Indirect standardization for rare events and a dynamic standard population rate: An analysis and simulation of U.S. military suicide mortality rates

2021 ◽  
Author(s):  
Derek J. Smolenski ◽  
Parrish P. Balcena ◽  
Jennifer Tucker ◽  
Justin C. Curry
Keyword(s):  
Rare Events ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Standard Population ◽  
Indirect Standardization ◽  
Military Suicide ◽  
Population Rate

Global Suicide Mortality Rates – A Light at the End of the Tunnel?

Crisis ◽  
2012 ◽  
Vol 33 (5) ◽  
pp. 249-253 ◽  
Author(s):  
José Manoel Bertolote ◽  
Diego De Leo
Keyword(s):  
Mortality Rates ◽  
Suicide Mortality

Caring Letters for Military Suicide Prevention

2017 ◽  
pp. 240-254 ◽  
Author(s):  
David D. Luxton
Keyword(s):  
Psychiatric Patients ◽  
Controlled Trial ◽  
Suicide Mortality ◽  
Suicide Intervention ◽  
Empirically Supported ◽  
Us Military ◽  
Risk Patients ◽  
High Level ◽  
Military Suicide ◽  
Suicide Behaviors

The caring letters concept is a suicide intervention that involves the routine sending of the brief expressions of care to high-risk patients following hospitalization or emergency department treatment. Caring letters is one of the only interventions that has been shown to reduce suicide mortality rates in a randomized controlled trial. Additional studies using various modalities including email, SMS texting, postcards, and phone contacts have further supported the caring letters concept in preventing suicide behaviors. Given the high level of suicide risk among posthospitalized psychiatric patients and the rise in suicide rates within the US military over the past decade, it is important to implement empirically supported interventions. This chapter describes the caring letters intervention and a test of the intervention at US military and veterans hospitals. The theoretical basis for the intervention, as well as practical procedures and recommendations for implementing caring contact programs, are discussed.

Suicides in Los Angeles County in Relation to the Northridge Earthquake

2004 ◽  
Vol 19 (04) ◽  
pp. 307-310 ◽  
Author(s):  
Kimberley Shoaf ◽  
Cary Sauter ◽  
Linda B. Bourque ◽  
Christian Giangreco ◽  
Billie Weiss
Keyword(s):  
Los Angeles ◽  
Rare Events ◽  
The United States ◽  
Suicide Mortality ◽  
Northridge Earthquake ◽  
Systematic Relationship ◽  
Suicide Rates ◽  
Significant Difference ◽  
Before And After ◽  
Over Time

AbstractIntroduction:Recently, there has been speculation that suicide rates increase after a disaster. Yet, in spite of anecdotal reports, it is difficult to demonstrate a systematic relationship between suicide and disaster. Suicides are fairly rare events, and single disasters rarely have covered geographic areas with large enough populations to be able to find statistically significant differences in such relatively rare events (annual suicide rates in the United States average 12/100,000 population).Hypothesis:Suicide rates increased in the three calendar years (1994–1996) following the Northridge earthquake as compared to the three calendar years (1991–1993) prior to the earthquake. Likewise the suicide rates for 1993 are compared with the rates in 1994. By looking at the suicide rates in a three-year period after the earthquake, the additional disasters that befell Southern California in 1995 and 1996 may have had an additive effect on psychological disorders and suicide rates that can be measured.Methods:Data on suicide mortality were compiled for the years from 1989 through 1996. Differences in rates for 1993 compared with 1994 and for three-year periods before and after the earthquake (1991–1993 vs. 1994 –1996) were analyzed using az-statistic.Results:There is a statistically significant difference in the rates for the years prior to the earthquake (1991–1993) when pooled and compared to the suicide rates for the years after the earthquake (1994–1996). The rates of suicide are lower in the three years following the earthquake (11.85 vs. 13.12/100,000 population) than they are in the three years prior to the earthquake (z= -3.85,p<0.05). Likewise, there is a similar difference when comparing 1993 to 1994 (11.77 vs. 13.84,z= -3.57,p<0.05). The patterns of suicide remain similar over time, with males and non-Hispanic Whites having the highest rates of suicide.Conclusion:It does not appear that suicide rates increase as a result of earthquakes in this setting. This study demonstrates that the psychological impacts of the Northridge earthquake did not culminate in an increase in the rates of suicide.

