Gay, lesbian, bisexual veterans at increased risk for suicide mortality

Gay, lesbian and bisexual veterans were at increased risk for suicide mortality, according to results of a retrospective population-based cohort study published in JAMA Network Open.

“Sexual minority individuals have a higher lifetime risk for suicide ideation and attempts than heterosexual individuals, but suicide data for [sexual minority] populations are not well characterized,” Kristine E. Lynch, PhD, of Veterans Affairs Salt Lake City Health Care System in Utah, and colleagues wrote. “Lack of reliable mortality data has been an obstacle to understanding mortality disparities experienced by [sexual minority] communities, including [sexual minority] veterans.”

The investigators aimed to assess suicide mortality of 8.1 million veterans by analyzing their Veterans Health Administration (VHA) electronic health record data between October 1999 and September 2017. Documentation of a minority sexual orientation served as the exposure. The researchers obtained this information using natural language processing of clinical notes and by extracting structured administrative sexual orientation data in VHA EHR records. Main outcomes and measures included suicide mortality rate according to data on the underlying cause of death obtained via the National Death Index. Lynch and colleagues calculated crude and age-adjusted mortality rates for death from suicide and all-cause death among veterans in this population vs. the general United States population and the general population of veterans.

Data were available of 96,893 veterans with one or more sexual minority documentation in the EHR record. Participants had a mean age of 46 years, 68% were men and 70% were white. Results showed 3.5% of 12,951 total deaths were from suicide. The mortality rate from suicide (standardized mortality rate = 4.5; 95% CI, 4.13-4.99) was significantly higher among veterans vs. the general U.S. population. Among gay, lesbian or bisexual veterans, suicide was the fifth-leading cause of death in 2017, comprising 3.8% of deaths. Among the general U.S. population, it was the 10th-leading cause of death, comprising 1.7% of deaths. Gay, lesbian or bisexual veterans had a crude suicide rate of 82.5 per 100,000 person-years compared with 37.7 per 100,000 person-years in the general veteran population.

“Further research is needed to determine whether and how suicide prevention efforts reach sexual minority veterans,” Lynch and colleagues wrote.