title: Estimating the rates of deaths by suicide among adults who attempt suicide in the United States.
abstract: BACKGROUND
  In 2012, over 1.3 million U.S. adults reported that they attempted suicide in the past year, and 39,426 adults died by suicide. This study estimated national suicide case fatality rates among adult suicide attempters (fatal and nonfatal cases) and examined how they varied by sociodemographic characteristics.
  
  
  METHODS
  We pooled data on deaths by suicide (n = 147,427, fatal cases in the U.S.) from the 2008-2011 U S. mortality files and data on suicide attempters who survived (n = 2000 nonfatal cases) from the 2008-2012 National Surveys on Drug Use and Health. Descriptive analyses and multivariable logistic regression models were applied.
  
  
  RESULTS
  Among adult suicide attempters in the U.S., the overall 12-month suicide case fatality rate was 3.2% (95% confidence interval (CI) = 2.9%-3.5%). It varied significantly by sociodemographic factors. For those aged 45 or older, the adjusted suicide case fatality rate was higher among men (7.6%) than among women (2.6%) (suicide case fatality rate ratio (SCFRR) = 3.0, 95% CI = 1.83-4.79), was higher among non-Hispanic whites (7.9%) than among non-white minorities (0.8-2.5%) (SCFRRs = 3.2-9.9), and was higher among those with less than high school education (16.0%) than among college graduates (1.8%) (SCFRR = 8.8, 95% CI = 3.83-20.16). Across male and female attempters, being aged 45 or older and non-Hispanic white and having less than secondary school were at a higher risk for death by suicide.
  
  
  CONCLUSIONS
  Focusing on these demographic characteristics can help identify suicide attempters at higher risk for death by suicide, inform clinical assessments, and improve suicide prevention and intervention efforts by increasing high-risk suicide attempters' access to mental health treatment.
authors.affiliation: Substance Abuse and Mental Health Services Administration, USA. Electronic address: Beth.Han@SAMHSA.HHS.GOV.
authors.forename: Beth
authors.initials: B
authors.lastname: Han
authors.affiliation: RTI International, USA.
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Kott
authors.affiliation: Substance Abuse and Mental Health Services Administration, USA.
authors.forename: Art
authors.initials: A
authors.lastname: Hughes
authors.affiliation: Substance Abuse and Mental Health Services Administration, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: McKeon
authors.affiliation: National Institute on Drug Abuse, National Institutes of Health, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.affiliation: National Institute on Drug Abuse, National Institutes of Health, USA.
authors.forename: Wilson M
authors.initials: WM
authors.lastname: Compton
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D003627:Data Interpretation, Statistical; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Adults at high suicide risk; Death by suicide; Suicide attempt; Suicide case fatality rates; Suicide prevention and intervention; Variance estimation techniques