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Psychiatric services (Washington, D.C.)
Feb 01, 2024;75 (2): 124-130.

Racial-Ethnic Differences in Receipt of Past-Year Health Care Services Among Suicide Decedents: A Case-Control Study.

Lisa R Miller-Matero, Hsueh-Han Yeh, Anissa Maffett, Jan T Mooney, Kelsey Sala-Hamrick, Cathrine B Frank, Gregory E Simon, Rebecca Rossom, Ashli A Owen-Smith, Frances L Lynch, Arne Beck, Stephen Waring, Yihe G Daida, Christine Y Lu, Brian K Ahmedani
Author Information
  1. Lisa R Miller-Matero: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  2. Hsueh-Han Yeh: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  3. Anissa Maffett: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  4. Jan T Mooney: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  5. Kelsey Sala-Hamrick: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  6. Cathrine B Frank: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  7. Gregory E Simon: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  8. Rebecca Rossom: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  9. Ashli A Owen-Smith: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  10. Frances L Lynch: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  11. Arne Beck: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  12. Stephen Waring: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  13. Yihe G Daida: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  14. Christine Y Lu: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
  15. Brian K Ahmedani: Behavioral Health (Miller-Matero, Maffett, Mooney, Frank, Ahmedani) and Center for Health Policy and Health Services Research (Miller-Matero, Yeh, Sala-Hamrick, Ahmedani), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Simon); HealthPartners Institute, Minneapolis (Rossom); Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, and Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta (Owen-Smith); Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Lynch); Institute for Health Research, Kaiser Permanente Colorado, Aurora (Beck); Essentia Institute of Rural Health, Duluth, Minnesota (Waring); Center for Integrated Health Care Research, Kaiser Permanente Hawaii, Honolulu (Daida); Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Lu).
PMID: 37554000 DOI: 10.1176/appi.ps.20220578

Abstract

OBJECTIVE: Suicide remains an urgent public health crisis. Although some sociodemographic characteristics are associated with greater suicide risk in the general population, it is unclear whether individuals utilizing health care in the United States have similar suicide incidence patterns. The authors examined whether race-ethnicity is associated with suicide death among patients seeking health care and investigated health care utilization patterns.
METHODS: Data were collected from electronic health records and government mortality records for patients seeking health care across nine health care systems in the United States. Patients who died by suicide (N=1,935) were matched with patients in a control group (N=19,350) within each health care system.
RESULTS: Patients who died by suicide were significantly more likely to be White, older, male, living in low-education areas, living in rural areas, or diagnosed as having mental health conditions or were significantly less likely to have commercial insurance (p<0.05). Among most racial-ethnic groups, those who died by suicide had a higher number of past-year mental health, primary care, and total health care visits; for American Indian/Alaska Native patients, the number of health care visits tended to be lower among suicide decedents.
CONCLUSIONS: These findings suggest that higher past-year health care utilization was associated with increased likelihood of suicide death across several racial-ethnic groups. This observation underscores the need for identifying and managing suicide risk in health care settings, including outside of mental health visits, among most racial-ethnic groups.

Keywords

Electronic health record Mental health systems Racial-ethnic disparities Self-destructive behavior Suicide

References

  1. Environ Health Prev Med. 2008 Sep;13(5):243-56 [PMID: 19568911]
  2. Psychiatr Serv. 2022 Feb 1;73(2):219-222 [PMID: 34189931]
  3. JAMA Netw Open. 2021 May 3;4(5):e2111563 [PMID: 34037735]
  4. Am J Prev Med. 2017 Oct;53(4):e123-e130 [PMID: 28756896]
  5. J Affect Disord. 2021 Jan 15;279:98-105 [PMID: 33045555]
  6. J Am Acad Child Adolesc Psychiatry. 2022 May;61(5):662-675 [PMID: 34509592]
  7. JAMA Psychiatry. 2022 Mar 01;79(3):219-231 [PMID: 35044428]
  8. JAMA Netw Open. 2019 Sep 4;2(9):e1910936 [PMID: 31490540]
  9. Am J Orthopsychiatry. 2000 Oct;70(4):455-64 [PMID: 11086524]
  10. MMWR Surveill Summ. 2017 Oct 06;66(18):1-16 [PMID: 28981481]
  11. Psychiatr Serv. 2016 Jul 1;67(7):749-57 [PMID: 27079987]
  12. Health Serv Res. 2014 Feb;49(1):206-29 [PMID: 23855750]
  13. NCHS Data Brief. 2021 Feb;(398):1-8 [PMID: 33663651]
  14. J Affect Disord. 2021 Nov 1;294:17-23 [PMID: 34256181]
  15. Am J Prev Med. 2019 May;56(5):648-654 [PMID: 30905484]
  16. Prev Med. 2019 Oct;127:105796 [PMID: 31400374]
  17. J Affect Disord. 2020 Jun 15;271:123-130 [PMID: 32479307]
  18. Soc Ment Health. 2018 Mar;8(1):1-24 [PMID: 31413888]
  19. Psychiatr Serv. 2014 Mar 1;65(3):387-90 [PMID: 24584526]
  20. J Affect Disord. 2022 Aug 15;311:157-164 [PMID: 35598742]
  21. Adm Policy Ment Health. 2018 Jan;45(1):5-14 [PMID: 28144762]
  22. Sentinel Event Alert. 2016 Feb 24;(56):1-7 [PMID: 26915165]
  23. Psychiatr Serv. 2019 Sep 1;70(9):750-757 [PMID: 31185853]
  24. J Am Med Inform Assoc. 2017 Sep 01;24(5):927-932 [PMID: 28371853]
  25. J Psychiatr Res. 2018 Dec;107:114-119 [PMID: 30390576]
  26. Psychol Med. 2023 Sep;53(12):5592-5602 [PMID: 36106374]

Grants

  1. R01 MH103539/NIMH NIH HHS
  2. U19 MH092201/NIMH NIH HHS
  3. U19 MH121738/NIMH NIH HHS

MeSH Term

Humans
Male
United States
Case-Control Studies
Suicide
Ethnicity
Health Services
Delivery of Health Care
Journal Article
Article has an altmetric score of 2

Word Cloud

Created with Highcharts 10.0.0healthcaresuicidepatientsSuicideassociatedamongdiedmentalracial-ethnicgroupsvisitsriskwhetherUnitedStatespatternsdeathseekingutilizationrecordsacrosssystemsPatientssignificantlylikelylivingareasAmonghighernumberpast-yearOBJECTIVE:remainsurgentpubliccrisisAlthoughsociodemographiccharacteristicsgreatergeneralpopulationunclearindividualsutilizingsimilarincidenceauthorsexaminedrace-ethnicityinvestigatedMETHODS:DatacollectedelectronicgovernmentmortalitynineN=1935matchedcontrolgroupN=19350withinsystemRESULTS:Whiteoldermalelow-educationruraldiagnosedconditionslesscommercialinsurancep<005primarytotalAmericanIndian/AlaskaNativetendedlowerdecedentsCONCLUSIONS:findingssuggestincreasedlikelihoodseveralobservationunderscoresneedidentifyingmanagingsettingsincludingoutsideRacial-EthnicDifferencesReceiptPast-YearHealthCareServicesDecedents:Case-ControlStudyElectronicrecordMentalRacial-ethnicdisparitiesSelf-destructivebehavior

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