title: Sociodemographic and career history predictors of suicide mortality in the United States Army 2004-2009.
abstract: BACKGROUND
  The US Army suicide rate has increased sharply in recent years. Identifying significant predictors of Army suicides in Army and Department of Defense (DoD) administrative records might help focus prevention efforts and guide intervention content. Previous studies of administrative data, although documenting significant predictors, were based on limited samples and models. A career history perspective is used here to develop more textured models.
  
  
  METHODS
  The analysis was carried out as part of the Historical Administrative Data Study (HADS) of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). De-identified data were combined across numerous Army and DoD administrative data systems for all Regular Army soldiers on active duty in 2004-2009. Multivariate associations of sociodemographics and Army career variables with suicide were examined in subgroups defined by time in service, rank and deployment history.
  
  
  RESULTS
  Several novel results were found that could have intervention implications. The most notable of these were significantly elevated suicide rates (69.6-80.0 suicides per 100 000 person-years compared with 18.5 suicides per 100 000 person-years in the total Army) among enlisted soldiers deployed either during their first year of service or with less than expected (based on time in service) junior enlisted rank; a substantially greater rise in suicide among women than men during deployment; and a protective effect of marriage against suicide only during deployment.
  
  
  CONCLUSIONS
  A career history approach produces several actionable insights missed in less textured analyses of administrative data predictors. Expansion of analyses to a richer set of predictors might help refine understanding of intervention implications.
authors: Departments of Social and Behavioral Sciences, and Epidemiology,Harvard School of Public Health,Boston, MA,USA.
authors: S E
authors: SE
authors: Gilman
authors: Department of Psychiatry and Behavioral Science,Stony Brook School of Medicine,Stony Brook, NY,USA.
authors: E J
authors: EJ
authors: Bromet
authors: US Army Public Health Command, Aberdeen Proving Ground,MD,USA.
authors: K L
authors: KL
authors: Cox
authors: Division of Services and Intervention Research,National Institute of Mental Health,Bethesda, MD,USA.
authors: L J
authors: LJ
authors: Colpe
authors: Center for the Study of Traumatic Stress, Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda, MD,USA.
authors: C S
authors: CS
authors: Fullerton
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: M J
authors: MJ
authors: Gruber
authors: Institute for Social Research,University of Michigan,Ann Arbor, MI,USA.
authors: S G
authors: SG
authors: Heeringa
authors: Institute for Social Research,University of Michigan,Ann Arbor, MI,USA.
authors: L
authors: L
authors: Lewandowski-Romps
authors: US Army Public Health Command, Aberdeen Proving Ground,MD,USA.
authors: A M
authors: AM
authors: Millikan-Bell
authors: Center for the Study of Traumatic Stress, Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda, MD,USA.
authors: J A
authors: JA
authors: Naifeh
authors: Department of Psychology,Harvard University,Cambridge, MA,USA.
authors: M K
authors: MK
authors: Nock
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: M V
authors: MV
authors: Petukhova
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: N A
authors: NA
authors: Sampson
authors: Office of Science Policy, Planning and Communications,National Institute of Mental Health,Bethesda, MD,USA.
authors: M
authors: M
authors: Schoenbaum
authors: Departments of Psychiatry and Family and Preventive Medicine,University of California San Diego,La Jolla, CA,USA.
authors: M B
authors: MB
authors: Stein
authors: Center for the Study of Traumatic Stress, Department of Psychiatry,Uniformed Services University School of Medicine,Bethesda, MD,USA.
authors: R J
authors: RJ
authors: Ursano
authors: King's Centre for Military Health Research,King's College London,London,UK.
authors: S
authors: S
authors: Wessely
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: A M
authors: AM
authors: Zaslavsky
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: R C
authors: RC
authors: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult