The Suicide Spectrum in Delaware County - PowerPoint PPT Presentation

Loading...

PPT – The Suicide Spectrum in Delaware County PowerPoint presentation | free to download - id: f6f99-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

The Suicide Spectrum in Delaware County

Description:

The Suicide Spectrum in Delaware County – PowerPoint PPT presentation

Number of Views:10
Avg rating:3.0/5.0
Slides: 37
Provided by: fredric2
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: The Suicide Spectrum in Delaware County


1
The Suicide Spectrum in Delaware County
  • Fredric N. Hellman, M.D., M.B.A.
  • Chief Medical Examiner, Delaware County, PA

2
Role of the Medical Examiner
  • Identification presumptive vs confirmatory
  • Estimation of Time of Death
  • Documentation of Injuries/Pathology
  • Collection of Trace Evidence
  • Determination of Cause Manner of Death

3
Manner of Death
  • A classification of the way in which the cause of
    death came about, with special reference to
    social relationships and personal causation
  • Categories
  • Natural
  • Accident
  • Suicide
  • Homicide
  • Undetermined

4
The Medical Examiners Role in Potential Suicide
Investigation
  • The medical examiner is responsible for the
    investigation of any unexplained, unexpected,
    mysterious or violent death
  • In the case of potential suicide, the ME must
    attempt to ascertain, to a reasonable degree of
    medical certainty, both intent towards
    self-destruction and a subsequent lethal act

5
The Medical Examiner You
  • Suicide has been a serious health problem for
    many years, but has only recently acquired the
    attention that it merits
  • Every year, approximately 30,000 individuals die
    by suicide in the U.S., and one million die
    worldwide
  • More than 650,000 people annually receive
    emergency treatment after a suicide attempt in
    this country
  • Suicide is the third-leading COD amongst American
    youth, being 11 for Americans across all ages

6
National Suicide Rates
  • While having remained fairly stable through time
    among this countrys general population
    (12.1/100,000 (1976) 10.8/100,000 (1996)),
    substantial shifts in suicide rates have been
    observed amongst various age, gender, ethnic
    groups

7
National Suicide Rates
  • While females are more likely than males to
    attempt suicide, males are 4X as likely to be
    successful
  • White males/females accounted for over 90 of
    suicides in 1997, with white males alone
    responsible for 72
  • Firearm-related deaths accounted for 58 of all
    suicides in 1997

8
Suicide-Regional Variation
  • Suicide rates have varied by geographic region,
    being consistently higher in the Western states
  • Reasons are unclear, but may reflect regional
    differences in certain demographic variables
    (Suicide rates are known to be higher for the
    elderly, for white males, for certain
    racial/ethnic groups)

9
Suicide-Regional Variation
  • From 1990-1994, 154,444 persons were reported to
    complete suicide in the U.S.
  • Northeast 23,734 (15)-8.6/100,000
  • Midwest 34,492 (22)-10.9/100,000
  • West 38,709 (25)-14.1/100,000
  • South 57,509 (37)-13.1/100,000
  • Total U.S. adjusted suicide rate during this
    period-11.8/100,000

10
Suicide-Regional Variation
  • Reasons other than for possible regional
    differences in certain demographics
  • Suicide rates are higher in communities with
    deficient social integration unstable social
    environments
  • Limited economic opportunity with increased
    unemployment as well as residential instability
    may also contribute to an elevated suicide rate

11
More Suicide Statistics
  • Suicide rates are inversely related to level of
    education
  • The incidence of suicide is also significantly
    lower among married individuals than among those
    who are single, separated, divorced or widowed

12
Suicide Among Youth
  • The Problem Rates of reported suicides among
    adolescents young adults have nearly tripled
    between 1952 1996
  • 1950 4.5/100,000
  • 1990 13.5/100,000

13
Suicide Among Youth
  • Suicide is now the 4th leading cause of death
    amongst children aged 10-14 years
  • Suicide is the 3rd leading cause of death amongst
    adolescents aged 13-24 years, exceeded only by
    unintentional injury homicide

14
Suicide Among Youth
  • Risk Factors include
  • Family history of suicide
  • Impulsive/aggressive behavior
  • Social isolation
  • Prior suicide attempt(s)
  • Easier access to alcohol, illicit drugs lethal
    suicide methods

15
Suicide Ideation/Attempts Among Youth
  • While suicide represents the 3rd leading cause of
    death among U.S teens, many more seriously
    consider suicide w/o attempting or attempt w/o
    completing the act

16
Suicide Ideation/Attempts Among Youth
  • 1999 20 of all H.S. students acknowledged
    having seriously considered or attempted suicide
    during the prior year
  • 8 actually attempted suicide
  • Less than 3 reported an injurious episode
    necessitating medical attention

17
The Suicide Profile- Delaware County
  • Suicide rates associated demographic data were
    tracked from 1990-2006
  • Deaths due to suicide during this period 933,
    with 904 initiated within Delaware Co.
  • Per annum range 45-69, with a median55 a
    mean56 deaths
  • Based upon a county population547,651, the 1990
    suicide rate per 100,000 individuals10.4

18
The Suicide Profile- Delaware County
  • Utilizing the Delaware Valley Regional Planning
    Commission est. population in 2000(549,070)
  • -DELCO suicide rate(2006)10.1

19
The Suicide Profile- Delaware County
  • By gender race, suicide was successfully
    completed by 210 females (22.5) 723 males
    (77.5). All but 116 such acts were completed by
    Caucasians (88), with the vast majority of
    suicides being completed by Caucasian males (71).

