Suicides and Deaths of Undetermined Intent by Poisoning: Reexamination of Classification Differences by Race/Ethnicity and State

Abstract

This study examined differences by race/ethnicity and state in poisoning deaths of undetermined intent (UnD) versus suicide classification and the potential impact of state variations on UnD rates for Blacks and Hispanics. We used data from the 2005–2015 U.S. National Violent Death Reporting System (N = 29,567 aged 15+) and weighted coarsened exact matching. The odds of UnD classification were 7–10 times higher in the 5 highest UnD states (Kentucky, Maryland, Michigan, Utah, and Rhode Island) than in other states. Blacks in these 5 states had twice the odds of Whites of being classified as UnDs than suicides, but had lower odds in other states. Other significant UnD classification factors were opioid and cocaine positive toxicologies.

Keywords:

• intent-undetermined death
• postmortem toxicology
• racial difference
• state variation
• suicide

ACKNOWLEDGMENT AND DISCLAIMER

The Centers for Disease Control and Prevention (CDC) administers the NVDRS in conjunction with participating NVDRS states. The CDC made the NVDRS Restricted Access Data used in this study available to the authors. This study’s findings and conclusions are those of the authors alone and do not necessarily represent the official position of the CDC or of the participating NVDRS states.

AUTHOR NOTE

Namkee G. Choi, Steve Hicks School of Social Work, The University of Texas, Austin, Texas, USA.

C. Nathan Marti, Steve Hicks School of Social Work, The University of Texas, Austin, Texas, USA.

Diana M. DiNitto, Steve Hicks School of Social Work, The University of Texas, Austin, Texas, USA.

Bryan Y. Choi, Department of Emergency Medicine, Brown University, Providence, Rhode Island, USA.

Correspondence concerning this article should be addressed to Namkee G. Choi, Steve Hicks School of Social Work, The University of Texas, 1925 San Jacinto Blvd, D3500, Austin, TX 78712, USA. E-mail: [email protected]

All four authors conceptualized the study. NGC and BYC did the literature review. NGC conducted statistical analysis and drafted the paper. CNM provided statistical consultation. BYC and DMD reviewed and edited it.