Comparing Precipitating Circumstances Among Military and Non-Military Men Who Died By Suicide

Background and Purpose:  Suicide is among the top 10 leading causes of death in the United States and, according to the National Center For Health Statistics 2016 report, suicide is increasing for all U.S. populations. Age-adjusted suicide rates have increased 24% from 1999 to 2014. This issue is particularly concerning among military service members and veterans (SM-V), as research shows elevated risk within this population. Suicide is the second leading cause of death among the armed forces. Furthermore, suicide rates in the state of Utah far exceed those of other states, ranking fifth highest in the nation in 2014.  Little research examines suicide deaths in the state of Utah, especially with Utah’s SM-V population.  In addition, no research we are aware of has studied Utah SM-Vs using data from the National Violent Death Reporting System (NVDRS).  The present study was exploratory in nature and aimed to fill this gap by examining risk factors and other NVDRS precipitating circumstance variables among SM-V suicide decedents compared to non-military suicide decedents in Utah.

Methods:  This study used the publically available NVDRS data set, which acts as a census of all suicide deaths and reports the total number of decedents who experienced each risk factor or other precipitating circumstance variable prior to death (e.g., mental health diagnosis, history of suicide attempts, relationship problems, etc.). We examined all Utah males who died by suicide from 2005 to 2014, both SM-V (N= 678) and non-military (N= 2,762). Twenty variables were examined to determine, of the decedents who experienced each variable, the proportion who were military vs. non-military. We meta-analyzed proportions across 10 years. The obtained proportions were then compared against expected proportions (SM-V 20% non-military 80%; obtained from a meta-analysis of total suicide deaths) using binomial z tests of proportions.

Results: Binomial z tests that showed significantly different proportions than expected revealed which risk factors may be particularly more or less salient for SM-Vs. Military males who died by suicide were significantly more likely to have experienced physical health problems compared to non-military males. Risk factors and other precipitating circumstances that were significantly lower than expected in military men included a history of suicide attempts, experiencing a crisis in the past 2 weeks, an intimate partner problem, other relationship problems, alcohol dependence, other substance problems, recent criminal legal problems, and job problems.

Conclusions and Implications:  The elevated risk in SM-Vs of experiencing physical health problems prior to suicide death may warrant added attention given that combat exposure is associated with lower physical health functioning among veterans of the recent Iraq and Afghanistan conflicts. The risk factors identified as less or equally prevalent in military males compared to non-military males still require attention when assessing for suicide risk.  The present findings encourage clinicians to recognize that many military men may not fit the typical risk profile of non-military men.  This increased understanding can improve prevention efforts of social workers, psychologist and other professionals working with this vulnerable population.