Unrecognised self-injury mortality (SIM) trends among racial/ethnic minorities and women in the USA

Ian R.H. Rockett, Eric D. Caine, Hilary S. Connery, Kurt B. Nolte, Paul S. Nestadt, Lewis S. Nelson, Haomiao Jia

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Aim To assess whether an enhanced category combining suicides with nonsuicide drug self-intoxication fatalities more effectively captures the burden of self-injury mortality (SIM) in the USA among US non-Hispanic black and Hispanic populations and women irrespective of race/ethnicity. Methods This observational study used deidentified national mortality data for 2008-2017 from the CDC's Web-based Injury Statistics Query and Reporting System. SIM comprised suicides by any method and age at death plus estimated nonsuicide drug self-intoxication deaths at age ≥15 years. Measures were crude SIM and suicide rates; SIM-to-suicide rate ratios; and indices of premature mortality. Results While the suicide rate increased by 29% for blacks, 36% for Hispanics and 25% for non-Hispanic whites between 2008 and 2017, corresponding SIM rate increases were larger at 109%, 69% and 55% (p<0.0001). SIM:suicide rate ratio gaps were widest among blacks but similar for the other two groups. Gaps were wider for females than males, especially black females whose ratios measured ≥3.71 across the observation period versus <3.00 for white and Hispanic counterparts. Total lost years of life for Hispanic, white and black SIM decedents in 2017 were projected to be 42.6, 37.1 and 32.4, respectively. Conclusion Application of SIM exposed substantial excess burdens from substance poisoning relative to suicide for minorities, particularly non-Hispanic blacks and for women generally. Results underscored the need to define, develop, implement and evaluate comprehensive strategies to address common antecedents of self-injurious behaviours.

Original languageEnglish (US)
Pages (from-to)439-447
Number of pages9
JournalInjury Prevention
Issue number5
StatePublished - Oct 1 2020


  • Cross Sectional Study
  • Drugs
  • Mental Health
  • Mortality
  • Poisoning
  • Suicide/Self?Harm

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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