Veterans and suicide: a reexamination of the National Death Index-linked National Health Interview Survey

Am J Public Health. 2012 Mar;102 Suppl 1(Suppl 1):S154-9. doi: 10.2105/AJPH.2011.300409. Epub 2012 Jan 25.


Objectives: We assessed the risk of suicide among veterans compared with nonveterans.

Methods: Cox proportional hazards models estimated the relative risk of suicide, by self-reported veteran status, among 500,822 adult male participants in the National Death Index (NDI)-linked National Health Interview Survey (NHIS), a nationally representative cohort study.

Results: A total of 482 male veterans died by suicide during 1,837,886 person-years of follow-up (76% by firearm); 835 male nonveterans died by suicide during 4,438,515 person-years of follow-up (62% by firearm). Crude suicide rates for veterans and nonveterans were, respectively, 26.2 and 18.8 per 100,000 person-years. The risk of suicide was not significantly higher among veterans, compared with nonveterans, after adjustment for differences in age, race, and survey year (hazard ratio = 1.11; 95% confidence interval = 0.96, 1.29).

Conclusions: Consistent with most studies of suicide risk among veterans of conflicts before Operation Iraqi Freedom/Operation Enduring Freedom, but in contrast to a previous study using the NDI-linked NHIS data, we found that male veterans responding to the NHIS were modestly, but not significantly, at higher risk for suicide compared with male nonveterans.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cause of Death
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Registries
  • Risk Assessment
  • Risk Factors
  • Suicide / psychology*
  • Suicide / statistics & numerical data*
  • United States / epidemiology
  • Veterans / psychology*
  • Veterans / statistics & numerical data*