Nathalie Huguet, Ph.D., Portland State University
Young Investigator Grant (2009): $84,722
Mentor: Mark Kaplan, Ph.D., Portland State University
Epidemiology of Undetermined Deaths: Prevalence and Patterns of Misclassified Suicides
Abstract: Suicide is a major public health problem. In the U.S., over 34,000 decedents were classified as suicides; suicide statistics are not accurate and the “true” rate of suicide is unknown. Evidence suggests that suicide rates may be underestimated by as much as 30%. Many, if not most, deaths classified as undetermined are considered “hidden suicides.” Many studies have demonstrated that certification of death, as undetermined, is not random. However, most of these studies relied exclusively on death certificate records limiting our understanding of the variations in death certification and of its impact on suicide rate estimates. The National Violent Death Reporting System (NVDRS) offers a unique opportunity to assess variations in death certification using characteristics other than the one available on the death certificate. The NVDRS provides a wide array of suicide risk factors and recent population data. The overall objective of this project is to assess the epidemiology of undetermined deaths and to estimate the rate of misclassified suicides. This study will describe decedents whose cause of death was classified as undetermined and compare them with suicide decedents using the NVDRS. The project will estimate the rate of suicides misclassified as undetermined deaths for specific subgroups of the population. This project will enhance our understanding of death certification and the potential impact of misclassification on suicide surveillance efforts. It is essential to delineate whether the variations in certifying decedents as undetermined deaths are random or socially patterned because the degree to which suicides are valid may differ in certain groups of the population which may result in less effective suicide preventions for these specific groups.