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The authors are affiliated with the Epidemiologic Research and Information Center, Department of Veterans Affairs Puget Sound Health Care System, 1100 Olive Way, Number 1400, Seattle, WA 98101 (e-mail: firstname.lastname@example.org). Amy M. Kilbourne, Ph.D., M.P.H., and Tami L. Mark, Ph.D., are editors of this column.
Recent research suggests that veterans are at increased risk of suicide (1). Our purpose is to compare suicide rates among veterans and nonveterans in Washington State.
Numbers of deaths from suicide were obtained from the Washington State Department of Health for the years 2000 through 2006. These records included the underlying cause of death as well as veteran status, gender, age, and year of death. ICD-10 codes X60—X84 and Y87.0 defined suicide as the underlying cause of death. The numbers of veterans in Washington State were obtained from VetPop, the VA's official estimate and projection of the veteran population. The numbers of nonveterans were determined by subtracting the veteran population from the total population. Total Washington State population by year and age was obtained from the Washington State Office of Financial Management. We calculated age-specific death rates for men aged 18—44, 45—64, and ≥65 for the years 2000 through 2006. Rates for women were not calculated, because there were few suicides in the veteran group.
Suicide rates for veterans aged 18—44 fluctuated from a high of 47.5 per 100,000 in 2002 to a low of 26.0 per 100,000 in 2006. Rates for nonveterans were much lower and remained stable at about 22 per 100,000 during the seven-year period (Figure 1). The suicide rates for veterans aged 45—64 increased 25%, from 26.8 to 33.6 per 100,000 during the study period, and the rate for nonveterans increased 23%, from 20.4 to 25.1 per 100,000. Suicide rates in the oldest group were over 40 per 100,000 in 2000 for both veterans and nonveterans. The rate for veterans was relatively constant over the seven-year period, whereas for nonveterans there was a decrease of 38% (45.9 to 28.5 per 100,000). Deaths due to suicide were <40 per year in the nonveteran group, resulting in fluctuating death rates.
There was an increase in the suicide rate among veterans 45—64, yet the highest rates were among older veterans (veterans comprised the majority of men aged ≥65). In 2006 suicide rates were higher among veterans than among nonveterans in all age categories. Whether these numbers are representative of the rest of the country is uncertain because of wide regional variation in suicide rates, although older white males have the highest suicide rates nationally (2). Because of the presence of several large military bases, Washington State has a significant veteran population, and it also has high suicide rates common to the Pacific Northwest. In conclusion, increases in the suicide rate in the middle age group as well as the high rate in the oldest group suggest that identifying and providing care for veterans who are at increased risk of suicide will be challenging for the VA, because most veterans do not receive health care from the department.
The views expressed in this article are those of the authors and do not necessarily represent the views of the U.S. Department of Veterans Affairs.
The authors report no competing interests.
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