Citation

Betz ME, Valley MA, Lowenstein SR, Hedegaard HB, Thomas D, Stallones L, Honigman B. Suicide Life Threat. Behav. 2011; 41(5): 562-573.

Affiliation

Marian E.Betz, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, Department of Epidemiology, Colorado School of Public Health; Morgan A.Valley, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado; Steven R.Lowenstein, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, Department of Community and Behavioral Health, Colorado School of Public Health; HollyHedegaard, Colorado Department of Public Health and Environment, Denver, Colorado; DeborahThomas, Department of Geography and Environmental Sciences, University of Colorado, Denver, Colorado; LorannStallones, Department of Psychology, Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado; and BenjaminHonigman, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Copyright

(Copyright © 2011, American Association of Suicidology, Publisher John Wiley and Sons)

DOI

10.1111/j.1943-278X.2011.00054.x

PMID

21883411

Abstract

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low<1000 m; middle = 1000-1999 m; high≥2000 m). Of reported suicides, 5% were at high and 83% at low altitude, but unadjusted suicide rates per 100,000 population were higher at high (17.7) than at low (5.7) altitude. High and low altitude victims differed with respect to race, ethnicity, rural residence, intoxication, depressed mood preceding the suicide, firearm use and recent financial, job, legal, or interpersonal problems. Even after multivariate adjustment, there were significant differences in personal, mental health, and suicide characteristics among altitude groups. Compared to low altitude victims, high altitude victims had higher odds of having family or friends report of a depressed mood preceding the suicide (OR 1.78; 95%CI:1.46-2.17) and having a crisis within 2 weeks before death (OR 2.00; 95%CI:1.63-1.46). Suicide victims at high and low altitudes differ significantly by multiple demographic, psychiatric, and suicide characteristics; these factors, rather than hypoxia or altitude itself, may explain increased suicide rates at high altitude.

Language: en