title: Do geographic regions with higher suicide rates also have higher rates of nonfatal intentional self-harm?
abstract: Fatal and nonfatal intentional self-harm events in eight U.S. states were compared using emergency department, hospital, and vital statistics data. Nonfatal event rates increased by an estimated 24.20% over 6 years. Case fatality ratios varied widely, but two northeastern states' total event rates (fatal plus nonfatal) were very high (New Hampshire 206.5/100,000 person years; Massachusetts 166.7/100,000). Geographic context did not uniformly impact the likelihood of self-harm across event types. The state-level public health burden posed by such acts cannot, therefore, be accurately estimated from either mortality or morbidity data alone.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75235-9119, USA. Cindy.Claassen@UTSouthwestern.edu
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Claassen
authors.forename: Thomas
authors.initials: T
authors.lastname: Carmody
authors.forename: Robert
authors.initials: R
authors.lastname: Bossarte
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
authors.forename: Stephen
authors.initials: S
authors.lastname: Elliott
authors.forename: Glenn W
authors.initials: GW
authors.lastname: Currier
mesh_terms: D002391:Catchment Area, Health; D005843:Geography; D006801:Humans; D015994:Incidence; D033182:Intention; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology