Unrecognised self-injury mortality (SIM) trends among racial/ethnic minorities and women in the USA

Ian R.H. Rockett, Eric D. Caine, Hilary S. Connery, Kurt B. Nolte, Paul Nestadt, Lewis S. Nelson, Haomiao Jia

Research output: Contribution to journalArticle


Aim: To assess whether an enhanced category combining suicides with nonsuicide drug self-intoxication fatalities more effectively captures the burden of self-injury mortality (SIM) in the USA among US non-Hispanic black and Hispanic populations and women irrespective of race/ethnicity. Methods: This observational study used deidentified national mortality data for 2008-2017 from the CDC's Web-based Injury Statistics Query and Reporting System. SIM comprised suicides by any method and age at death plus estimated nonsuicide drug self-intoxication deaths at age ≥15 years. Measures were crude SIM and suicide rates; SIM-to-suicide rate ratios; and indices of premature mortality. Results: While the suicide rate increased by 29% for blacks, 36% for Hispanics and 25% for non-Hispanic whites between 2008 and 2017, corresponding SIM rate increases were larger at 109%, 69% and 55% (p<0.0001). SIM:suicide rate ratio gaps were widest among blacks but similar for the other two groups. Gaps were wider for females than males, especially black females whose ratios measured ≥3.71 across the observation period versus <3.00 for white and Hispanic counterparts. Total lost years of life for Hispanic, white and black SIM decedents in 2017 were projected to be 42.6, 37.1 and 32.4, respectively. Conclusion: Application of SIM exposed substantial excess burdens from substance poisoning relative to suicide for minorities, particularly non-Hispanic blacks and for women generally. Results underscored the need to define, develop, implement and evaluate comprehensive strategies to address common antecedents of self-injurious behaviours.

Original languageEnglish (US)
JournalInjury Prevention
StateAccepted/In press - Jan 1 2019



  • Cross Sectional Study
  • Drugs
  • Mental Health
  • Mortality
  • Poisoning
  • Suicide/Self?Harm

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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