Death by Suicide-The EMS Profession Compared to the General Public.

BACKGROUND: In 2016, nearly 45,000 deaths in the United States were attributed to suicide making this the 10th leading cause of death for all ages. National survey data suggest that among Emergency Medical Technicians (EMTs), including firefighters and Paramedics, rates of suicide are significantly higher than among the general public. EMTs face high levels of acute and chronic stress as well as high rates of depression and substance abuse, which increase their risk of suicide. OBJECTIVE/AIM: To determine the statewide Mortality Odds Ratio (MOR) of suicide completion among EMTs as compared to non-EMTs in Arizona. METHODS: We analyzed the Arizona Vital Statistics Information Management System Electronic Death Registry of all adult (≥18) deaths between January 1, 2009 and December 31, 2015. Manual review of decedent occupation was performed to identify the EMT cohort; all other deaths were included in the non-EMT cohort. Using the underlying cause of death as the outcome, we calculated the MOR of both the EMT and non-EMT cohorts. RESULTS: There were a total of 350,998 deaths during the study period with 7,838 categorized as suicide. The proportion of deaths attributed to suicide among EMTs was 5.2% (63 of 1,205 total deaths) while the percentage among non-EMTs was 2.2% (7,775/349,793) (p < 0.0001). The crude Mortality Odds Ratio for EMTs compared with non-EMTs was [cMOR 2.43; 95% CI (1.88-3.13)]. After adjusting for gender, age, race, and ethnicity, EMTs had higher odds that their death was by suicide than non-EMTs [aMOR: 1.39; 95% CI (1.06-1.82)]. CONCLUSION: In this statewide analysis, we found that EMTs had a significantly higher Mortality Odds Ratio due to suicide compared to non-EMTs. Further research is necessary to identify the underlying causes of suicide among EMTs and to develop effective prevention strategies.

Racial/Ethnic Disparities in Rates of Traumatic Injury in Arizona, 2011-2012.

OBJECTIVE: The purpose of this study was to compare the rates of traumatic injury among five racial/ethnic groups in Arizona and to identify which mechanisms and intents of traumatic injury were predominant in each group. METHODS: We obtained 2011 and 2012 data on traumatic injury from Arizona's trauma registry and data on mortality from Arizona's death registry. We calculated location- and age-adjusted rates (aRs) of traumatic injury and rates of mortality per 100,000 Arizona residents and rate ratios (RRs) for each racial/ethnic group. We also calculated race/ethnicity specific aRs and RRs by mechanism of injury, intent of injury, and alcohol use. RESULTS: We analyzed data on 58,034 cases of traumatic injury. After adjusting for age and location, American Indians/Alaska Natives (AI/ANs) had the highest overall rate of traumatic injury (n = 6,287; aR = 729) and Asian Americans/Pacific Islanders had the lowest overall rate of traumatic injury (n = 553; aR = 141). By intent, AI/ANs had the highest rate of homicide/assault-related traumatic injury (n = 2,170; aR = 221) and by mechanism, non-Hispanic black/African American people had the highest rate of firearm-related traumatic injury (n = 265; aR = 40). In 2011-2012, 8,868 deaths in Arizona were related to traumatic injury. AI/ANs had the highest adjusted mortality rate (n = 716; aR = 95). CONCLUSION: Racial/ethnic disparities in traumatic injuries persisted after adjusting for age and injury location. Understanding how these disparities differ by mechanism, intent, and alcohol use may lead to the development of more effective initiatives to prevent traumatic injury.