title: Seasonality of suicide behavior in Northwest Alaska: 1990-2009.
abstract: OBJECTIVE
  Suicide is a leading cause of death worldwide, and disproportionately affects Indigenous populations. Seasonal suicide patterns are variable in the literature, and could offer novel approaches to the timing and focus of prevention efforts if better understood. With a suicide surveillance system in place since 1989, this study offers an unprecedented opportunity to explore seasonal variations in both fatal and non-fatal suicide behavior in an Indigenous Arctic region.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  In this descriptive study, we analyzed data collected from 1990 to 2009 in the rural northwest region of Alaska, both graphically and using the chi-squared test for multinomials.
  
  
  RESULTS
  We found a significant monthly variation for suicide attempts, with a peak in suicide behavior observed between April and August (P = 0.0002). Monthly variation was more pronounced among individuals ≤29 years of age, and was present in both males and females, although the seasonal pattern differed by sex.
  
  
  CONCLUSIONS
  Our findings of a significant seasonal pattern in suicide behavior, with monthly variation (summer peak) in non-fatal suicide behavior among younger age groups, and among both males and females can assist planners in targeting subpopulations for prevention at different times of the year.
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Silveira
authors.affiliation: Division of Community Health Education, Department of Public Health, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. Electronic address: lwexler@schoolph.umass.edu.
authors.forename: L
authors.initials: L
authors.lastname: Wexler
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Chamberlain
authors.affiliation: Women's Psychological Services, USA.
authors.forename: K
authors.initials: K
authors.lastname: Money
authors.affiliation: Department of Psychological & Brain Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: R M C
authors.initials: RM
authors.lastname: Spencer
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: N G
authors.initials: NG
authors.lastname: Reich
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
authors.forename: E R
authors.initials: ER
authors.lastname: Bertone-Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000413:Alaska / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data; D012621:Seasons; D017678:Sex Distribution; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: American Indian/Alaska native; Seasonal pattern; Suicidal behavior; Suicide