Suicide Attempts in Michigan HealthCare System; Racial Differences

Abstract

Background. Community-based studies have documented racial differences in social, psychiatric, and medical determinants of suicidal ideation; however, less is known about racial differences in the profile of suicide attempts in clinical settings. Aim. The current study aimed to compare Blacks and Whites who attempted suicide for demographic factors, socioeconomic status, medical history, psychiatric disorders, and outcomes. Methods. This retrospective study was a retrospective chart review of DataDirect, which is an electronic data repository of the Michigan Health Care System, 2014 to 2017. This analysis included 6147 suicide attempts (5388 Whites and 759 Blacks). Race, sociodemographic factors, medical history, psychiatric disorders, and outcomes were measured. Results. Blacks and Whites with suicide attempt did not differ in age or gender, but varied by insurance type. Blacks were more commonly under Medicare and Medicaid, while Whites were more commonly under private insurance or self-pay (p < 0.05). Blacks with suicide attempt were more likely to be obese, while Whites with suicide attempt were more likely to be underweight. Frequency of psychiatric disorders, including depression, alcohol abuse, drug abuse, and psychosis, were not different between Whites and Blacks with suicide attempt; however, medical conditions showed a different profile across racial groups. When compared to Whites, Blacks had higher prevalence of uncomplicated hypertension, renal failure, chronic obstructive pulmonary disease, coagulopathy, and obesity (p < 0.05 for all comparisons). In contrast, Whites had higher prevalence of other neurological disorders than Blacks. There were no differences in in-patient survival rate between Whites and Blacks who attempted suicide. Conclusion. There are considerable differences between Blacks and Whites with at least one suicide attempt. Although their psychiatric diagnoses seem to be similar, Blacks who have attempted suicide attempt have more medical comorbidities than their White counterparts. Lack of racial disparities in in-patient mortality rate of suicide attempts in the Michigan Health Care System is promising news given the higher physical health needs of Blacks when compared to Whites.

Investigation of the Predictors of Self-rated Health of Economically Disadvantaged African American Men and Women: Evidence for Sponge Hypothesis

“…In other terms, race/ethnicity, gender, and SES have complex effects in depicting what poorer SRH means. 40,62,63 For example, education and income impact SRH of White but not AA individuals. [33][34][35] At the same time, SRH predicts mortality risk for Whites but not AAs.…”

Health Insurance Coverage Better Protects Blacks than Whites against Incident Chronic Disease

“…At least two studies have suggested racial differences exist in the effects of expanding health insurance on health [53,54]. Such reports reduce enthusiasm for expansion of health insurances as a core strategy to eliminate the health gap by race/ethnicity [54].…”

Psychiatric Disorders and Alcohol Consumption Among Low-Income African Americans:Gender Differences

“…Patterns of comorbidities between SES, physical health problems, health behaviors, and psychiatric disorders in AAs differ from those of Whites [35,36,37]. For example, obesity is a weaker risk factor for MDD for AAs than for Whites [38,39,40,41].…”

“…Previous studies have documented race and race by gender variation in the correlations between MDD, anxiety, alcohol use, substance use, suicidality, and perceived health, perceived mental health need, and service use [35,37,43,50,51]. The Fragile Families and Child Well-Being compared AA ( n = 2407) and White ( n = 894) individuals.…”

“…Although the frequency of psychiatric disorders (i.e., MDD, SUDs, and psychotic disorders) was equally distributed between AAs and Whites who were hospitalized for a suicide attempt, AAs had more comorbid medical conditions than their White counterparts. Compared to Whites, AAs were more likely to have chronic diseases such as obesity, chronic renal disease, hypertension, chronic obstructive pulmonary disease, hematological conditions (i.e., coagulopathy), and obesity, while compared to AAs, Whites were more likely to have other neurological disorders [35].…”