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Abstract
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Suicide is the third leading cause of death among young people aged 10-24 years in the United States. Nonfatal suicidal behavior is even more prevalent and results in significant morbidity and risk of suicide. The National Action Alliance for Suicide Prevention (Action Alliance) in partnership with the American Foundation for Suicide Prevention set a goal to reduce the suicide rate up to 20% by 2025. To reach this goal, more effective suicide prevention policies, programs, and practices are needed.
Understanding the role of place in shaping the geographic distribution of suicide is critical to informing appropriate public health responses for suicide prevention. A geospatial perspective of suicide expands the focus beyond the individual and provides public health guidance for action at the community, regional, and/or national level. In this issue of the Journal, the report by Sugg et al. adds to a growing number of state-level studies that have described the spatial pattern of suicide clusters. Using geographically and statistically appropriate methodology and state-of-the-art spatial statistics, this ecological study identified the pattern of spatial clusters for suicide and self-injury in North Carolina for 10-year-olds to 24-year-olds between 2009 and 2018 and assessed differences in individual demographic and contextual factors within these clusters. Suicide deaths were extracted from North Carolina Violent Death Reporting System and death certificates. Self-injury data (which included suicide attempts, suicidal ideation, self-harm, and poisoning) came from emergency department (ED) data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool. Spatial scan statistics were used to detect high-risk clusters of suicide at the zip-code level.
During the study period, a total of 1,398 suicides and 48,865 ED visits for self-injury occurred. Suicides primarily occurred among non-Hispanic White males, with firearms as the most common method, whereas self-injury was more frequent among females. A total of four significant suicide clusters and 10 significant self-injury clusters were identified; the spatial patterns of suicide and self-injury clusters differed across the state, with some overlap in the southeastern and northwestern parts of the state. Excess risk of suicide was up to 3.6 times higher in suicide clusters than no clusters and excess risk of self-injury was up to 2.3 times higher in self-injury clusters than no clusters. These results have the potential to inform suicide prevention efforts in these high-risk locations.
Language: en |