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Self-injury mortality rates surpass influenza, pneumonia, kidney disease mortality rates

Rates of “accidental” death, which often involve self-intoxication, have steadily increased from 1999 to 2014 and are comparable with rates of death due to diabetes.

“Fatal self-injury in the United States associated with deliberate behaviors is seriously underestimated owing to misclassification of poisoning suicides and mischaracterization of most drug poisoning deaths as ‘accidents’ on death certificates,” Ian R. H. Rockett, PhD, MPH, of West Virginia University, Morgantown, and colleagues wrote.

Self-injury mortality was defined by researchers as a combination of known suicides by any method and estimated death from drug self-intoxication classified by medical examiners as “accident” or undetermined.

To compare national trends of self-injury mortality with mortality from three of the 10 top causes of death (ie, diabetes, influenza/pneumonia and kidney disease), researchers analyzed death certificate data from the CDC’s Wide-Ranging Online Data for Epidemiologic Research online databases for 1999 to 2014.

There were an estimated 40,289 self-injury deaths in 1999 and 76,227 in 2014. Females accounted for 22.1% of self-injury deaths in 1999 and 28.8% of deaths in 2014.

The estimated crude rate of self-injury mortality increased by 65%, from 14.4 deaths per 100,000 persons in 1999 to 23.9 deaths per 100,000 persons in 2014 (rate ratio = 1.03; 95% CI, 1.03-1.04; P < .001).

The rate of self-injury mortality exceeded the rate of kidney disease mortality and surpassed the influenza/pneumonia mortality rate by 2006.

In 2014, the rate of self-injury mortality was comparable to the diabetes mortality rate.

Further, the rate of self-injury mortality was 1.8 times higher than the suicide mortality rate in 2014 vs. 1.4 times higher in 1999.

The male-to-female ratio for self-injury mortality decreased from 3.7 in 1999 to 2.6 in 2014 (rate ratio = 0.98; 95% CI, 0.97-0.98; P < .001).

In 2014, self-injury mortality accounted for 32.2 and 36.6 years of life lost for male and female decedents, respectively, compared with 15.8 and 17.3 years from diabetes; 15 and 16.6 years from influenza/pneumonia; and 14.5 and 16.2 years from kidney disease.

“The burgeoning [self-injury mortality] rate has converged with the diabetes rate, but [self-injury mortality] accounts for approximately 6-fold more deaths to individuals younger than 55 years and is increasingly affecting women relative to men. Accurately characterizing, measuring, and monitoring this major clinical and public health challenge will be essential for developing a comprehensive etiologic understanding and evaluating preventive and therapeutic interventions,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.