Suicide in Missouri: Where We Stand Liz Sale Missouri Ins6tute of - - PowerPoint PPT Presentation

Suicide in Missouri: Where We Stand

Liz Sale Missouri Ins6tute of Mental Health University of Missouri-St. Louis June 2016

Outline

• Prevalence of suicide

– World, U.S., Missouri comparisons – Trends over 6me

• Means of suicide
• Suicidal idea6on and inten6onal self-injury
• Vulnerable popula6ons

Worldwide Suicide Rates

• 800,000 people die each year to suicide worldwide
• 15th leading cause of death

(World Health Organiza6on, 2014)

Na6onal Suicide Rates

• In 2010, Missouri’s suicide rate was the 22nd highest in the na6on.
• In 2014, Missouri’s suicide rate was 20th highest

Suicide Rates by County (1990-2014)

• Rates highest in rural coun0es (DHSS, MICA, 2014)

Age Groups

Rank 10-14 15-24 25-34 35-44 45-54

1

Uninten6onal Injury Uninten6onal Injury Uninten6onal Injury Uninten6on al Injury Malignant Neoplasms

2

Suicide

Homicide

Suicide

Heart Disease Heart Disease

3

Malignant Neoplasms

Suicide

Homicide

Malignant Neoplasms Uninten6onal Injury

4

Homicide

Malignant Neoplasms Heart Disease Suicide Suicide

5

Benign Neoplasms Heart Disease Malignant Neoplasms

Homicide

Diabetes

Five Leading Causes of Death Missouri, 2014, Ages 10-54

• 10th leading cause of death for all age groups (CDC, 2014)

Comparisons with Other Fatal Injuries: 2014

Number of Deaths Rate (per 100,000) Suicide 1,017 16.77 Motor Vehicles Accidents 801 13.21 Homicide 441 7.27

Missouri 2014

• Largely a white male issue:

– 80% males – 95% Whites – 76% White males

• Highest rates among those 35-59 and 75+
• 58% firearms

# of Suicides (2014) by Age Group: Males and Females

50 100 150 200 250 0-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Females Males

2014 Suicide Rates by Age Group

5 10 15 20 25 30 35 40 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Rate per 100,000

Male Suicide Rate by Age (2014)

10 20 30 40 50 60 70 80 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

2014 Suicide Rates by Race and Ethnicity

5 10 15 20 25 30 35 40 Caucasian African American Hispanic Rate per 100,000

2010-2014 Suicide Rates by Gender and Race*

5 10 15 20 25 30 35 40 Caucasian Males African American Males Caucasian Female African American Females Asian Males Rate per 100,000 * Data aggregated to allow for greater race/gender comparisons

Trends

Missouri and U.S. Suicide Rates (1999-2014)

5 10 15 20 25 30 35 40 45 50 1999 2004 2009 2014 Rate per 100,000 MO U.S.

Missouri Suicide Rates (1999-2014) Males and Females

5 10 15 20 25 30 35 40 45 50 1999 2004 2009 2014 Rate per 100,000 Males Females CDC, Wisqars, 2016

Missouri Suicide Rates (1999-2014) Caucasians and African Americans

5 10 15 20 25 30 35 40 45 50 1999 2004 2009 2014 Rate per 100,000

Chart Title

Caucasian African American

Missouri and U.S. Rates (1999-2014) 45-54 Year Old Caucasian Males

5 10 15 20 25 30 35 40 45 50 U.S. MO

• Resistance to help seeking, job loss, divorce, decline in physical health,

addic6on

Missouri and U.S. Rates (1999-2014) Caucasian Males 75 and Older

10 20 30 40 50 60 70 1999 2004 2009 2014 MO U.S.

Lethal Means

Firearms Hanging Drugs Jumping Sharp

• bjects

Gases and vapors Other 0% 20% 40% 60% 80% 100%

Means of Suicide (All Ages) 2010-2014

0% 20% 40% 60% 80% 100% Males Females

Means of Suicide: Males and Females 2010-2014

Means by Age, Race and Region (2010-2014)

• 75+ more likely to use firearms than any other

age group (80%)

• African Americans more likely to use firearms

than Caucasians (65% vs. 58%)

• Slightly more likely to use firearms in rural

areas

% Firearms by Region in Missouri

0% 20% 40% 60% 80% 100% Large Central Large Fringe Medium metro Small Metro Micropolitan Non-core

• Trend for firearm use to be higher in more rural areas though

in all areas, firearms are primary means

Missouri and U.S. Rates (1999-2014) % Suicides by Firearms

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 1999 2004 2009 2014

Suicidal Idea6on in Youth

• 11.7% of Missouri middle and high school

students reported seriously considering suicide in 2014.

• Rates higher for females than males (16% vs. 7%).
• Suicidal thoughts highest in 8th – 9th grade
• 15% of Missouri college students experienced

suicidal thoughts in 2014.

Middle and high school data: Missouri Student Survey, 2014 College data: Missouri College hHealth Behavioral Survey

Inten6onal Self-Injury

• Over 8,000 Missourians are treated in

emergency rooms for inten6onal self-injury every year.

• Females 15-24 have highest rates: double the

rate for all Missourians (141.5 per 100,000).

• Poison or drug/alcohol overdose accounted

for around 80% of all inten6onal self-injuries.

• Rate of inten6onal self-injury declines with

age regardless of race or gender.

MO DHSS MICA database, 2012)

Popula6ons at High Risk

LGBTQ Community

• LGBTQ youth are at least 3 to 4 6mes more likely to

alempt suicide.

• Alempts by LGBTQ youth are 4 to 6 6mes more likely to

require treatment from a health professional.

• LGBTQ college students three 6mes more likely to have

had suicidal thoughts than their peers.

• Gay men 6 6mes more likely to alempt suicide
• Around one-third of transgender youth have alempted

suicide

U.S. Ac6ve 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
• Rates slightly lower in 2014 compared to 2012;

much lower for National Guard

Veteran Suicides

• In 2010, it was es6mated 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 6me, similar to na6onal

rates

• Among veterans under 25, around 25% of those who

died, died by suicide. (U.S. Veterans Affairs, 2010; MO DHSS, 2014)

Other Vulnerable Popula6ons

• People with a mental illness, par6cularly

untreated depression

• People with substance use disorders
• People who are bullied and those who bully
• People with disabili6es
• People with terminal illnesses
• Individuals in juvenile and criminal jus6ce system
• Homeless

Ques6ons?