Epidemiology of suicide in an Iowa cohort

Suicide is an ongoing public health problem in the United States. The purpose of this epidemiologic investigation was to characterize and identify populations at risk of suicide, which in turn may lead to targeted intervention and improvements in suicide prevention.

This is a descriptive analysis of 657 suicide decedents autopsied by the University of Iowa Hospitals and Clinics between 7/1/2003 and 6/30/2018 (180 months, 15 years).

Data were obtained via autopsy report abstraction. Chi-squared tests were used for categorical variables and Wilcoxon rank-sum tests were used for continuous variables. Statistical analyses were conducted using SAS 9.3.

Decedents were primarily white (88.2%) and male (75.7%). Average age was 43 years. Suicides were more likely to occur at a residence (69.3%), earlier in the week, and in the late night to early morning hours. Suicides were most likely to occur in spring and least likely to occur in winter. The most common method was a firearm (44.6%), most often a handgun (61.3% of firearm suicides). Less than one-half (42.8%) of decedents communicated intent to end their life. Approximately one-quarter (22.1%) of suicides were without a known identified life stressor or a known inciting event, a phenomenon that was markedly more common among men.

More than one-half of decedents left no communication of intent to commit suicide, and one-quarter-more commonly men-had no known life stressor or other specifically identified motivating factor. While women were more likely to have a known mental health condition, prior contact with mental health care, or prior suicidal behavior, we found that, statistically speaking, the typical profile of a completed suicide is a white male who used a firearm in his place of residence. Future studies should seek to further elucidate factors leading to suicide in this at-risk population.