Suicide among North Carolina women, 1989–93: information from two data sources

Abstract

Objectives: To characterize the events and examine suicide precursors among women and to examine gaps in surveillance. Setting: A statewide study in North Carolina. Methods: Suicides of women age 15 and older for the time period 1989-93, as identified from the Office of the Chief Medical Examiner, were included. All case files were reviewed by hand and telephone interviews were attempted with investigating law enforcement officials for every case in 1993. Results: Altogether 882 suicides met the case definition, for an age adjusted rate that fluctuated between 5.53 and 7.26 per 100 000 women across the period. Interviews with law enforcement officials were completed for 135 of the 177 cases from 1993. White women had rates nearly three times those of racial minorities. Women under age 45 were proportionally more likely than older women to have recently experienced the breakup of an intimate relationship. Information about precursors was not as consistently reported as had been hoped. Medical examiner records were variable in completeness. Law enforcement interviews frequently did not yield information about the factors we had hoped to examine, probably because the investigations were conducted primarily to rule out homicide. Conclusions: This study suggests somewhat different precursor patterns by age group. It also points to the need for reconsidering how suicide surveillance is accomplished as a strategy to guide intervention. S uicide accounts for nearly 6000 deaths among women ages 15 and older in the US each year, making it the second leading cause of injury death among women.

Ethnic Differences in Patterns of Suicide Across the Life Cycle

“…There were five times as many suicides by white females as by black females in Fulton County. This result is consistent with a recent report by Runyan et al (3). They reported that white females commit suicide at three times the rate of black females.…”

“…Suicide risk is not equal across individuals in the population, as the rates in different ethnic and demographic groups and geographic regions vary considerably. In particular, the rate of suicide is lower in blacks than whites (3). This difference may be due to the interplay of risk and protective factors that are differentially expressed and experienced by different demographic and cultural groups.…”

The association between exposure to interpersonal violence and suicide among women: a systematic review

“…Dowry occurs in countries such as India, Pakistan, Bangladesh and Iran and refers to a cultural process whereby after a marriage, a husband's family takes the newly wed bride into their home and in exchange, demands a form of financial or material compensation from the bride's family. 50,70 The reported community rates of exposure to IPV are in fact similar to these reported prevalence rates among women dying from suicide. Young brides may view suicide as the only escape from this brutality and it is reported to be the most common motive for young women to take their own lives in these countries.…”

“…50,70 One high-quality study found that any exposure to violence may increase the risk of death from suicide by up to 17-fold, compared to women not exposed to violence. The reported lifetime prevalence of exposure to violence in women dying from suicide ranged from 3.5%-62.5%.…”

“…The most frequently studied relationship was between intimate partners (n=16). All six case reports focused primarily on IPA, [55][56][57]59,60,67 while four retrospective audits, 52,61,68,69 three crosssectional, 53,70,71 two case-control 49,72 and one news report based study 63 also examined suicide in women exposed to IPA. The next most commonly studied relationship was violence experienced from other family members (n=8).…”