dc.contributor.author | Adams, Rachel Sayko | |
dc.contributor.author | Forster, Jeri E. | |
dc.contributor.author | Gradus, Jaimie L. | |
dc.contributor.author | Hoffmire, Claire A. | |
dc.contributor.author | Hostetter, Trisha A. | |
dc.contributor.author | Larson, Mary Jo | |
dc.contributor.author | Walsh, Colin G | |
dc.contributor.author | Brenner, Lisa A. | |
dc.date.accessioned | 2023-01-26T20:58:47Z | |
dc.date.available | 2023-01-26T20:58:47Z | |
dc.date.issued | 2022-01-14 | |
dc.identifier.other | eISSN 2197-1714 | |
dc.identifier.other | PubMed ID36564780 | |
dc.identifier.uri | http://hdl.handle.net/1803/17953 | |
dc.description.abstract | Background: To date, knowledge is limited regarding time-dependent suicide risk in the years following return from deployment and whether such rates vary by military rank (i.e., enlisted, officer) or component (i.e., active duty, National Guard, reserve). To address these gaps in knowledge, the objectives of this study were to determine and compare postdeployment suicide rates and trends (percent change over time), and hazard rates for Army soldiers, by rank and component (measured at the end of the deployment). Methods: Longitudinal cohort study of 860,930 Army soldiers returning from Afghanistan/Iraq deployment in fiscal years 2008-2014 from the Substance Use and Psychological Injury Combat study. Death by suicide was observed from the end of the first deployment in the study period through 2018 (i.e., the most recently available mortality data) for up to 11 years of follow-up. Analyses were conducted in 2021-2022. Results: Adjusting for age, lowest-ranking Junior Enlisted (E1-E4) soldiers had a suicide rate 1.58 times higher than Senior Enlisted (E5-E9)/Warrant Officers (95% CI [1.24, 2.01]) and 2.41 times higher than Officers (95% CI [1.78, 3.29]). Suicide rates among lower-ranking enlisted soldiers remained elevated for 11 years postdeployment. Overall and annual postdeployment suicide rates did not differ significantly across components. Comparisons across rank and component for females were generally consistent with the full cohort results. Conclusions: Lower-ranking enlisted soldiers had the highest rate of suicide, underscoring the importance of understanding rank as it relates to social determinants of health. For over a decade following Afghanistan/Iraq deployment, lower-enlisted rank during deployment was associated with an elevated rate of suicide; thereby suggesting that postdeployment prevention interventions targeting lower-ranking military members are warranted. | en_US |
dc.description.sponsorship | Page 9 of 10Adams et al. Injury Epidemiology (2022) 9:46
Additional file 10: Hazard Ratios from Cox Proportional Hazards Models
by Military Component within the Female Cohort. Table of hazard ratios
from six Cox proportional hazards models among female military mem-
bers: three unadjusted models, and three models adjusting for demo-
graphics, comparing military component within 1) the full cohort, 2) first
deployers and 3) 2+ deployers.
Acknowledgements
We acknowledge support with cohort and variable development from Natalie
Moresco at Brandeis University and AXIOM Resource Management.
Author contributions
RSA, JEF, JLG, CAH, TAH, MJL, CGW, and LAB contributed to the study concep-
tion and design. Acquisition of data: RSA, MJL, LAB, JEF, CAH, TAH. Analysis of
the data: TAH and JEF. All authors contributed to the interpretation of data and
drafting and revising of the manuscript. All authors read and approved the
final manuscript.
Funding
This study was funded by the National Institute of Mental Health and Office
of the Director at NIH (R01MH120122). Funding to support cohort develop-
ment was from the National Center for Complementary and Integrative
Health (NCCIH; R01AT008404) and the National Institute on Drug Abuse (NIDA;
R01DA030150). The opinions and assertions herein are those of the authors
and do not necessarily reflect the official views of the Department of Defense,
Uniformed Services University, the Veterans Health Administration, the US
Army, US Navy, US Air Force, the US Government, National Institutes of Health,
or the Henry M. Jackson Foundation for the Advancement of Military Medi-
cine, Inc., and do not imply endorsement by the Federal Government. Our
Department of Defense data sponsor is Major Ryan C. Costantino, PharmD | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Injury Epidemiology | en_US |
dc.rights | © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
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regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this
licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco
mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | |
dc.source.uri | https://injepijournal.biomedcentral.com/counter/pdf/10.1186/s40621-022-00410-9.pdf | |
dc.subject | Suicide | en_US |
dc.subject | Military | en_US |
dc.subject | Veterans | en_US |
dc.subject | Deployment | en_US |
dc.title | Time-dependent suicide rates among Army soldiers returning from an Afghanistan/Iraq deployment, by military rank and component | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.1186/s40621-022-00410-9 | |