Abstract
Suicide is a pressing public health concern. Identifying risk factors and understanding their interplay is vital for effective prevention and intervention. This study examined the association of alcohol misuse, veteran status, and urbanization on suicide risk among U.S. adults. Using data from the 2015-2020 National Survey on Drug Use and Health (NSDUH), a cross-sectional analysis was conducted on a representative sample of U.S. adults. To determine overall risk for suicide, adjusted odds ratios were calculated through multivariable adjusted multinomial logistic regression. The study utilized self-report survey data collected from noninstitutionalized U.S. population. The NSDUH utilized a stratified multistage probability sampling method to ensure representative data collection. Suicide risk did not differ significantly between urban and rural areas. Heavy drinking increased risk for suicide ideation and attempts among urban veterans and nonveterans. Binge drinking had a positive association with suicide ideation in urban nonveterans. In rural areas, alcohol misuse did not significantly influence suicide risk among veterans. Alcohol misuse is a significant risk factor for suicide among both veterans and nonveterans in urban settings. Tailored suicide prevention strategies that account for urbanization and veteran status are critically needed.