Abstract
BACKGROUND: Suicide rates in the United States have been consistently increasing since 2005 and increasing faster among females than among males. Understanding circumstances related to the changes in suicide may help inform prevention programs. This study describes the circumstances associated with suicides among females in the United States using the National Violent Death Reporting System. METHODS: We analyzed the circumstances of suicides occurring from 2005 to 2016 in 16 states (Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia, and Wisconsin) among females aged 10 years and above. We compared the percentages of circumstances reported for the entire sample, by age group, and by race/ethnicity. Trends in changes in the leading circumstances were analyzed using Joinpoint regression. RESULTS: From 2005 to 2016, there were 27,809 suicides among females 10 years and older in the 16 states. Overall, the 2 leading precipitating circumstances were current mental health problem and ever treated for mental health problem. The leading circumstances differed by demographics. Joinpoint analysis showed inflection points in reports of job problems, financial problems, and non-intimate partner relationship problems during 2005-2009. During 2010-2016, downward inflections were seen in reports of job problems and financial problems and upward inflections in substance abuse problems and a recent or impending crisis. CONCLUSIONS: These findings show changes by age group and race/ethnicity in the circumstances associated with suicides among females in the 16 states have occurred. Studying these shifts and identifying the most salient circumstances among female suicide decedents may help prevention programs adapt to different needs.