马里兰州的自杀和未确定死亡的种族差异
Leslie B Adams1,2, Christopher Kitchen3, Paul S Nestadt2,4
1Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California.
JAMA psychiatry
|August 6, 2025
概括
与白人死者相比,与白人死者相比,黑人死者的死亡不成比例地被归类为未确定而不是自杀. 这凸显了潜在的自杀低估和错误分类,影响了健康公平和自杀预防工作.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康差异 在健康上的差异
背景情况:
- 不确定的死亡方式可以掩盖真正的自杀率,特别是在黑人死者中,这可能导致医疗保健不平等.
- 准确的死亡分类对于了解自杀率和解决差异至关重要.
研究的目的:
- 为了比较黑人和白人死者之间的医疗保健利用率和死亡分类方式.
- 在自杀与不确定的死亡的分类中识别种族差异.
主要方法:
- 使用马里兰州自杀数据库 (2012-2020) 进行回顾性队列研究.
- 将验尸医生记录与黑人和白人死者的医疗保险索赔联系起来.
- 分析了死亡前12个月的医疗保健使用情况 (门诊,精神病学,急诊室).
主要成果:
- 与白人 (64.8%) 相比,黑人死者更有可能将死亡归类为不确定的 (83.0%).
- 与黑人死者相比,白人死者在死亡前的门诊和精神病学访问率更高.
- 枪支是最常见的自杀方法;过量服用/中毒在不确定的死亡中占主导地位.
结论:
- 调查结果表明,黑人死者的自杀事件可能被低估和错误分类.
- 解决这些种族差异对于准确的自杀监测和有效的预防策略至关重要.
- 在种族群体之间观察到死亡前医疗保健利用率的差异.
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