Author ORCID Identifier
https://orcid.org/0000-0002-4584-9337
N/A
https://orcid.org/0000-0002-1312-9773
https://orcid.org/0000-0002-9446-0459
N/A
Document Type
Article
Publication Date
2009
College/Unit
School of Medicine
Department/Program/Center
Community Practice
Abstract
Background
Clinician training deficits and a low and declining autopsy rate adversely impact the quality of death certificates in the United States. Self-report and records data for the general population indicate that proximate mental and physical health of minority suicides was at least as poor as that of white suicides.
Methods
This cross-sectional mortality study uses data from Multiple Cause-of-Death (MCOD) public use files for 1999–2003 to describe and evaluate comorbidity among black, Hispanic, and white suicides. Unintentional injury decedents are the referent for multivariate analyses.
Results
One or more mentions of comorbid psychopathology are documented on the death certificates of 8% of white male suicides compared to 4% and 3% of black and Hispanic counterparts, respectively. Corresponding female figures are 10%, 8%, and 6%. Racial-ethnic discrepancies in the prevalence of comorbid physical disease are more attenuated. Cross-validation with National Violent Death Reporting System data reveals high relative underenumeration of comorbid depression/mood disorders and high relative overenumeration of schizophrenia on the death certificates of both minorities. In all three racial-ethnic groups, suicide is positively associated with depression/mood disorders [whites: adjusted odds ratio (AOR) = 31.9, 95% CI = 29.80–34.13; blacks: AOR = 60.9, 95% CI = 42.80–86.63; Hispanics: AOR = 34.7, 95% CI = 23.36–51.62] and schizophrenia [whites: AOR = 2.4, 95% CI = 2.07–2.86; blacks: AOR = 4.2, 95% CI = 2.73–6.37; Hispanics: AOR = 4.1, 95% CI = 2.01–8.22]. Suicide is positively associated with cancer in whites [AOR = 1.8, 95% CI = 1.69–1.93] and blacks [AOR = 1.8, 95% CI = 1.36–2.48], but not with HIV or alcohol and other substance use disorders in any group under review.
Conclusion
The multivariate analyses indicate high consistency in predicting suicide-associated comorbidities across racial-ethnic groups using MCOD data. However, low prevalence of documented comorbid psychopathology in suicides, and concomitant racial-ethnic discrepancies underscore the need for training in death certification, and routinization and standardization of timely psychological autopsies in all cases of suicide, suspected suicide, and other traumatic deaths of equivocal cause.
Digital Commons Citation
Rockett, Ian R H; Lian, Yinjuan; Stack, Steven; Ducatman, Alan M.; and Wang, Shuhui, "Discrepant comorbidity between minority and white suicides: a national multiple cause-of-death analysis" (2009). Faculty & Staff Scholarship. 2862.
https://researchrepository.wvu.edu/faculty_publications/2862
Source Citation
Rockett, I.R., Lian, Y., Stack, S. et al. Discrepant comorbidity between minority and white suicides: a national multiple cause-of-death analysis. BMC Psychiatry 9, 10 (2009). https://doi.org/10.1186/1471-244X-9-10
Comments
© 2009 Rockett et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.