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Sexual and Gender Minority Status and Suicide Mortality: An Explainable Artificial Intelligence Analysis
Ying Yin1,2, T Elizabeth Workman1,2, John R Blosnich3,4
1Washington DC VA Medical Center, United States Department of Veterans Affairs, Washington, DC, United States.
International Journal of Public Health
|May 21, 2024
Summary
Disclosed lesbian, gay, bisexual, and transgender (LGBT) status in US Veterans was not directly linked to increased suicide risk. However, factors like stigma-related mental health issues remain significant suicide death risk factors.
Area of Science:
- Public Health
- Mental Health Research
- Health Informatics
Background:
- Suicide risk is disproportionately high among lesbian, gay, bisexual, and transgender (LGBT) individuals.
- Limited data on LGBT status within healthcare systems impedes comprehensive risk assessment.
- Understanding specific risk factors for suicide among LGBT Veterans is crucial.
Purpose of the Study:
- To utilize natural language processing (NLP) and deep neural networks (DNNs) to identify and analyze suicide death risk factors among US Veterans.
- To investigate the association between disclosed LGBT status and suicide risk, controlling for numerous covariates.
- To identify demographic and clinical factors associated with higher suicide risk within the LGBT Veteran population.
Main Methods:
- Analysis of electronic health records for 8.8 million US Veterans from 2010-2017.
- Application of NLP to extract LGBT status from clinical notes.
- Utilized a deep neural network (DNN) for a case-control study to analyze suicide death risk, evaluating feature impacts and interactions.
Main Results:
- Crude suicide mortality rates were higher in LGBT patients.
- After adjusting for over 200 factors, known LGBT status showed a reduced suicide risk compared to unknown LGBT status.
- Within the LGBT Veteran group, higher risk was associated with being Black, female, married, or older; lower risk was associated with certain religious affiliations.
Conclusions:
- Disclosed LGBT status itself is not directly associated with an increased risk of suicide death.
- Factors contributing to suicide risk in LGBT Veterans are complex and may be indirectly linked to stigma, such as increased depression and anxiety.
- Further research and targeted interventions are needed to address the unique mental health needs and suicide risks within the LGBT Veteran population.
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