MMWR, 2018, 67(8): 237-242

Suicide disproportionately affects American Indians/Alaska Natives (AI/AN). The suicide rate among AI/AN has been increasing since 2003 (1), and in 2015, AI/AN suicide rates in the 18 states participating in the National Violent Death Reporting System (NVDRS) were 21.5 per 100,000, more than 3.5 times higher than those among racial/ethnic groups with the lowest rates.* To study completed suicides across all ages of AI/AN, NVDRS data collected from 2003 to 2014 were analyzed by comparing differences in suicide characteristics and circumstances between AI/AN and white decedents. Considering circumstance information the following was noted: "Circumstance information, obtained primarily through information provided by persons who knew the decedent as indicated in coroner/medical examiner reports and law enforcement reports, was known for 87.5% of AI/AN and 89.8% of white suicides (Table 2). Although intimate partner problems were a common precipitating circumstance for both AI/AN (39.1%) and white decedents (29.4%), AI/AN had significantly higher odds of experiencing this circumstance (aOR = 1.2; 95% CI = 1.1–1.3). Approximately two in 10 AI/AN suicides were preceded by an argument, compared with one in 10 white suicides (aOR  =  1.4; 95% CI  =  1.2–1.7). Compared with white decedents, AI/AN decedents had 2.4 times the odds of the suicide of a friend or family member affecting their death (as ascertained through a note or interviews with persons who knew the decedent) (95% CI = 1.9–3.1) and 1.7 times the odds of the nonsuicide death of a friend or family member affecting their death (95% CI = 1.4–2.1)." (pp.238-9). Record #5778