What is it about?

Suicides are undercounted in the United States, in part reflecting data discrepancies based on race/ethnicity and sex. This study applies an enhanced concept of self-injury mortality (SIM), as a composite of registered suicides and estimated “accidental”/undetermined intent substance-related fatalities, to place racial/ethnic and sex differences in a new light. Examination of SIM-to-suicide rate gaps exposed substantial excess burdens from substance poisoning for minorities, especially non-Hispanic Blacks, and for women generally. Arbitrary distinctions based on determining the proximate manner of death fail to provide the necessary foundation for planning effective upstream prevention and clinical intervention strategies in the face of rapidly rising suicide and drug overdose death rates.

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Why is it important?

Applying a more comprehensive category than suicide for self-injury mortality in the USA has exposed excesses in drug poisoning deaths and premature mortality for minorities relative to non-Hispanic Whites and women relative to than men regardless of their race/ethnicity. Prevention and treatment efforts need to target all groups and to address risk factors, like social inequality, that are common both to suicide and non-suicide drug self-intoxication deaths.


The research for this article has benefited from the experience and wisdom of people representing such diverse disciplines as epidemiology, social science, biostatistics, psychiatry, emergency medicine, toxicology and forensic pathology. Ending the inter-connected 21st century epidemics of suicide and opioid mortality in the USA will require comprehensive and sustained approaches involving multiple stakeholders.

Ian Rockett
West Virginia University

Read the Original

This page is a summary of: Unrecognised self-injury mortality (SIM) trends among racial/ethnic minorities and women in the USA, Injury Prevention, September 2019, BMJ,
DOI: 10.1136/injuryprev-2019-043371.
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