Physical health problems as a suicide precipitant: Associations with other risk factors and suicide methods in three age groups of older decedents

Background and Objectives: Physical health problems are a significant late-life suicide precipitant. This study’s purpose was to examine differences in (i) other suicide precipitants and psychiatric/substance use problems, and (ii) suicide methods (firearms, hanging/suffocation, and poisoning) in 3 age groups (55–64, 65–74, and 75+) of older suicide decedents who had physical health problems as a suicide precipitant.

Research Design and Methods: Data came from the 2017–2019 U.S. National Violent Death Reporting System (N = 34,912; 27,761 males [79.5%] and 7,151 females [20.5%]). Generalized linear models for a Poisson distribution with a log link were used to examine the study questions.

Results: Physical health problems were a suicide precipitant for 25.8%, 41.9%, and 57.7% of the 55–64, 65–74, and 75+ age groups, respectively, and were associated with a higher likelihood of having had depressed mood (IRR = 1.38, 95% CI: 1.33–1.43) and other substance use problems (IRR = 1.22, 95% CI: 1.13–1.31). Interaction effects showed that when job/finance/housing problems, depressed mood, or any psychiatric disorders were co-present with physical health problems, the age group differences in the predicted rates of physical health problems were diminished. Physical health problems were also positively associated with firearm and poisoning use, but negatively associated with hanging/suffocation. Interaction effects indicated that the predicted rates of firearm and poisoning use significantly increased among those aged 55–64 with than without physical health problems.

Discussion and Implications: In all 3 age groups of older suicide decedents, physical health problems were the predominant suicide precipitant, and those with physical health problems had elevated depressed mood. Assessment of suicide risk, affordable and accessible health, and mental health services, restriction of access to lethal suicide methods, and policy-based suicide prevention approaches for older adults with physical health problems are needed.