Aims: Suicide rates in the general population in the United States are correlated with altitude. To explore factors contributing to suicide among military veterans, we examined the relationship between veteran state-level suicide rates and altitude for 2014, including firearm-related and nonfirearm-related rates. Methods: Pearson's coefficients were calculated for altitude and each outcome. Mixed linear models were used to determine the association between suicide and altitude while adjusting for demographic confounds. Results: State mean altitude was significantly correlated with total veteran suicide rate ( r = 0.678, p < 0.0001), veteran firearm-related suicide rate ( r = 0.578, p < 0.0001), and veteran nonfirearm suicide rate ( r = 0.609, p < 0.0001). In mixed models, altitude was significantly correlated with total veteran suicide rate (β = 0.331, p < 0.05), veteran firearm suicides (β = 0.282, p < 0.05), and veteran nonfirearm suicides (β = 0.393, p < 0.05). Conclusion: This study adds to evidence linking altitude and suicide rates, arguing for additional research into the relationship between altitude and suicide among veterans.

Suicidal thoughts and behaviors (STB) often emerge during adolescence and have varying degrees of severity which may include suicide ideation (SI) and/or suicide attempts (SA). Approximately 18.8% of adolescents in the US reported "seriously considered attempting suicide during the past year" in the 2019 Youth Risk Behavior Survey. 1 While most individuals with SI will not make a SA, 2 almost 55% of individuals with SI that have a plan will go on to make a SA. 3 Moreover, the majority of individuals who die by suicide (50%-80%) do so on their first attempt. 4 Furthermore, the suicide rate among persons aged 10-24 in the US is increasing, having risen