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Reducing Suicide: A National Imperative
TABLE A-2 Observed and Expected Suicide Rates by Age, Race, and Sex. Data: CMF 1996–1998
Age Group
Race
Sex
Number of Suicides
Population
Observed Rate
Expected Rate (1)
Expected Rate (2)
05–14
Black
Male
79
9,256,227
0.000009
0.000010
0.000009
05–14
Black
Female
28
8,978,221
0.000003
0.000003
0.000002
05–14
Other
Male
620
50,356,003
0.000012
0.000014
0.000012
05–14
Other
Female
206
47,847,778
0.000004
0.000005
0.000004
15–24
Black
Male
1,333
8,389,386
0.000159
0.000177
0.000160
15–24
Black
Female
191
8,352,196
0.000023
0.000024
0.000021
15–24
Other
Male
9,482
47,906,710
0.000198
0.000222
0.000198
15–24
Other
Female
1,673
45,396,608
0.000037
0.000042
0.000037
25–44
Black
Male
2,546
15,274,935
0.000167
0.000184
0.000164
25–44
Black
Female
474
17,191,095
0.000028
0.000033
0.000030
25–44
Other
Male
27,209
109,106,670
0.000249
0.000283
0.000250
25–44
Other
Female
6,977
108,864,081
0.000064
0.000072
0.000064
45–64
Black
Male
861
7,741,680
0.000111
0.000124
0.000111
45–64
Black
Female
224
9,633,227
0.000023
0.000026
0.000023
45–64
Other
Male
17,358
72,740,945
0.000239
0.000267
0.000239
45–64
Other
Female
5,307
76,289,629
0.000070
0.000078
0.000070
65+
Black
Male
415
3,295,133
0.000126
0.000142
0.000131
65+
Black
Female
83
5,140,632
0.000016
0.000014
0.000013
65+
Other
Male
14,074
38,889,596
0.000362
0.000398
0.000361
65+
Other
Female
2,814
55,229,051
0.000051
0.000057
0.000051
Note: (1) Mixed-effect model
(2) GEE model
spection of Table A-3 reveals remarkably close agreement between observed and expected numbers of suicides.
Second, we can use the Bayes estimates directly to obtain county-level suicide rates adjusted for the effects of race, sex, and age. In the case of a Poisson model, the Bayes estimate for a given county is a multiple of the national suicide rate adjusted for the case mix in that county (i.e., race, sex and age). For example, a Bayes estimate of 1.0 represents an adjusted rate that is equal to the national rate. By contrast, a Bayes estimate of 2.0 represents a doubling of the national rate, and a Bayes estimate of 0.5 represents one-half of the national rate. Figure A-2 displays the Bayes estimates by county across the U.S. Inspection of Figure A-2 reveals that even after accounting for these important demographic variables, considerable spatial variability remains. Again, the highest adjusted rates are typically found in the less densely populated areas of the western U.S.
The map in Figure A-2 also provides a useful tool for qualitative research into the etiology of suicide. A natural approach is to examine the