20
The Suicide Profile- Delaware County
  • Suicide rate by race(1990/1998)
  • White-8.4/7.2
  • Black-4.9/7.2
  • Asian-0/0
  • Hispanic-16.7/0

21
Suicide at the Extremes-Delaware County
  • Between 1990-2006, 61 individuals (6.5) between
    the ages of 16-20 years completed suicide, with
    153 additional suicides (16.4) among those aged
    21-30 years
  • At the opposing end of the age spectrum, 221
    persons 61 years of age or older (18.8)
    completed suicide during this period of time

22
Delaware County Suicide Rate (1990-2006)
23
Delaware County Demographics
  • A total of 65 boroughs, townships and communities
    comprised the study distribution of completed
    suicides within the county during the period
    1990-2006.
  • Two communities were without completed suicides
    during this timeframe (Corcordville, Lester)
  • Eight communities outside of the county
    contributed 29 suicides during this period
    (inciting act versus location of pronouncement of
    death)
  • Adjusted Delaware County suicide rate
    (1990-2006) 9.8

24
Delaware County Demographics
  • Community population range (2000 census data)
  • Largest population Upper Darby (81,529)
  • Smallest population Ruttledge (852)
  • Per capita income (PCI) range
  • Highest PCI Rose Valley (54.2K)
  • Suicide rate/100,000 11.3
  • Lowest PCI Chester City (13.1K)
  • Suicide rate/100,000 12.1
  • Mean PCI 25.0K

25
Delaware County Household Demographics
  • Married couples (104,911) versus single-parent
    households (26,542) 4.01
  • Highest ratio Thornbury (16.11), with PCI
    22.0K
  • Suicide rate/100,000 10.1
  • Lowest ratio Chester City (0.81), with PCI
    13.1K
  • Suicide rate/100,000 12.1

26
Delaware County Household Demographics
  • Households of those 65 years alone 5,792 M
    and 18,057 F
  • Highest per total community population
    Edgemont (7.3)
  • Suicide rate/100,000 20.1
  • Lowest per total community population Bethel
    (1.1)
  • Suicide rate/100,000 7.6
  • Average 4.5
  • Suicide rate/100,000 9.8

27
Delaware County Demographics Educational Level
  • Delaware County residents with educational
    attainment of bachelors degree or above
    109,670 out of 355,174 residents 25 years of age
    (30.0)
  • Community with highest of residents with
    educational attainment of bachelors degree or
    above Swarthmore (2,618/3,395 (77.1))
  • Suicide rate-13.3
  • Community with lowest of residents with
    educational attainment of bachelors degree or
    above Chester City (1,804/21,174 (0.85))
  • Suicide Rate-12.1

28
Community Suicide Rate Demographics
  • Communities with suicide rates of 14.1/100,000 or
    greater 14/65
  • Range 14.1-48.1/100,000
  • Mean 21.9/100,000
  • Communities with suicide rates of 7.0/100,00 or
    less 11/65
  • Range 4.2-7.0/100,000
  • Mean 5.8/100,000

29
Community Suicide Rate Demographics
  • Communities with suicide rates of 14.1/100,000 or
    greater
  • PCI 21.9K
  • Married Single parent households 3.61
  • Households of 65 years alone 4.85
  • Educational attainment of bachelors degree or
    above 18.4

30
Community Suicide Rate Demographics
  • Communities with suicide rates of 7.0/100,000 or
    less
  • PCI 29.4K
  • Married Single Parent household 7.11
  • Households of 65 years alone 4.35
  • Educational attainment of bachelors degree
    above 40.6

31
Suicide Risk Factors
  • Suicide rates are higher in communities with
    deficient social integration unstable social
    environments
  • Limited economic opportunity with increased
    unemployment as well as residential instability
    may also contribute to an elevated suicide rate

32
Suicide Associations
  • Suicide rates are inversely related to level of
    education
  • The incidence of suicide is also significantly
    lower among married individuals than among those
    who are single, separated, divorced or widowed

33
Suicide Associations
  • Suicide rates are known to be higher for the
    elderly, for white males, for certain
    racial/ethnic groups

34
Suicide Among Youth
  • Risk Factors include
  • Family history of suicide
  • Impulsive/aggressive behavior
  • Social isolation
  • Prior suicide attempt(s)
  • Easier access to alcohol, illicit drugs lethal
    suicide methods

35
Suicide Among the Elderly
  • Risk factors include
  • Widowhood
  • Serious medical illness, with associated
    anxieties
  • Social isolation
  • Depression
  • Alcoholism prescription drug abuse
  • Financial constraints

36
The Surgeon Generals Call To Action
  • The public health approach
  • Define the problem
  • Identify the causes protective factors
  • Develop test interventions
  • Implement interventions
About PowerShow.com