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Achieving health equity in US suicides: a narrative review and commentary.
Perry, Seth W; Rainey, Jacob C; Allison, Stephen; Bastiampillai, Tarun; Wong, Ma-Li; Licinio, Julio; Sharfstein, Steven S; Wilcox, Holly C.
Afiliación
  • Perry SW; Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. perryse@upstate.edu.
  • Rainey JC; Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. perryse@upstate.edu.
  • Allison S; Department of Neurosurgery, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. perryse@upstate.edu.
  • Bastiampillai T; Department of Public Health and Preventive Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA. perryse@upstate.edu.
  • Wong ML; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
  • Licinio J; Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
  • Sharfstein SS; Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
  • Wilcox HC; Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
BMC Public Health ; 22(1): 1360, 2022 07 15.
Article en En | MEDLINE | ID: mdl-35840968
ABSTRACT
Suicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity.The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51-85 + years old for both sexes. Of all US suicides from 1999-2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71-85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2-4 times higher suicide rates than women, despite having only 1/4-1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations.To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention depression and firearms.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Armas de Fuego / Equidad en Salud Tipo de estudio: Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Armas de Fuego / Equidad en Salud Tipo de estudio: Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos