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    Original Investigation
    Psychiatry
    December 13, 2019

    A Historical Examination of Military Records of US Army Suicide, 1819 to 2017

    Author Affiliations
    • 1Department of History, University of Hawaii, Hilo
    • 2The Department of Defense, Arlington, Virginia
    • 3University of Hawaii, Hilo
    • 4Department of Psychology, University of Hawaii, Hilo
    • 5Department of Psychiatry, University of Texas Health Sciences Center, Houston
    JAMA Netw Open. 2019;2(12):e1917448. doi:10.1001/jamanetworkopen.2019.17448
    Key Points español 中文 (chinese)

    Question  How do suicide rates among active-duty US Army service members in the 21st century compare with those in the 20th and 19th centuries?

    Findings  This cross-sectional study, which includes data on all active-duty personnel in the US Army from 1819 to 2017, documented trends in suicide rates. The findings suggest that suicides historically decreased during wartime, but that pattern seems to have changed during the wars in Vietnam, Iraq, and Afghanistan.

    Meaning  The results of this study demonstrate the usefulness of increased historical-epidemiological partnerships to better separate long-term causes from more short-term factors and to aid in understanding the current spike in suicides among active-duty personnel in the US Army.

    Abstract

    Importance  Suicide rates among active-duty personnel in the US military have increased substantially since 2004, and numerous studies have attempted to contextualize and better understand this phenomenon. Placing contemporary examinations of suicides among active-duty personnel in the US Army in historical context provides opportunities for joint historical and epidemiological research to inform health care professionals and policy makers.

    Objectives  To consolidate data on suicide rates among active-duty personnel in the US Army as far back as historical records allow and to identify historical trends to separate them from more acute causal factors.

    Design, Setting, and Participants  This cross-sectional study included all active-duty service members in the US Army from 1819 to 2017 as identified and detailed in US government publications, studies, and journal articles. Empirical data were extracted from US government publications and journal articles published from 1819 to 2017. Data collection and analysis were completed between July and August of 2019.

    Exposure  Suicide.

    Main Outcomes and Measures  Suicide rates per 100 000 individuals.

    Results  Starting in 1843, the overall trend in annual suicide rates among active-duty service members in the US Army increased, with a peak rate of 118.3 per 100 000 in 1883. From that historical high point, the rate decreased in 3 successive waves, each corresponding to the end of the following wars: the Spanish-American War (1898), World War I (1914-1918), and World War II (1939-1945). The latter had the historically lowest rate of 5 per 100 000 in 1944 to 1945. During the Cold War (approximately 1945-1991), the rate generally stabilized in the low teens to midteens (ie, 10-15 per 100 000). The rate increased again during the Afghanistan and Iraq Wars, increasing to 29.7 per 100 000 in 2012. From 2008 to present, the annual rate has remained within the range of 20.2 to 29.7 per 100 000.

    Conclusions and Relevance  This study represents the most extensive historical examination of suicides in the US Army to date. By taking a long-term historical approach to suicide among active-duty personnel in the US Army, this study affords future researchers a new analytical tool and an additional perspective from which to better differentiate long-term and historical trends from more short-term and temporary causal factors.

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