Citation

Fontanella CA, Warner LA, Steelesmith DL, Bridge JA, Brock GN, Campo JV. Am. J. Prev. Med. 2019; 56(3): 447-451.

Affiliation

Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, West Virginia; Rockefeller Neuroscience Institute, Morgantown, West Virginia.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.amepre.2018.10.008

PMID

30661887

Abstract

INTRODUCTION: In the U.S., youth enrolled in Medicaid experience more risk factors for suicide, such as mental illness, than youth not enrolled in Medicaid. To inform a national suicide prevention strategy, this study presents suicide rates in a sample of youth enrolled in Medicaid and compares them with rates in the non-Medicaid population.

METHODS: Data sources were death certificate data matched with Medicaid data from 16 states, and the Web-based Injury Statistics Query and Reporting System. Deaths by suicide that occurred between 2009 and 2013 by youth aged 10 to 18 years were identified for Medicaid and non-Medicaid groups. Age-, gender-, and cause-specific mortality rates were calculated separately for both groups. Standardized mortality ratios were calculated to compare rates, and standardized mortality ratio 95% CIs were estimated with Poisson regressions. The data were analyzed in 2018.

RESULTS: A substantial proportion (39%) of the total number of deaths by suicide (N=4,045) in youth occurred among those enrolled in Medicaid. The overall suicide rate did not significantly differ between groups (standardized mortality ratio=0.96, 95% CI=0.90, 1.03). However, compared with the non-Medicaid group, the suicide rate in the Medicaid group was significantly higher among youth aged 10 to 14 years (standardized mortality ratio=1.28, 95% CI=1.11, 1.47), females (regardless of age; standardized mortality ratio=1.14, 95% CI=1.01, 1.29), and those who died by hanging (standardized mortality ratio=1.26, 95% CI=1.16, 1.38).

CONCLUSIONS: The population-based profile of suicide among youth enrolled in Medicaid differs from the profile of youth not enrolled in Medicaid, confirming the importance of Medicaid as a "boundaried" suicide prevention setting.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Language: en