, Kameron Sheats, Emiko Petrosky, Asha Ivey-Stephenson, Katherine A Fowler, Rachel A Leavitt, Allison Ertl, Kameron Sheats, Emiko Petrosky, Asha Ivey-Stephenson, Katherine A Fowler

Abstract

Suicide disproportionately affects American Indians/Alaska Natives (AI/AN). The suicide rate among AI/AN has been increasing since 2003 (1), and in 2015, AI/AN suicide rates in the 18 states participating in the National Violent Death Reporting System (NVDRS) were 21.5 per 100,000, more than 3.5 times higher than those among racial/ethnic groups with the lowest rates.* To study completed suicides across all ages of AI/AN, NVDRS data collected from 2003 to 2014 were analyzed by comparing differences in suicide characteristics and circumstances between AI/AN and white decedents. Group differences were assessed using chi-squared tests and logistic regression. Across multiple demographics, incident characteristics, and circumstances, AI/AN decedents were significantly different from white decedents. More than one third (35.7%) of AI/AN decedents were aged 10-24 years (versus 11.1% of whites). Compared with whites, AI/AN decedents had 6.6 times the odds of living in a nonmetropolitan area, 2.1 times the odds of a positive alcohol toxicology result, and 2.4 times the odds of a suicide of a friend or family member affecting their death. Suicide prevention efforts should incorporate evidence-based, culturally relevant strategies at individual, interpersonal, and community levels (2) and need to account for the heterogeneity among AI/AN communities (3,4).

Conflict of interest statement

No conflicts of interest were reported

References

    1. Suicide Prevention Resource Center. Suicide among racial/ethnic populations in the U.S.: American Indians/Alaska Natives. Waltham, MA: Education Development Center, Inc.; 2013.
    1. Stone DM, Holland KM, Bartholow B, Crosby AE, Davis S, Wilkins N. Preventing suicide: a technical package of policies, programs and practices. Atlanta, GA: US Department of Health and Human Services, CDC; 2017.
    1. Wexler L, Silveira ML, Bertone-Johnson E. Factors associated with Alaska Native fatal and nonfatal suicidal behaviors 2001–2009: trends and implications for prevention. Arch Suicide Res 2012;16:273–86. 10.1080/13811118.2013.722051
    1. Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services. To live to see the great day that dawns: preventing suicide by American Indian and Alaska Native youth and young adults. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2010.
    1. Cwik M, Barlow A, Tingey L, et al. Exploring risk and protective factors with a community sample of American Indian adolescents who attempted suicide. Arch Suicide Res 2015;19:172–89. 10.1080/13811118.2015.1004472
    1. Oetzel J, Duran B, Lucero J, et al. Rural American Indians’ perspectives of obstacles in the mental health treatment process in three treatment sectors. Psychol Serv 2006;3:117–28. 10.1037/1541-1559.3.2.117
    1. CDC. The Community Guide: excessive alcohol consumption. Atlanta, GA: US Department of Health and Human Services, CDC; 2017.
    1. Evans-Campbell T. Historical trauma in American Indian/Native Alaska communities: a multilevel framework for exploring impacts on individuals, families, and communities. J Interpers Violence 2008;23:316–38. 10.1177/0886260507312290
    1. Arias E, Heron M, Hakes J; National Center for Health Statistics; US Census Bureau. The validity of race and Hispanic origin reporting on death certificates in the United States: an update. Vital Health Stat 2 2016;172:1–21.
    1. Cwik MF, Tingey L, Maschino A, et al. Decreases in suicide deaths and attempts linked to the White Mountain Apache suicide surveillance and prevention system, 2001–2012. Am J Public Health 2016;106:2183–9. 10.2105/AJPH.2016.303453

Source: PubMed

3
Subscribe