Matthew Miller, MD, MPH, ScD¹, David Hemenway, PhD², and Deborah Azrael, PhD¹. (1) Harvard Injury Control Research Center, Harvard School of Public Health, 677 Huntington Ave., Kresge 312, Boston, MA 02143, 617-432-1459, mmiller@hsph.harvard.edu, (2) Health Policy and Management, Harvard University, 677 Huntington Avenue, Boston, MA 02115

Study objective: To evaluate how age, gender, poverty, and urbanization influence the proportion of suicide acts with a given method that result in death. Methods: Seven states provided mortality and hospital discharge data for all suicide acts resulting in death or hospitalization between 1996 and 2000. Suicide acts were divided into eight categories based on the method used. For each method, the fraction of acts resulting in death (the method-specific case fatality rate) was calculated. Results: Overall, thirteen percent of our 44,831 suicide acts proved lethal. Poisoning with drugs accounted 74% of all acts, but only 14% of fatalities. Firearms and hanging accounted for 10% of all acts and 67% of fatalities. Firearms were the most lethal means used (9 1% of all acts resulted in death), followed by drowning (84%), and hanging (82%). Method-specific case fatality rates were higher for males and older individuals, but were independent of rates of poverty and urbanization and did not vary across states. Conclusion: Our estimates of method specific case fatality rates are based on suicide acts that result in death or hospitalization, and therefore necessarily underestimate the actual incidence of suicide acts and overestimate case fatality rates, especially for methods least likely to prove lethal. Nevertheless, we find that age, gender, poverty, and urbanization influence overall case fatality rates primarily by way of their influence on the distribution of methods chosen, rather than because of variation in method specific case fatality rates associated with these factors.

Learning Objectives:

Participants will be able to 1)understand the relationship between age, gender, poverty, and urbanization and the proportion of suicide acts with a given method that result in death,
• summarize the relative lethality of various methods of attempted suicide,
• calculate case fatality rates using mortality and hospital discharge data

Keywords: Suicide,

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.