Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component

Injury Epidemiology

Original Contribution

Jaimie L. Gradus¹  Rachel Sayko Adams²  Rachel Sayko Adams²  Colin G. Walsh³  Mary Jo Larson⁴  Trisha A. Hostetter⁵  Jeri E. Forster⁶  Lisa A. Brenner⁶  Claire A. Hoffmire⁶ 

[1] Department of Epidemiology, Boston University School of Public Health, Boston University, Boston, MA, USA;Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, 02118, Boston, MA, USA;Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA;VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, CO, USA;Departments of Biomedical Informatics, Medicine, and Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA;Institute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA;VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, CO, USA;VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, CO, USA;University of Colorado, Anschutz Medical Campus, Aurora, CO, USA;

关键词: Suicide;    Military;    Veterans;    Deployment;   

DOI  :  10.1186/s40621-022-00410-9

 received in 2022-08-22, accepted in 2022-12-07,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTo date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge, the objectives of this study were to determine and compare postdeployment suicide rates and trends (percent change over time), and hazard rates for Army soldiers, by rank and component (measured at the end of the deployment).MethodsLongitudinal cohort study of 860,930 Army soldiers returning from Afghanistan/Iraq deployment in fiscal years 2008–2014 from the Substance Use and Psychological Injury Combat study. Death by suicide was observed from the end of the first deployment in the study period through 2018 (i.e., the most recently available mortality data) for up to 11 years of follow-up. Analyses were conducted in 2021–2022.ResultsAdjusting for age, lowest-ranking Junior Enlisted (E1–E4) soldiers had a suicide rate 1.58 times higher than Senior Enlisted (E5–E9)/Warrant Officers (95% CI [1.24, 2.01]) and 2.41 times higher than Officers (95% CI [1.78, 3.29]). Suicide rates among lower-ranking enlisted soldiers remained elevated for 11 years postdeployment. Overall and annual postdeployment suicide rates did not differ significantly across components. Comparisons across rank and component for females were generally consistent with the full cohort results.ConclusionsLower-ranking enlisted soldiers had the highest rate of suicide, underscoring the importance of understanding rank as it relates to social determinants of health. For over a decade following Afghanistan/Iraq deployment, lower-enlisted rank during deployment was associated with an elevated rate of suicide; thereby suggesting that postdeployment prevention interventions targeting lower-ranking military members are warranted.

【 授权许可】

CC BY   
© The Author(s) 2022

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