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APHA Scientific Session and Event Listing

Recorded presentation

Sandro Galea, MD, DrPH¹, Melissa Tracy, MPH¹, Tinka Markham Piper, MPH, CSW², Angela M. Bucciarelli, MPH², Ken Tardiff, MD MPH³, Robyn Gershon, PhD⁴, and David Vlahov, PhD². (1) Department of Epidemiology, University of Michigan School of Public Health, 1214 South University, Room 243, Ann Arbor, MI 48104, 734 647 9741, sgalea@nyam.org, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (3) Department of Psychiatry, Cornell University, 525 East 68th Street Box 140, New York, NY 10021, (4) Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 600 West 168th Street, 4th Floor, New York, NY 10032

Several investigations have documented subway-related suicides in metropolitan areas worldwide; however there has been relatively little analysis of suicide in North American subway systems. Data on characteristics of subway suicide decedents from existing studies remain conflicting. We collected data from the Office of the Chief Medical Examiner (CME) of New York City (NYC) on all suicides between 1990-2003. NYC has had the same CME and has used the same criteria for determining cause and method of death throughout this time period. We collected data about demographics, timing of suicides, and drug use (via toxicology) by victims of suicide. There were a total of 7394 suicides in NYC during this time period; among these 343 (4.6%) were subway-related. Overall nonparametric best-fit models suggest a significant decline in suicides over this time period overall (27.1% net decrease), but an increase in proportion of subway-related suicides (30.5% net increase). In multivariable analyses, subway suicide decedents were more likely than other suicide decedents to be between age 25-54 (odds ratio (OR)=1.68 for 25-34, 1.66 for 35-44, and 1.63 for 45-54 compared to 24 years of age and younger), black (OR=2.08 compared to whites), and to occur in the afternoon (OR=1.67 compared to early morning). Subway-related suicides appear to be increasing in NYC; middle-aged, minority persons appear to be at greater risk of using subways as a means of suicide. Suicide prevention efforts may consider the growing importance of subway related suicides among these groups in North American metropolitan areas.

Learning Objectives:

• 1. To describe current research on subway-related suicides in metropolitan areas, both internationally and in the United States.
• 2. To identify trends, correlates and characteristics of subway-related suicides and decedents in New York City from 1990-2003
• 3. To outline potential suicide prevention efforts to reduce mortality from subway-related suicide in New York City.

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation