Running head: SUICIDE

Suicide Group Two Andia Hughes-Hicks Linda Ngameduru Keir Reid-Young Sybil illiams

!oppin S"a"e #ni$ersi"y N#RS %&'( )pidemiology *r+ )mmanuel ,biako *r+ Rena -oss-.ic"oria April /&0 &'/&

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1n"roduc"ion Suicide0 "he ac" o2 "aking one3s own li2e0 has been s"eadily increasing in "he #ni"ed S"a"es+ The !en"ers 2or *isease !on"rol and 4re$en"ion 5!*!6 indica"ed "ha" 7809'9 suicide dea"hs were repor"ed in "he #+S+ in &''9+ The rise in suicide ra"es places i" as "he "en"h leading cause o2 dea"h in "he #+S+ Na"ionally: "he suicide ra"e has increased &+; percen" since &''<0 which now e=uals appro>ima"ely /&+' suicides per /''0''' people+ This is an alarming increase since &'''+ This is "he highes" ra"e o2 suicide in 2i2"een years+ According "o "he ?orbidi"y and ?or"ali"y eekly

Repor" 5?? R60 communi"ies wi"h high unemploymen"0 heal"h care dispari"ies0 and uns"able social en$ironmen"s ha$e higher le$els o2 suicide beha$iors+ 4eople who ha$e a his"ory o2 prior suicide a""emp" are a" an increased risk o2 a""aining a success2ul suicide+ The ?? R repor"ed a sur$ey "ha" was done be"ween @anuary /0 &''< "o *ecember 7/0 &''9 by "he Na"ional Sur$ey on *rug #se and Heal"h 5NS*#H60 which sur$eyed "he suicidal "hough"s0 planning0 and a""emp"s o2 persons based on race0 se>0 and age+ -urden o2 *isease Nearly /0'''0''' people make a suicide a""emp" e$ery year+ ,2 "he people who die 2rom suicides0 9'A o2 "hem ha$e diagnosable and "rea"able psychia"ric disorders "ha" ha$e gone un"rea"ed+ ?ales are 2our "imes more likely "han 2emales "o be success2ul a" suicides while 2emales are "hree "imes more likely "o a""emp" suicide+ Bor e$ery suicide dea"h "here are an es"ima"ed <-&% a""emp"ed suicides+ )$ery /;+& minu"es someone in "he #ni"ed S"a"es dies by suicide+ Suicides cos" nearly C/'' million yearly in "he medical assis"ance and managemen"s+

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Suicides among Age Groups The si>"h leading cause o2 dea"h among %-/; year olds and "he "hird leading cause o2 dea"h among "hose /%-&; year olds0 suicides are a growing concern+ Risk 2ac"ors 2or suicide among "he young include suicidal "hough"s0 psychia"ric disorders 5such as depression0 impulsi$e aggressi$e beha$ior0 bipolar disorder0 and cer"ain an>ie"y disorders60 drug andDor alcohol abuse and pre$ious suicide a""emp"s0 wi"h "he risk increased i2 "here is si"ua"ional s"ress and access "o 2irearms+ The suicide ra"es 2or men rise wi"h age0 mos" signi2ican"ly a2"er age 8%+ ?en 8% and older are se$en "imes more likely "o commi" suicide "han 2emales o2 "he same age group+ The suicide ra"es 2or women peak be"ween "he ages o2 ;%-%; years old0 and again a2"er age E%+ Abou" 8' percen" o2 elderly pa"ien"s who "ake "heir own li$es see "heir primary care physician wi"hin a 2ew mon"hs o2 "heir dea"h o2"en because o2 depression rela"ed symp"oms+ Suicidal idea"ions ha$e been repor"ed in a"leas" 7' percen" o2 pa"ien"s su22ering 2rom maFor depression+ Nine"y-si> percen" o2 alcoholics who die by suicide con"inue "heir subs"ance abuse up "o "he end o2 "heir li$es+ Thir"y percen" o2 comple"ed suicides a""ribu"e alcoholism is a predominan" 2ac"or+ Alcoholic dependences con"ribu"e "o appro>ima"ely E percen" o2 suicides+ ?any gun owners repor" keeping a 2irearm in "heir home 2or Gpro"ec"ionG or Gsel2 de2ense0G bu" <7 percen" o2 suicides are 2rom handguns and occur in "he homes0 o2"en by someone o"her "han "he gun owner+ Birearm use 2or suicides is a growing me"hod 2or sel2 harm wi"h 2irearms being used more 2or suicides "han homicides+ Bi2"y percen" o2 all suicides can be a""ribu"ed "o comple"ion by 2irearms+ ?any medically ill people consider suicide and people wi"h A1*S or H1. ha$e a higher ra"e o2 suicide idea"ions0 &' percen" more "ha" "he general popula"ion+

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Suicide Though"s and 4lans The resul"s o2 "he NS*#H sur$ey0 during &''< "o &''90 re$ealed an es"ima"ed <+7 million adul"s o$er "he age o2 /< years who repor"ed ha$ing suicidal "hough"s+ According "o "he ?? R0 suicide resul"ed in 780'7% dea"hs during "he year o2 &''<0 which "ransla"ed "o "he "en"h leading cause o2 dea"h during "ha" year+ *uring &''< "o &''90 "he NS*#H sur$eyed 9&0&8; people $ia in-person in"er$iews o$er "he age o2 /< years0 on suicidal "hough"s and beha$iors+ The highes" repor"ed pre$alence o2 suicidal "hough"s and plans were non-Hispanic whi"es0 which resul"ed in an es"ima"ed si> million non-Hispanic whi"es or 7+9 percen" o2 "he whi"e popula"ion during &''< "o &''9: howe$er0 9//0''' non-Hispanic blacks in "he #ni"ed S"a"es or 7+% percen" o2 "he black popula"ion had suicidal "hough"s wi"hin "ha" same year+ Suicidal plans0 an ac"ual road map consis"ing o2 $arious s"eps "ha" would be "aken "o carry ou" an e22ec"i$e suicide0 were also sur$eyed by "he Na"ional Sur$ey on *rug #se and Heal"h+ An es"ima"ed &+& million adul"s in "he #ni"ed S"a"es during &''< "o &''9 had plans "o commi" suicide+ *uring "ha" period0 an es"ima"ed /+8 million non-Hispanic whi"es cons"ruc"ed plans "o commi" suicide0 which "ransla"es "o / percen" o2 "ha" popula"ion+ Appro>ima"ely0 &8&0''' blacks made suicide plans during "he &''< "o &''9 year0 which is / percen" o2 "he #ni"ed S"a"es black popula"ion during "ha" period+ Suicide A""emp"s Suicide a""emp"s0 an unsuccess2ul suicide0 were sur$eyed by "he NS*#H "o de"ermine which groups were more suscep"ible "o commi" "o such an ac"+ Speci2ic groups0 such as $arious age groups ranging 2rom /< "o &9 and persons grea"er "han or e=ual "o "he age o2 7'0 $arious e"hnici"ies and races0 and genders were compared "o e$alua"e which groups were more likely "o

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a""emp" suicide+ *uring &''< "o &''90 8870''' whi"e adul"s a""emp"ed suicide compared "o /<&0''' black adul"s wi"hin "ha" same period+ There2ore0 percen"age-wise0 '+; percen" o2 "he whi"e popula"ion compared "o '+E percen" o2 "he black popula"ion a""emp"ed suicide wi"hin "ha" year+ ?or"ali"y Suicide mor"ali"y ra"es $ary across "he #ni"es S"a"es+ 1n "he #S0 "he ra"e o2 dea"hs 2or suicides remains cons"an" around 7%A+ This is an alarming number when Heal"hy 4eople &'&' obFec"i$es 5!*!0 &'/&6 2ocus on a""aining a ra"e less "han %A per /''0''' persons+ 1n -al"imore0 "he suicide ra"es in A2rican Americans s"ar"ed high bu" began "o drop only "o re"urn "o "he higher ra"e0 while among Non- hi"es "he ra"e has con"inue "o remain cons"an"+ ?ul"iple reasons are behind "he suicide ra"e 2luc"ua"ions wi"h "he economy as o2 la"e being "he la"es" reason+ 4hiladelphia has shown s"a"is"ically "o ha$e a signi2ican"ly higher ra"e o2 suicide0 wi"h Nonhi"es ha$ing succeeded in suicide more so "han A2rican Americans 5see Graphs / H &6+ !onclusion Suicide0 now one o2 "he mos" leading causes o2 dea"h0 can be pre$en"ed wi"h proper "rea"men" modali"ies+ ,ne o2 "he mos" e22ec"i$e "rea"men"s is "alk "herapy+ Talk "herapy is a modali"y "ha" enables "he pa"ien" "o 2ocus on how "heir own "hough"s and beha$iors a22ec" "hem+ 4rograms $ia schools are help2ul in recogniIing and aiding "eenagers who ha$e problems wi"h suicidal idea"ions 5*ryden-)dwards0 &'//6+ !onsis"en" care and in"erac"ions enable open lines o2 communica"ion and allow 2or changes "o be no"ed early and ac"ed on+ Nurse 4rac"i"ioners are 2aced wi"h "he 2ac" "ha" i" is becoming more elusi$e "o no"ice and "rea" people wi"h suicidal

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idea"ions+ Bu"ure goals are 2ocused on be""er assessmen" o2 suicidal "hough"s and promp" e22icien" "rea"men" 5*ryden-)dwards0 &'//6+

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Tables Table /( Suicidal ?or"ali"y in -al"imore0 &''' J &'/' Year &''' &''/ &''& &''7 &''; &''% &''8 &''E &''< &''9 &'/' To"al Number o2 Suicidal ?or"ali"y 8& 8/ ;< ;; 77 79 88 %E ;% %' 8' Number o2 A2ricanAmericans &7 &9 &E &7 &/ /% 7; &% /8 /< /7 Number o2 NonHispanic hi"es 79 7& &' &' /& &7 7/ &9 &8 7/ ;;

Table &( Suicidal ?or"ali"y in 4hiladelphia0 /999 J &'/' Year To"al Number o2 Suicidal ?or"ali"y /%7 /8& /7< /%E /87 /%/ /8' /77 /&% /&< /%' Number o2 A2ricanAmericans K K K K 8' ;' &; 7/ 7& ;7 ;E Number o2 NonHispanic hi"es K K K K /'/ /'8 97 88 E< /// <<

/999 &''' &''/ &''& &''7 &''; &''% &''8 &''E &''< &''9

K*a"a una$ailable 2or years earlier "han &''7

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#S ?or"ali"y Ra"es 2or A2rican Americans and Non-Hispanic

Year /999 &''' &''/ &''& &''7 &''; &''% &''8 &''E To"al 4opula"ion &E&0E<E0;<% &<&0/8&0;// &<;098<09%% &<E08&%0/97 &9'0/'E0977 &9&0<'%0&9; &9%0%/80%99 &9<07E909/& 7'/0&7/0&'E A2rican Americans 7%+7 7%+& 7%+E 78+/ 7%+7 78+' 7%+8 7%+% 7%+9

hi"es
hi"es

Non-Hispanic &7+; &7+; &;+/ &;+E &;+& &;+8 &;+% &;+E &;+;

-al"imore !i"y 4opula"ion0 &''' - &'/'