Marital status and suicide as a competing cause of mortality among cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19113-e19113
Author(s):  
Nosayaba Osazuwa-Peters ◽  
Matthew C Simpson ◽  
Eric Y Du ◽  
Scott A Hong ◽  
Aleksandr R Bukatko ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Marital Status ◽  
Head And Neck ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Cancer Site ◽  
Mortality Risks

e19113 Background: The risk of suicide among cancer survivors more than double that of the general population, highlighting the need to mitigating risk factors for suicide. While several studies have described marital status, a surrogate for social support, as associated with cancer mortality, it is inconclusive whether marital status impacts suicide as a competing cause of cancer mortality. We tested this hypothesis by describing the association of marital status and suicide among survivors of four cancer sites with the highest suicide mortality rates in the United States. Methods: Adult cancer patients were identified from the Surveillance, Epidemiology and End Results database from 2004 to 2016 for four index cancer sites previously identified with highest suicide mortality rates: pancreas, head and neck, lung/bronchus and stomach ( n = 800,798). Cumulative incidence curves stratified by marital status (divorced/separated, widowed, never unmarried, and married/partnered) estimated unadjusted probability of suicide (outcome of interest). A multivariable competing risk proportional hazards model yielded sub-distribution hazard ratios (sdHRs) and 95% confidence intervals (CI) to estimate the association of marital status with suicide for each cancer site, while controlling for clinical and nonclinical factors. Results: Half (50.7%) of the cohort were married/partnered, males (56.8%), and non-Hispanic whites (71.0%). Mean age at diagnosis was 67.3 years. Most patients (60.9%) had cancer in the lung/bronchus, 17.9% head and neck, 13.8% pancreas, and 8.3% stomach. Unadjusted probability of suicide was highest among head and neck cancer survivors (0.3%). In the fully adjusted model, mortality by suicide was more likely among divorced/separated patients vs. married/partnered patients across cancer sites (sdHRhead and neck = 1.81; 95% CI 1.38, 2.37; sdHRlung/bronchus = 1.68; 95% CI 1.28, 2.19; sdHRpancreas = 2.19; 95% CI 1.27, 3.78; and sdHRstomach = 2.38; 95% CI 1.17, 4.58). Additionally, for lung/bronchus cancer, patients who were never married patients were more likely to die by suicide than those married/partnered (sdHRlung/bronchus = 1.47; 95% CI 1.09, 1.98). Conclusions: Marital status is associated with suicide mortality among cancer survivors, and divorced/separated survivors may have greater suicide mortality risks, independent of cancer site. As overall probability of suicide remains low, these findings might help identify cancer survivors who may be candidates for ongoing surveillance and psychosocial support to mitigate suicide mortality risks.

scholarly journals Age-Period-Cohort Analysis of Suicide Mortality Rates in Spain, 1959–1991

1996 ◽  
Vol 25 (4) ◽  
pp. 814-820 ◽  
Author(s):  
JUAN J GRANIZO ◽  
ELISEO GUALLAR ◽  
FERNANDO RODRÍGUEZ-ARTALEJO
Keyword(s):  
Cohort Analysis ◽  
Mortality Rates ◽  
Suicide Mortality

scholarly journals COVID-19 mortality across selected states in India: the role of age structure.

2021 ◽  
Author(s):  
Mohamed Jainul Azarudeen ◽  
Tanzin Dikid ◽  
Karishma Kurup ◽  
Khyati Aroskar ◽  
Himanshu Chauhan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Age Structure ◽  
Disease Surveillance ◽  
Economic Status ◽  
Age Groups ◽  
The Elderly ◽  
Mortality Rates ◽  
Health System Intervention ◽  
Indirect Standardization ◽  
Standardized Mortality Rate

Background Mortality rates provide an opportunity to identify and act on the health system intervention for preventing deaths. Hence, it is essential to appreciate the influence of age structure while reporting mortality for a better summary of the magnitude of the epidemic. Objectives We described and compared the pattern of COVID-19 mortality standardized by age between selected states and India from January to November 2020. Methods We initially estimated the Indian population for 2020 using the decadal growth rate from the previous census (2011). This was followed by estimations of crude and age-adjusted mortality rate per million for India and the selected states. We used this information to perform indirect standardization and derive the age-standardized mortality rates for the states for comparison. In addition, we derived a ratio for age-standardized mortality to compare across age groups within the state. We extracted information regarding COVID-19 deaths from the Integrated Disease Surveillance Programme special surveillance portal up to November 16, 2020. Results The crude mortality rate of India stands at 88.9 per million population(118,883/1,337,328,910). Age-adjusted mortality rate (per million) was highest for Delhi (300.5) and lowest for Kerala (35.9).The age-standardized mortality rate (per million) for India is (<15 years=1.6, 15-29 years=6.3, 30-44 years=35.9, 45-59 years=198.8, 60-74 years=571.2, & ≥75 years=931.6). The ratios for age-standardized mortality increase proportionately from 45-59 years age group across all the states. Conclusion There is high COVID-19 mortality not only among the elderly ages, but we also identified heavy impact of COVID-19 on the working population. Therefore, we recommend further evaluation of age-adjusted mortality for all States and inclusion of variables like gender, socio-economic status for standardization while identifying at-risk populations and implementing priority public health actions. Keywords COVID-19, Mortality, Age Standardized Mortality Rate, Indirect Standardization.

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