1. An Overview of Texas Suicide
John Hellsten, PhD
Environmental & Injury Epidemiology and Toxicology Unit
Texas Department of State Health Services
DSHS Grand Rounds
Austin, TX; November 9, 2011

2. What is suicide?
Suicide is death due to an injury which was intentionally inflicted upon the decedent by him/her self.
Reported on death certificates by Medical Examiners and Justices of the Peace

4. 2007 Ranking by State United States 34,598 11.5
# deaths
rate per 100,000 population
United States 34,
New Mexico (3)
Oklahoma (13)
Arkansas (17)
Louisiana (28)
Texas 2, (41)

5. Demographic Patterns 2007 AGE US TX 10-14 15-19 20-24 25-34 35-44
180
0.9 12
0.7
15-19
1,481
6.9
134
7.7
20-24
2,659
12.7
219
12.5
25-34
5,278
13.1
424
12.1
35-44
6,722
15.6
471
13.8
45-54
7,778
17.7
524
16.2
55-64
5,069
15.5
329
14.5
65-74
2,444
12.6
149
11.7
75+
2,977
16.0
171
15.3
SEX US TX
Male
27,269
18.4
1,932
17.2
Female
7,329
4.7
501
4.3
Total
34,598
11.3
2,433
10.5
Data retrieved from WISQARS, CDC. Age-adjusted rates/100,000
RACE/
ETHNICITY US TX
White
28,897
13.5
1,827
15.0
Black
1,916
5.1
116
4.4
Hispanic
2,465
6.0
434
Other
1,248
6.7 49
4.3
Suicide statistics are often skewed/driven by particular demographics:
SEX - M:F rate is ~4:1; Females account for only 20% of suicide deaths.
RACE – Whites account for 75 and 83% respectively of suicide deaths in Texas y US – somewhat less racial disparity in TX
AGE – suicide DEATHS rare among young, however not to say suicidal behavior (ideation, attempts) is not exhibited at young ages
Bimodal distribution with rates highest among elderly y among middle ages (prevention emphasis is usually on youth).

6. Suicide Across the Life-Span Texas
deaths per 100,000
Bimodal distribution – peaks at y 75+ (~16.0/100000); double the rate (8.9)
How different would this look if each indiv age was charted?
Source: TX DSHS, Center for Health Statistics;

7. Suicide Across the Life-Span Females
deaths per 100,000
Rates stay lower/flatter in the younger ages than males – doesn’t increase so quickly until mid 20s
Source: TX DSHS, Center for Health Statistics;

8. Texas Suicide Deaths Across the Life-Span by Race/Ethnicity
deaths per 100,000
Whites
African Americans
Hispanics

9. Texas Suicide Mortality 1931-2010*
deaths per 100,000
: 12.3 to 12.1
Large decline during WWII : low at 6.8 in ’43, risen to 8.3 in ’45, nearly a 33% drop during the war.
:relatively stable till late 60s; 9.1 in ’50, 8.7 in’60, 9.0 in ’66.
Next 20 years (’66 to ’85) increase to 13.7 in ’85, a 52% increase!
From ’90 (12.7) to ’99 (10.0) a 21% decline to rates we havent seen since 60s
Since 2000, nearly 9% increase in
1950
1960
1970
1980
1990
2000
2010*
Thanks to TDH Injury Epidemiology & Surveillance Program, 2001.
*2010 data have not been finalized and are subject to change

10. Trends in Suicide Deaths US & Texas
Age-adjusted rates per 100,000 US
Texas

11. Recent Changes Texas, 2007 to 2010*
AGE
2007
2010*
10-14 12
0.7 21
1.2
15-19
134
7.7
138
7.4
20-24
219
12.5
249
13.0
25-34
424
12.1
475
12.4
35-44
471
13.8
511
14.1
45-54
524
16.2
615
17.9
55-64
329
14.5
432
16.9
65-74
149
11.7
201
13.9
75+
171
15.3
212
18.8
SEX
2007
2010*
Male
1,932
17.2
2,267
18.6
Female
501
4.3
590
4.6
Total
2,433
10.5
2,857
11.6
Source: DSHS Center for Health Statistics. Age-adjusted rates/100,000
RACE/
ETHNICITY
2007
2010*
White
1,827
15.0
2,104
17.0
Black
116
4.4
165
5.9
Hispanic
434
6.0
539
5.8
Other 49
4.3
4.2

12. Trends in Texas Suicide Deaths by Sex
Age-adjusted rates per 100,000
Male
Female
~10% increase for both from

13. Trends in Texas Suicide Deaths Females
Age-adjusted rates per 100,000
~10% increase for both from

14. Texas Suicide Deaths by Race/Ethnicity
Age-adjusted rates per 100,000
White
Hispanic
African-American
Source: TX DSHS, Center for Health Statistics

15. Suicide Methods
Source: TX DSHS, Center for Health Statistics,

16. Texas Suicide Deaths by Mechanism Males
Source: TX DSHS, Center for Health Statistics,

17. Texas Suicide Deaths by Mechanism Females

19. Metropolitan Suicide 2007-2009
deaths per 100,000
Texas
Source: DSHS, Center for Health Statistics

20. Non-fatal Attempts
0.5% of US adult population attempted suicide during ; Texas estimate is 0.6% of population (109,000 people).
MMWR October 21, 2011 / 60(SS13);1-22
$71,738,300 in medical costs for 2003 Texas hospitalizations for self-inflicted injuries.
Children's Safety Network Economics and Data Analysis Resource Center & West Virginia University Injury Control Research Center
$343,832,600 in total costs (medical, quality of life, work-loss)

21. Youth Risk Behavior Survey Texas, 2011
Felt sad or hopeless (at least 2 weeks in a row) %
Seriously considered attempting %
Made a plan – 13.2%
Attempted 1 or more times – 10.8%
Injury requiring medical treatment – 3.5%
Jennifer Haussler Garing
512/

22. Suicide Attempt Requiring Medical Treatment Youth Risk Behavior Survey, Texas%