Racial/Ethnic differences in health care visits made before suicide attempt across the United States. 2015

Brian K Ahmedani, and Christine Stewart, and Gregory E Simon, and Frances Lynch, and Christine Y Lu, and Beth E Waitzfelder, and Leif I Solberg, and Ashli A Owen-Smith, and Arne Beck, and Laurel A Copeland, and Enid M Hunkeler, and Rebecca C Rossom, and Keoki Williams
*Henry Ford Health System, Center for Health Policy and Health Services Research, Detroit, MI †Group Health Cooperative, Group Health Research Institute, Seattle, WA ‡Kaiser Permanente Northwest, Center for Health Research, Portland, OR §Department of Population Medicine and Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA ∥Kaiser Permanente Hawaii, Center for Health Research, Honolulu, HI ¶HealthPartners, Institute for Education and Research, Bloomington, MN #Kaiser Permanente Georgia, Center for Health Research, Atlanta, GA **Kaiser Permanente Colorado, Institute for Health Research, Denver, CO ††Baylor Scott & White Health, Center for Applied Health Research, Temple, TX ‡‡Kaiser Permanente Northern California, Division of Research, Oakland, CA.

BACKGROUND Suicide is a public health concern, but little is known about the patterns of health care visits made before a suicide attempt, and whether those patterns differ by race/ethnicity. OBJECTIVE To examine racial/ethnic variation in the types of health care visits made before a suicide attempt, when those visits occur, and whether mental health or substance use diagnoses were documented. METHODS Retrospective, longitudinal study, 2009-2011. METHODS 22,387 individuals who attempted suicide and were enrolled in the health plan across 10 health systems in the Mental Health Research Network. METHODS Cumulative percentage of different types of health care visits made in the 52 weeks before a suicide attempt, by self-reported racial/ethnicity and diagnosis. Data were from the Virtual Data Warehouse at each site. RESULTS Over 38% of the individuals made any health care visit within the week before their suicide attempt and ∼95% within the preceding year; these percentages varied across racial/ethnic groups (P<0.001). White individuals had the highest percentage of visits (>41%) within 1 week of suicide attempt. Asian Americans were the least likely to make visits within 52 weeks. Hawaiian/Pacific Islanders had proportionally the most inpatient and emergency visits before an attempt, but were least likely to have a recorded mental health or substance use diagnosis. Overall, visits were most common in primary care and outpatient general medical settings. CONCLUSIONS This study provides temporal evidence of racial/ethnic differences in health care visits made before suicide attempt. Health care systems can use this information to help focus the design and implementation of their suicide prevention initiatives.

UI MeSH Term Description Entries
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005006 Ethnicity A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. Ethnic Groups,Nationality,Ethnic Group,Nationalities
D005260 Female Females
D006296 Health Services Services for the diagnosis and treatment of disease and the maintenance of health. Services, Health,Health Service
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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