Geospatial estimates of suicidal ideation and suicide attempt prevalence in the U.S. veteran population (2022).

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Injury Epidemiology Pub Date : 2025-06-10 DOI:10.1186/s40621-025-00584-y

Julie A Kittel, Lindsey L Monteith, Ryan Holliday, Theresa T Morano, Alexandra L Schneider, Lisa A Brenner, Claire A Hoffmire

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引用次数: 0

Abstract

Background: Veteran suicide remains a major public health concern; rates increased 64.3% from 2001 to 2022 and substantial geospatial variation exists, with state-level rates ranging from 15.4/100,000 (Maryland) to 87.1/100,000 (Montana). Surveillance of suicidal ideation (SI) and suicide attempts (SA) can provide insights to reduce suicide risk within communities.

Methods: A population-based, cross-sectional survey of 17,949 Veterans residing in all 50 U.S. states, the District of Columbia, Puerto Rico, and U.S. Pacific Island (PI) Territories, was conducted in 2022 to assess SI and SA prevalence. Lifetime and post-military SI and SA and past-year SI prevalence were estimated by Census region, division, and state. Prevalence ratios were calculated for post-military SI and SA to assess differences by division, accounting for demographic covariates (i.e., age, race, gender, rurality, and time since military separation). Methods used in lifetime SA and considered in past-year SI were also examined by region.

Results: The West had the highest prevalence of lifetime (36.94%; 95%CI = 34.65-39.23) and post-military SI (28.73%; 95%CI = 26.51-30.96), significantly higher than all other regions except for PI Territories and Puerto Rico. PI Territories had the highest prevalence of past-year SI (15.68%; 95%CI = 10.91-20.44) and lifetime (9.86%; 95%CI = 6.36-13.37) and post-military SA (5.67%; 95%CI = 3.21-8.14). At the divisional level, the Pacific West (29.12%; 95%CI = 26.01-32.23) and West South Central (29.09%; 95%CI = 26.18-32.00) divisions had the highest prevalence of post-military SI, while West South Central had the highest prevalence of post-military SA (6.89%; 95%CI = 5.07-8.70), and the PI Territories remained highest for lifetime SA. After adjusting for covariates, numerous significant differences across divisions were observed. Differences in suicide methods considered and used were also observed across regions.

Conclusions: Variability in SI and SA prevalence among Veterans at state, divisional and regional levels supports the need for nuanced surveillance efforts, along with targeted prevention efforts in areas at greatest risk.

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美国退伍军人自杀意念和自杀企图患病率的地理空间估计（2022年）。

背景：退伍军人自杀仍然是一个主要的公共卫生问题；从2001年到2022年，发病率增加了64.3%，并且存在显著的地理空间差异，州一级的发病率从15.4/100,000（马里兰州）到87.1/100,000（蒙大拿州）不等。对自杀意念（SI）和自杀企图（SA）的监测可以为减少社区内的自杀风险提供见解。方法：在2022年对居住在美国所有50个州、哥伦比亚特区、波多黎各和美国太平洋岛（PI）地区的17,949名退伍军人进行了基于人群的横断面调查，以评估SI和SA的患病率。终生和退役后SI、SA和过去一年SI患病率按普查地区、分区和州估计。在考虑人口统计协变量（即年龄、种族、性别、农村地区和自军事分离以来的时间）的情况下，计算退伍后SI和SA的患病率，以评估不同地区的差异。终身SA中使用的方法和过去一年SI中考虑的方法也按地区进行了检查。结果：西部地区终生患病率最高，为36.94%；95%CI = 34.65 ~ 39.23)和退伍后SI (28.73%；95%CI = 26.51-30.96)，显著高于除PI领地和波多黎各以外的所有其他地区。PI地区过去一年SI患病率最高(15.68%；95%CI = 10.91-20.44)和寿命(9.86%；95%CI = 6.36-13.37)和退伍后SA (5.67%；95%ci = 3.21-8.14)。在分区层面，西太平洋（29.12%）；95%CI = 26.01-32.23)和西南中南部(29.09%；95%CI = 26.18-32.00)区军后SI患病率最高，而西南区军后SA患病率最高(6.89%；95%CI = 5.07-8.70)， PI领土在终身SA中保持最高。在调整协变量后，观察到不同部门之间存在许多显著差异。不同地区考虑和使用的自杀方法也存在差异。结论：退伍军人SI和SA患病率在州、区和地区层面的差异支持了细致监测工作的必要性，以及在风险最大的地区进行有针对性的预防工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Injury Epidemiology Medicine-Medicine (all)

CiteScore

3.20

自引率

4.50%

发文量

审稿时长

13 weeks

期刊介绍： Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.