Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement.
Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement.
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DOI：
10.1038/s41380-021-01078-1
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发表时间：
2021-07
影响因子：
11
通讯作者：
Keyes KM
中科院分区：
文献类型：
--
作者：
Martínez-Alés G;Pamplin JR 2nd;Rutherford C;Gimbrone C;Kandula S;Olfson M;Gould MS;Shaman J;Keyes KM
性别、种族和自杀方式在最近美国自杀死亡率上升中的作用尚不清楚。估计自杀死亡率趋势背后的年龄、时期和队列效应可以为因果假设的生成过程提供重要的见解。我们使用1999年至2018年美国所有死亡证明的数据，对美国近期自杀死亡率进行了更新的年龄期队列效应估计，研究了性别、种族和自杀方法的假定作用。在根据ICD-10潜在死亡原因代码X60-X84、Y87.0和U03指定可归因于自杀的死亡后，我们(i)使用六边形网格直观地描述年龄、时期和队列的自杀率，（ii）模拟性别、种族和自杀方法特定的年龄、时期和队列效应。我们发现，尽管1999年至2018年期间美国的自杀死亡率在年龄、性别、种族和自杀方式方面都有所上升，但在年龄和群体效应方面，在方法、性别和种族方面存在很大的异质性，自杀风险的第一个高峰是年轻人，第二个高峰是年龄较大的男性枪支自杀，而非白人的年轻群体的自杀风险则有所上升。我们的研究结果应该促进有关年龄特异性临床枪支安全干预措施、少数群体不良早期生活经历的驱动因素以及精神卫生保健获取和质量的种族差异的讨论。
The role of sex, race, and suicide method on recent increases in suicide mortality in the United States remains unclear. Estimating the age, period, and cohort effects underlying suicide mortality trends can provide important insights for the causal hypothesis generating process. We generated updated age-period-cohort effect estimates of recent suicide mortality rates in the US, examining the putative roles of sex, race, and method for suicide, using data from all death certificates in the US between 1999 and 2018. After designating deaths as attributable to suicide according to ICD-10 underlying cause of death codes X60-X84, Y87.0, and U03, we (i) used hexagonal grids to describe rates of suicide by age, period, and cohort visually and (ii) modeled sex-, race-, and suicide method-specific age, period, and cohort effects. We found that, while suicide mortality increased in the US between 1999 and 2018 across age, sex, race, and suicide method, there was substantial heterogeneity in age and cohort effects by method, sex, and race, with a first peak of suicide risk in youth, a second peak in older ages—specific to male firearm suicide, and increased rates among younger cohorts of non-White individuals. Our findings should prompt discussion regarding age-specific clinical firearm safety interventions, drivers of minoritized populations’ adverse early-life experiences, and racial differences in access to and quality of mental healthcare.
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