Jain Vageesh, Hemenway David
Harvard T H Chan School of Public Health, Boston, Massachusetts, USA.
BMJ Public Health. 2025 May 19;3(1):e002387. doi: 10.1136/bmjph-2024-002387. eCollection 2025.
To determine whether physicians have similar rates of suicide to the general population, and the role of firearms.
Cross-sectional study (2010-2021).
46 US states.
The population from states participating in the National Violent Death Reporting System.
State-level household gun ownership from 2007 to 2016.
Age/sex standardised firearm and non-firearm suicide rates.
Across 46 states and 1.93 billion person-years, there were 1387 suicides among physicians and 267 714 suicides among non-physicians. Physicians and non-physicians had similar sex-standardised and age-standardised rates of total (and firearm) suicide. The sex-standardised total suicide rate for physicians was 1.10 (95% CI 0.98 to 1.22) times that of non-physicians and the age-standardised total suicide rate was 0.97 (95% CI 0.86 to 1.09) times that for non-physicians. Female, younger (<30 years) and older (>60 years) physicians had significantly higher suicide rates compared with non-physicians. Firearms were the most common cause of suicide in both physicians (48.2%) and non-physicians (51.7%). In high gun ownership states compared with low, physicians had 5.1 (95% CI 4.25 to 6.02) and 4.87 (95% CI 4.09 to 5.83) times more sex and age-standardised firearm suicides and no significant differences in non-firearm suicides. The percentage of suicides that were firearm suicides (FS/S), and the demographic patterns of FS/S, were largely similar for physicians and non-physicians. FS/S was highest among those who were older, white non-Hispanic, men and living in the South.
Physicians in high gun states have higher suicide rates than physicians in low gun states, because of their higher rates of firearm suicide. This evidence may support suicide prevention efforts in addressing physician attitudes and behaviours related to firearms, to minimise risks to both physicians and their patients.
确定医生的自杀率是否与普通人群相似，以及枪支在其中所起的作用。
横断面研究（2010 - 2021年）。
美国46个州。
参与国家暴力死亡报告系统的各州人群。
2007年至2016年各州家庭枪支拥有情况。
年龄/性别标准化的枪支自杀率和非枪支自杀率。
在46个州，共19.3亿人年的随访中，医生中有1387例自杀，非医生中有267714例自杀。医生和非医生的性别标准化和年龄标准化的总（及枪支）自杀率相似。医生的性别标准化总自杀率是非医生的1.10倍（95%置信区间0.98至1.22），年龄标准化总自杀率是非医生的0.97倍（95%置信区间0.86至1.09）。女性、年龄较小（<30岁）和年龄较大（>60岁）的医生自杀率显著高于非医生。枪支是医生（48.2%）和非医生（51.7%）自杀的最常见原因。与低枪支拥有率州相比，高枪支拥有率州的医生性别和年龄标准化枪支自杀率分别高出5.1倍（95%置信区间4.25至6.02）和4.87倍（95%置信区间4.09至5.83），非枪支自杀率无显著差异。医生和非医生的枪支自杀占自杀总数的百分比（FS/S）及其人口统计学模式基本相似。FS/S在年龄较大、非西班牙裔白人、男性以及居住在南方的人群中最高。
高枪支拥有率州的医生自杀率高于低枪支拥有率州的医生，原因是他们的枪支自杀率更高。这一证据可能支持自杀预防工作，以解决医生与枪支相关的态度和行为问题，从而将对医生及其患者的风险降至最低。
