Racial Differences in Suicide and Undetermined Deaths in Maryland

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Undetermined manner of death can obscure true suicide rates, particularly among Black decedents, potentially leading to health care inequities.
• Accurate classification of death is crucial for understanding suicide prevalence and addressing disparities.

Purpose of the Study:

• To compare health care utilization and manner of death classification between Black and White decedents.
• To identify racial disparities in the classification of suicide versus undetermined deaths.

Main Methods:

• Retrospective cohort study using Maryland Suicide Data Warehouse (2012-2020).
• Linked medical examiner records with health care claims for Black and White decedents.
• Analyzed health care use (outpatient, psychiatry, emergency department) in the 12 months prior to death.

Main Results:

• Black decedents were more likely to have deaths classified as undetermined (83.0%) compared to White decedents (64.8%).
• White decedents showed higher rates of outpatient and psychiatry visits before death compared to Black decedents.
• Firearms were the most common suicide method; overdose/poisoning predominated in undetermined deaths.

Conclusions:

• Findings suggest potential undercounting and misclassification of suicides among Black decedents.
• Addressing these racial disparities is essential for accurate suicide surveillance and effective prevention strategies.
• Disparities in health care utilization prior to death were observed between racial groups.