Department of Population Health, Hofstra University, 106 Hofstra Dome, Hempstead, NY 11549, United States of America.
Prev Med. 2022 Jun;159:107064. doi: 10.1016/j.ypmed.2022.107064. Epub 2022 Apr 20.
Suicide is an important cause of mortality in the United States. This study aimed to examine US suicide trends by race and ethnicity from 1999 to 2020. Publicly available de-identified data were extracted from the CDC's Wide-ranging Online Data for Epidemiologic Research. The International Classification of Diseases Codes, 10th Revision- X60-X84, U03, and Y87.0 were used to identify suicide decedents aged 10 years and above from 1999 to 2020. A Joinpoint regression model was fitted to estimate the annual percentage change (APC) and average annual percentage change in suicide rate over the study period. From 1999 to 2020, a total of 838,560 persons died by suicide in the US. Recent mortality trends have declined by 3.8% per year (95% CI: -7.1, -0.5) among Non-Hispanic Whites from 2018 to 2020, but have increased among Non-Hispanic Blacks (APC = 6.1; 95% CI: 5.0, 7.3), Asians/Pacific Islanders (APC = 1.5; 95% CI: 1.2, 1.9), American Indians/Alaska Natives (APC = 3.3; 95% CI: 3.0, 3.6), and Hispanics (APC = 3.8; 95% CI: 2.7, 5.0). Based on suicide mechanism, recent trends have increased by firearm (APC = 1.7; 95% CI: 1.5, 2.0) and suffocation (APC = 3.8; 95% CI: 3.5, 4.1), decreased by drug poisoning (APC = -2.9; 95% CI: -3.9, -1.9), and stabilized by non-drug poisoning (APC = 0.6; 95% CI: -2.4, 3.7). Racial and ethnic disparities exist in suicide trends in the United States. Further research to identify individual and contextual factors for the differences may guide effective public health intervention efforts.
自杀是美国一个重要的死亡原因。本研究旨在从 1999 年至 2020 年，按种族和族裔来分析美国的自杀趋势。本研究从疾病预防控制中心的广范围在线流行病学研究数据提取了公开的匿名数据。使用国际疾病分类第十版 X60-X84、U03 和 Y87.0 代码来识别 1999 年至 2020 年期间年龄在 10 岁及以上的自杀死亡者。采用 Joinpoint 回归模型来估计研究期间自杀率的年百分比变化（APC）和平均年百分比变化。从 1999 年至 2020 年，美国共有 838560 人自杀死亡。最近的死亡率趋势显示，2018 年至 2020 年期间，非西班牙裔白人每年下降 3.8%（95%可信区间：-7.1，-0.5），而非西班牙裔黑人（APC=6.1；95%可信区间：5.0，7.3）、亚洲/太平洋岛民（APC=1.5；95%可信区间：1.2，1.9）、美国印第安人/阿拉斯加原住民（APC=3.3；95%可信区间：3.0，3.6）和西班牙裔（APC=3.8；95%可信区间：2.7，5.0）的自杀率则有所增加。根据自杀手段，最近的趋势显示，自杀率通过枪支（APC=1.7；95%可信区间：1.5，2.0）和窒息（APC=3.8；95%可信区间：3.5，4.1）有所增加，通过药物中毒（APC=-2.9；95%可信区间：-3.9，-1.9）有所减少，非药物中毒（APC=0.6；95%可信区间：-2.4，3.7）则保持稳定。美国的自杀趋势存在种族和族裔差异。进一步研究识别差异的个体和环境因素可能有助于指导有效的公共卫生干预措施。
