Suicide in Missouri: Where We Stand Liz Sale, PhD Missouri Institute of Mental Health University of Missouri-St. Louis August 2017
Outline Prevalence of suicide World, U.S., Missouri comparisons Trends over time Means of suicide Suicidal ideation and intentional self-injury Vulnerable populations
Worldwide Suicide Rates 800,000 people die each year to suicide worldwide 17 th leading cause of death
National Suicide Rates 121 suicide per day nationally 44,000 suicides in 2015, 1 million attempts (1:25) 10 th leading cause of death In 2015, Missouri s suicide rate was 17 th highest (16.98 per 100,000) CDC WISQARS, 2015
Five Leading Causes of Death Missouri, 2015, Ages 10-54 Age Groups Rank 10-14 15-24 25-34 35-44 45-54 1 Unintentional Injury Unintentional Injury Unintentional Injury Unintentional Injury Malignant Neoplasms 2 Malignant Neoplasms Homicide Suicide Heart Disease Heart Disease 3 Suicide Suicide Homicide Malignant Neoplasms Unintentional Injury 4 Homicide Malignant Neoplasms Heart Disease Suicide Suicide 5 Benign Neoplasms Heart Disease Malignant Neoplasms Homicide Diabetes 10 th leading cause of death for all age groups CDC, 2015
Suicide Rates by County (1990-2014) Rates highest in rural counties DHSS, MICA, 2014
Comparisons with Other Fatal Injuries: (2015) Homicide 547 Motor Vehicle Accidents 936 Suicide 1,052
Suicide in Missouri 73% of those who die by suicide in Missouri are white males. Males: 49% of MO population; 78% of those who die by suicide are male Whites: 83% of MO population 93% of those who die by suicide are white Rates highest among white males 45-54 and 75+
Missouri Suicide Rates by Race, Age and Gender (2015) White Males Black Males White Females Black Females 60 50 Rates Per 100,000 40 30 20 10 0 10-14 15-17 18-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ CDC, WISQARS, 2015
Trends
Missouri and U.S. Suicide Rates (2005-2015) 30 Missouri United States 25 Rate Per 100,000 20 15 10 5 0 2005 2007 2009 2011 2013 2015 CDC, WISQARS, 2015
Missouri Suicide Rates by Gender (2005-2015) 30 Males Females 25 Rate Per 100,000 20 15 10 5 0 2005 2007 2009 2011 2013 2015 CDC, WISQARS, 2015
Missouri Suicide Rates: Youth and Adults (2005-2015) 30 Youth 15-24 Adults 25+ 25 Rate Per 100,000 20 15 10 5 0 2005 2010 2015 CDC, WISQARS, 2015
Missouri Suicide Rates by Gender: All Ages and 45-64 Year Olds (2005-2015) 45 40 35 Rate Per 100,000 30 25 20 15 All Males All Females 45-64 Year Old Males 45-64 Year Old Females 10 5 0 2005 2007 2009 2011 2013 2015
20 18 16 Missouri Suicide Rates Whites and African Americans (2005-2015) Rate Per 100,000 14 12 10 8 6 Whites Blacks 4 2 0 2005 2007 2009 2011 2013 2015
Missouri and U.S. Rates 75 and Older (2005-2015) White Males 75+ 70 60 50 Rate Per 100,000 40 30 20 10 0 2005 2007 2009 2011 2013 2015
Lethal Means
Means of Suicide (All Ages) 2011-2015 100% 80% 60% 40% 20% 0% Firearms Hanging Poisoning Jumping Sharp objects Gases and vapors Other
Means of Suicide: Males and Females (2011-2015) Males Poisoning Firearms Suffocation Other Females Poisoning Firearms Suffocation Other 5% 9% 5% 21% 26% 38% 65% 31%
Means of Suicide: Youth and Adults (2011-2015) Under 18 18 and Older Poisoning Firearms Suffocation Other Poisoning Firearms Suffocation Other 2% 7% 5% 15% 22% 48% 43% 58%
Means by Age, Race and Region (2011-2015) 75+ year olds more likely to use firearms (82%) than any other means in 2015. Caucasians more likely to use firearms than African Americans. Slightly higher use of firearms in nonmetropolitan areas. MO Department of Health and Senior Services, Missouri Public Health Information Management System (MOPHIMS)
Firearm-related Suicides (2000-2015) 100% 80% 60% 40% 20% 0% 2000 2002 2004 2006 2008 2010 2012 2014
Intentional Self-Injury Around 7,000 Missourians were treated in emergency rooms or were hospitalized for intentional self-injury in 2014. Poison or drug/alcohol overdose accounted for 84% of all intentional self-injuries. Highest among females 15-19. Rose steadily from 2001 to 2011; declined steadily since then. MO DHSS MICA database, 2012
Missouri Intentional Self-Injury Rate by Age and Gender (2014) 600 500 Rate Per 100,000 400 300 200 Males Females 100 0 Missouri Department of Health and Senior Services, 2014
Youth Suicidal Ideation (2016) One of 8 middle school students seriously considered suicide in the past year. One in 6 high school students Almost 1 in 5 college students Ideation rates higher for females than males On average, suicidal thoughts highest in 8 th 9 th grade Middle and high school data: Missouri Student Survey, 2016 College data: Missouri Assessment of College Health Behaviors, 2016
20% Suicidal Ideation: Students who Seriously Considered Suicide in Past Year (2016) 16% 12% 8% 4% 0% Middle School Students High School Students College Students Missouri Student Survey, 2016; Missouri Assessment of College Health Behaviors, 2016
% Seriously Considered Suicide : Middle, High School and College Students (2016) Grade in Middle/High School Age in College 30% 25% 25% 20% 20% 15% 15% 10% 10% 5% 5% 0% 6 8 10 12 0% 18 20 22 24 Missouri Student Survey, 2016; Missouri Assessment of College Behaviors Survey, 2016
Populations at High Risk
LGBTQ Community LGB youth are at least 3-4 times more likely to attempt suicide Attempts by LGBTQ youth are 4-6 times more likely to require treatment from a health professional. Missouri LGBTQ college students are more than 3 times more likely to have had suicidal thoughts than their peers. Nationally, 40% of transgender adults have attempted suicide. 92% attempted before the age of 25.
U.S. Active Military Primarily white males under 30 68% used firearms; 92% were not military issued Rates highest in the Army and National Guard Failed relationships number one stressor Rates in military similar to civilian rates (adjusting for age)
Veteran Suicides In 2010, it was estimated that 22 U.S. veterans die by suicide every day. Almost all Missouri veteran suicides are male. Rates highest among older veterans. MO suicide rates stable over time, similar to national rates Among veterans under 25, around 25% of those who died, died by suicide. U.S. Veterans Affairs, 2010; MO DHSS, 2014
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