Citation

Jones DS. JAMA Netw. Open 2019; 2(12): e1917498.

Affiliation

Department of the History of Science, Harvard University, Cambridge, Massachusetts.

Copyright

(Copyright © 2019, American Medical Association)

DOI

10.1001/jamanetworkopen.2019.17498

PMID

31834387

Abstract

According to the latest data from the US Department of Defense, 541 service members died by suicide in 2018. The suicide rate for the active component of the military, 24.8 per 100 000 service members, has increased to the highest level since before World War II. How can this be reversed? Smith et al have provided a major contribution to the effort to understand military suicide. They analyzed 200 years of US Army data in pursuit of the best possible chronicle of soldier suicides. They found a striking pattern. From the 1840s to the 1940s, suicide rates decreased during times of war. However, with the “endless wars” in Vietnam, Afghanistan, and Iraq, suicide rates have increased during times of war. The authors hope that this insight will help decipher the long- and short-term stressors that are associated with suicide in the military. A model that can explain past trends might help prevent future deaths.

Before embarking on the challenge of explaining historical trends, it is important to ask whether the data are robust enough to serve as the basis for meaningful analyses. Any physician or historian who has worked with data on the historical burden of disease knows how hard it is to produce accurate time series. Data, even when fastidiously collected, can raise more questions than they answer. Medical nosology and diagnostic practices change substantially over centuries, even over decades. Simply tracing the causes of death can be devilishly difficult. In many cases, the source data are imperfect, something that is acknowledged by those who produced them ...

Language: en