title: Veterans and suicide: a reexamination of the National Death Index-linked National Health Interview Survey.
abstract: OBJECTIVE
  We assessed the risk of suicide among veterans compared with nonveterans.
  
  
  METHODS
  Cox proportional hazards models estimated the relative risk of suicide, by self-reported veteran status, among 500,822 adult male participants in the National Death Index (NDI)-linked National Health Interview Survey (NHIS), a nationally representative cohort study.
  
  
  RESULTS
  A total of 482 male veterans died by suicide during 1,837,886 person-years of follow-up (76% by firearm); 835 male nonveterans died by suicide during 4,438,515 person-years of follow-up (62% by firearm). Crude suicide rates for veterans and nonveterans were, respectively, 26.2 and 18.8 per 100,000 person-years. The risk of suicide was not significantly higher among veterans, compared with nonveterans, after adjustment for differences in age, race, and survey year (hazard ratio = 1.11; 95% confidence interval = 0.96, 1.29).
  
  
  CONCLUSIONS
  Consistent with most studies of suicide risk among veterans of conflicts before Operation Iraqi Freedom/Operation Enduring Freedom, but in contrast to a previous study using the NDI-linked NHIS data, we found that male veterans responding to the NHIS were modestly, but not significantly, at higher risk for suicide compared with male nonveterans.
authors.affiliation: Department of Health Policy and Management, Harvard Injury Control Research Center, Harvard School of Public Heath, Boston, MA 02115, USA. mmiller@hsph.harvard.edu
authors.forename: Matthew
authors.initials: M
authors.lastname: Miller
authors.forename: Catherine
authors.initials: C
authors.lastname: Barber
authors.forename: Melissa
authors.initials: M
authors.lastname: Young
authors.forename: Deborah
authors.initials: D
authors.lastname: Azrael
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mukamal
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lawler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*