The 130th Annual Meeting of APHA

Abstract #44834

Deborah Azrael, PhD¹, David Hemenway, PhD¹, and Matt Miller, MD, ScD². (1) Health Policy and Management, Harvard University, 677 Huntington Avenue, Boston, MA 02115, (2) Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, 3rd Floor, Boston, MA 02115, 617-432-1439, azrael@hsph.harvard.edu

Objective: To explore the determinants of adolescent suicide, suicide attempts and case fatality rates.

Methods: Mortality and hospital discharge data for youths 10-19 years of age from 8 states in census regions 1 and 2 were used to explore the relationship between individual and community level characteristics and 1) the case fatality rate, and 2) the suicide rate. Firearm ownership rates are assessed using a validated proxy. Negative binomial hierarchical models are used to exploit the multilevel nature of the available count data.

Results: Among methods used in attempting suicide among 10-19 year olds, firearms were the most lethal: 83% of gun attempts resulted in death (accounting for 44% of all deaths), compared with 73% of attempts using carbon monoxide or hanging (accounting for 33% of all deaths); 22% of jumping attempts, 0.5% of intentional drug overdoses (accounting for 90% of all attempts), and 0.5% of all cutting/piercing. Overall, suicide rates were higher in areas where guns ownership rates were higher even after controlling several potential confounders.

Conclusion: Compared to areas where guns are less prevalent, areas where guns are more prevalent have higher aggregate case fatality rates and higher completed suicide rates, even after controlling for several potential confounders.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

1.List the case fatality rates for the 5 leading methods used by adolescents who attempt suicide. 2.Describe the relationship between individual and community level characteristics and the rate of suicide, firearm suicide, and non-firearm suicide among adolescents.
• Discuss the way that case fatality rates vary according to method, age and socioeconomic factors

Keywords: Suicide, Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.