Examining Contextual Differences in Suicide by Rural-urban Designation and Military Status, 2009-2019: a Cross-sectional Analysis of the National Violent Death Reporting System.

Details

• Alternative Title:
  Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention, 2025, v. 31, no. 2: Examining Contextual Differences in Suicide by Rural-urban Designation and Military Status, 2009-2019: a Cross-sectional Analysis of the National Violent Death Reporting System.
• Journal Article:
  Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention
• Personal Author:
  Vakkalanka, J Priyanka ; Leon, Eliezer Santos ; Davis, Jon ; Williams, Cameron ; Castee, Carri
• Description:
  To evaluate differences in mental health and substance use circumstances by rurality and military affiliations among suicide decedents.
  
  Multiyear (2009-2019) cross-sectional study of adult suicide decedents reported to the National Violent Death Reporting System. We classified suicide decedents into a four-level variable by geography (urban/rural) and military status and evaluated the prevalence of current and past alcohol and substance use problems, mental health problem recognition and mental illness treatment. We estimated prevalence ratios using multiple imputation chain equations to account for missing data and log-binomial regression models and present stratified estimates by military and rural classification.
  
  There was no significant relationship between rural-military classification and alcohol use problem. Compared with urban civilians, other groups had a lower risk identified of having a substance use problem: urban military (adjusted prevalence ratio (aPR): 0.65; 95% CI: 0.60 to 0.71), rural military (aPR: 0.57; 95% CI: 0.50 to 0.66) and rural civilians (aPR: 0.95; 95% CI: 0.90 to 1.00). Recognition of a mental health problem was lower among both rural military (aPR: 0.88; 95% CI: 0.81 to 0.96) and rural civilians (aPR: 0.89; 95% CI: 0.86 to 0.92). The likelihood of current mental treatment was lower in other groups (urban military (aPR: 0.93; 95% CI: 0.89 to 0.96); rural military (aPR: 0.87; 95% CI: 0.81 to 0.94); and rural civilian (aPR: 0.89; 95% CI: 0.85 to 0.92)). There was no evidence of effect modification by military and rural classification for any outcome.
  
  Mental health outcomes by military affiliation and urbanicity/rurality may need to be independently assessed as social determinants of health.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Cross-Sectional Studies
  • Male
  • Female
  • Rural Population
  • Adult
  • Urban Population
  • Middle Aged
  • Military Personnel
  • Suicide
  More +
• Keywords:
  • Suicide
  • Rural health
  • Military personnel
  • Public health surveillance
  • Social determinants of health
• Source:
  Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention, 2025, v. 31, no. 2
• DOI:
  https://doi.org/10.1136/ip-2024-045430
• ISSN:
  1353-8047 ; 1475-5785
• Pubmed ID:
  40011043
• Pubmed Central ID:
  PMC13075480
• Document Type:
  Text
• Funding:
  R49 CE003095/CE/NCIPC CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  121-127 (19 pdf pages)
• Volume:
  31
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261646/cdc_261646_DS1.pdf
• File Type:
  [PDF - 632.44 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b3d8b2f98c2cf5be4d28e8ba97cda83c3d392f231c9214132f0fd8024e6ff10e6fd890a1ff8ff1b8358f33f2b865141f304073b65cdd85cb32fed159f32006a3