WVU study finds suicide data is deficient

Rates for minorities may be undercounted

MORGANTOWN, W.Va. – Government statistics indicate the suicide rate for whites in the U.S. is more than double that for blacks and Hispanics.  New research at West Virginia University suggests that deficiencies in data gathering may explain at least part of the apparent difference.

“This data problem goes beyond race and ethnicity. If you’re not measuring suicide accurately, it makes it all the more difficult to prevent,” Ian Rockett, M.P.H., Ph.D., said.

Dr. Rockett, of the WVU School of Medicine, is the lead author of an article just published in “BMC Psychiatry” on the accuracy of suicide data. He and his colleagues question whether undercounting may be greater for blacks and Hispanics than for whites.

Rockett says medical examiners and coroners strive to provide high quality information when they classify suicide, using all available resources and accessible evidence. Resources they use can include toxicology tests and medical records.

However, suicide may be particularly underestimated as a public health problem for blacks. The study strongly suggests that at least part of the suicide gap between blacks and whites is due to health data disparities. Data disparities are also apparent between the less and more educated, and younger and older people. Major obstacles include social stigma of mental illness and suicide, and variations between groups in obtaining appropriate healthcare when needed.

“Suicide rates for blacks and Hispanics may be lower than that for whites because of better coping skills and stronger condemnation of suicide,” Rockett said. “On the other hand, the great magnitude of the rate gap may be because authorities have more complete evidence in justifying suicide classifications for white victims.”

The research is based on recent death certificate data (2003-2005), including information on multiple causes of death and mode of injury, compiled by the National Center for Health Statistics, U.S. Centers for Disease Control and Prevention.

Individuals with no health insurance are less likely to see a doctor when they are ill, and so they have fewer health records. In addition, a mental illness may go undiagnosed and untreated. Mental illness may lead to suicidal thoughts, and with no medical intervention, can end in suicide. Alcohol and other drug abuse also may figure in suicide.

Rockett says equal access to healthcare and improved educational opportunities should lead to more accurate suicide data, and even more importantly, reduce suicide substantially among all racial/ethnic groups. Provision of additional resources for death investigations is also important for improving suicide surveillance and prevention.

Rockett, associate chair in the Department of Community Medicine and a member of the Injury Control Research Center at WVU, published this research with two WVU colleagues and five others from the U.S. and overseas. WVU researchers are Alan Ducatman, M.D., chair of Community Medicine and James Frost, M.D. from the Department of Pathology.

Other authors include: 
•    Shuhui Wang, M.S., National Institute for Occupational Safety and Health
•    Steven Stack, Ph.D, Wayne State University
•    Diego De Leo, M.D., Ph.D., Griffith University, Australia
•    Rheeda Walker, Ph.D., University of Georgia
•    Nestor Kapusta, M.D., Medical University of Vienna, Austria

“Race/Ethnicity and Potential Suicide Misclassification: Window on a Minority Suicide Paradox?” was published in the online open access medical journal, “BMC Psychiatry,” headquartered in Great Britain.

To read it, see www.biomedcentral.com/content/pdf/1471-244X-10-35.pdf.


For more information:
Amy Johns, HSC News Service, 304-293-7087
kf: 05-21-10

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