@article{ref1,
title="Evaluation of suicide mortality among sexual minority US Veterans from 2000 to 2017",
journal="JAMA network open",
year="2020",
author="Lynch, Kristine E. and Gatsby, Elise and Viernes, Benjamin and Schliep, Karen C. and Whitcomb, Brian W. and Alba, Patrick R. and DuVall, Scott L. and Blosnich, John R.",
volume="3",
number="12",
pages="e2031357-e2031357",
abstract="IMPORTANCE: Identification of subgroups at greatest risk for suicide mortality is  essential for prevention efforts and targeting interventions. Sexual minority  individuals may have an increased risk for suicide compared with heterosexual  individuals, but a lack of sufficiently powered studies with rigorous methods for  determining sexual orientation has limited the knowledge on this potential health  disparity. <br><br>OBJECTIVE: To investigate suicide mortality among sexual minority  veterans using Veterans Health Administration (VHA) electronic health record data. DESIGN, SETTING, AND PARTICIPANTS: This retrospective population-based cohort study  used data on 8.1 million US veterans enrolled in the VHA after fiscal year 1999 that  were obtained from VHA electronic health records from October 1, 1999 to September  30, 2017. Data analysis was carried out from March 1, 2020 to October 31, 2020. EXPOSURE: Veterans with documentation of a minority sexual orientation. Documentation of sexual minority status was obtained through natural language  processing of clinical notes and extraction of structured administrative data for  sexual orientation in VHA electronic health records. MAIN OUTCOMES AND MEASURES:  Suicide mortality rate using data on the underlying cause of death obtained from the  National Death Index. Crude and age-adjusted mortality rates were calculated for  all-cause death and death from suicide among sexual minority veterans compared with  the general US population and the general population of veterans. <br><br>RESULTS: Among the  96 893 veterans with at least 1 sexual minority documentation in the electronic  health record, the mean (SD) age was 46 (16) years, 68% were male, and 70% were  White. Of the 12 591 total deaths, 3.5% were from suicide. Veterans had a  significantly higher rate of mortality from suicide (standardized mortality ratio,  4.50; 95% CI, 4.13-4.99) compared with the general US population. Suicide was the  fifth leading cause of death in 2017 among sexual minority veterans (3.8% of deaths)  and the tenth leading cause of death in the general US population (1.7% of deaths). The crude suicide rate among sexual minority veterans (82.5 per 100 000  person-years) was higher than the rate in the general veteran population (37.7 per  100 000 person-years). <br><br>CONCLUSIONS AND RELEVANCE: The results of this  population-based cohort study suggest that sexual minority veterans have a greater  risk for suicide than the general US population and the general veteran population. Further research is needed to determine whether and how suicide prevention efforts  reach sexual minority veterans.<p /> <p>Language: en</p>",
language="en",
issn="2574-3805",
doi="10.1001/jamanetworkopen.2020.31357",
url="http://dx.doi.org/10.1001/jamanetworkopen.2020.31357"
}