Year &''' &''/ &''& &''7 &''; &''% &''8 &''E &''< &''9 &'/' To"al 4opula"ion 8%/0/%; 8;%07'% 87<08/; 8;707'; 8;/09;7 8;'0'8; 8;'098/ 8;'0/%' 87809/9 87E0;/< 8&'098/ Number o2 A2ricanAmericans ;/<09%/ ;/70&%7 ;/&0&&% ;//09E& ;'90<EE 7980;9% ;'80;9/ ;'E0<%/ ;'/0%E7 ;'&0E&/ 79%0E</ Number o2 NonHispanic hi"es &'%09<& /990E<8 /990&9' /990/8E /980&&/ /<709E; /9%0'7' &'809&/ /980//& &//0&<% /<70<7'

4hiladelphia 4opula"ion0 /999 J &'/'

Year /999 &''' &''/ &''& &''7 &''; &''% &''8 &''E &''< &''9 &'/' To"al 4opula"ion /0;/E08'/ /0;<80%9; /0;9<0%'/ /0;9&0&7/ /0;E90779 /0;E'0/%/ /0;870&</ /0;;<079; /0;;9087; /0;;E079% /0%;E0&9E /0%&80''8 Number o2 A2ricanAmericans 8/&0/9; 8%%0<&; No *a"a No *a"a 88<0/'7 8E'09E& 88909'' 8%<0/9E 8&80''& 8%&098< 8;'088% 8;;0&<E Number o2 NonHispanic hi"es E;'0';8 8<70&8E No *a"a 8%/0%%< E'80/'; E'&08;/ %E<0E77 %8%0&'& %E'0<88 %E'0<88 8%E087; %8&0%<%

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Graphs Graph /( ?or"ali"y Ra"es 2or -al"imore and "he #S

Graph &( ?or"ali"y Ra"es 2or 4hiladelphia and "he #S

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10

Re2erence !en"er 2or *isease !on"rol+ 5&'/&6+ Suicides+ Re"rie$ed on April 90 &'/& 2rom h""p(DDwww+cdc+go$D.iolence4re$en"ionDsuicideDinde>+h"ml+ !i"y o2 4hiladelphia 4ublic Heal"h+ 5&'/'6+ 4hiladelphia .i"al S"a"is"ic Repor"s+ Re"rie$ed on April 90 &'/& 2rom h""p(DDwww+phila+go$Dheal"hD!ommissionerD.i"alS"a"is"ics+h"ml+ !rosby0 ?*0 A+ )+0 Han0 ?*0 4h*0 -+0 ,r"ega0 ?*0 L+0 4arks0 4h*0 S+0 H G2roerer0 -A0 @+ 5&'//6+ Suicidal Though"s and -eha$iors Among Adul"s Aged L /< Years-#ni"ed S"a"es0 &''<-&''9+ Morbidity and Mortality Weekly Report, 605/760 /-&&+ *ryden-)dwards0 ?*0 R+ 5&'//6+ Suicides+ Re"rie$ed on April E0 &'/& 2rom h""p(DDwww+medicinene"+comDscrip"DmainDar"+aspMar"iclekeyN&;;/<+ ?aryland Assessmen" Tool 2or !ommuni"y Heal"h+ 5&'/&6+ Suicide+ Re"rie$ed on April 90 &'/& 2rom h""p(DDwww+ma"chs"a"s+orgDcgi-binDbroker+dllM OS)R.1!)N?*?AT!HHO4R,GRA?Nma"ch+dea"hsmap+sas+ 4hiladelphia .i"al S"a"is"ics+ 5&'//6+ Re"rie$ed on April 90 &'/& 2rom h""p(DDwww+phila+go$Dheal"hDpd2sD&''EA&'.i"alA&'S"a"is"ics A&'Repor"O/'+/+/'O2inal+pd2+ #S !ensus -ureau+ 5&'/'6+ *ea"h Ra"es by Suicides+ Re"rie$ed on April 90 &'/& 2rom www+census+go$DcompendiaDs"a"abD&'//D"ablesD//s'/&%+>ls - &'/'-/&-'E+