美国退伍军人自杀意念和自杀未遂患病率的地理空间估计（2022年）

Geospatial estimates of suicidal ideation and suicide attempt prevalence in the U.S. veteran population (2022).

作者信息

Kittel Julie A, Monteith Lindsey L, Holliday Ryan, Morano Theresa T, Schneider Alexandra L, Brenner Lisa A, Hoffmire Claire A

机构信息

VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, CO, USA.

Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

出版信息

Inj Epidemiol. 2025 Jun 10;12(1):32. doi: 10.1186/s40621-025-00584-y.

DOI:10.1186/s40621-025-00584-y

PMID:40495255

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12153138/

Abstract

BACKGROUND

Veteran suicide remains a major public health concern; rates increased 64.3% from 2001 to 2022 and substantial geospatial variation exists, with state-level rates ranging from 15.4/100,000 (Maryland) to 87.1/100,000 (Montana). Surveillance of suicidal ideation (SI) and suicide attempts (SA) can provide insights to reduce suicide risk within communities.

METHODS

A population-based, cross-sectional survey of 17,949 Veterans residing in all 50 U.S. states, the District of Columbia, Puerto Rico, and U.S. Pacific Island (PI) Territories, was conducted in 2022 to assess SI and SA prevalence. Lifetime and post-military SI and SA and past-year SI prevalence were estimated by Census region, division, and state. Prevalence ratios were calculated for post-military SI and SA to assess differences by division, accounting for demographic covariates (i.e., age, race, gender, rurality, and time since military separation). Methods used in lifetime SA and considered in past-year SI were also examined by region.

RESULTS

The West had the highest prevalence of lifetime (36.94%; 95%CI = 34.65-39.23) and post-military SI (28.73%; 95%CI = 26.51-30.96), significantly higher than all other regions except for PI Territories and Puerto Rico. PI Territories had the highest prevalence of past-year SI (15.68%; 95%CI = 10.91-20.44) and lifetime (9.86%; 95%CI = 6.36-13.37) and post-military SA (5.67%; 95%CI = 3.21-8.14). At the divisional level, the Pacific West (29.12%; 95%CI = 26.01-32.23) and West South Central (29.09%; 95%CI = 26.18-32.00) divisions had the highest prevalence of post-military SI, while West South Central had the highest prevalence of post-military SA (6.89%; 95%CI = 5.07-8.70), and the PI Territories remained highest for lifetime SA. After adjusting for covariates, numerous significant differences across divisions were observed. Differences in suicide methods considered and used were also observed across regions.

CONCLUSIONS

Variability in SI and SA prevalence among Veterans at state, divisional and regional levels supports the need for nuanced surveillance efforts, along with targeted prevention efforts in areas at greatest risk.

摘要

背景

退伍军人自杀仍是一个重大的公共卫生问题；从2001年到2022年，自杀率上升了64.3%，且存在显著的地理空间差异，州一级的自杀率从每10万人15.4例（马里兰州）到87.1例（蒙大拿州）不等。对自杀意念（SI）和自杀未遂（SA）的监测可为降低社区内的自杀风险提供见解。

方法

2022年对居住在美国所有50个州、哥伦比亚特区、波多黎各和美属太平洋岛屿（PI）领土的17949名退伍军人进行了一项基于人群的横断面调查，以评估SI和SA的患病率。按人口普查区域、分区和州估计终身和退伍后的SI和SA以及过去一年的SI患病率。计算退伍后SI和SA的患病率比值，以评估各分区之间的差异，并考虑人口统计学协变量（即年龄、种族、性别、农村地区以及退伍后的时间）。还按地区检查了终身SA中使用的方法以及过去一年SI中考虑的方法。

结果

西部地区终身SI（36.94%；95%CI = 34.65 - 39.23）和退伍后SI（28.73%；95%CI = 26.51 - 30.96）的患病率最高，但除PI领土和波多黎各外，显著高于所有其他地区。PI领土过去一年SI（15.68%；95%CI = 10.91 - 20.44）、终身SA（9.86%；95%CI = 6.36 - 13.37）和退伍后SA（5.67%；95%CI = 3.21 - 8.14）的患病率最高。在分区层面，太平洋西部地区（29.12%；95%CI = 26.01 - 32.23）和西中南部地区（29.09%；95%CI = 26.18 - 32.00）退伍后SI的患病率最高，而西中南部地区退伍后SA的患病率最高（6.89%；95%CI = 5.07 - 8.70），PI领土终身SA的患病率仍然最高。在调整协变量后，各分区之间观察到许多显著差异。不同地区在考虑和使用的自杀方法上也存在差异。