Suicide among veterinarians in the United States from 1979 through 2015

Abstract

OBJECTIVE To assess proportionate mortality ratios (PMRs) for suicide among male and female US veterinarians from 1979 through 2015. DESIGN PMR study. SAMPLE Death records for 11,620 veterinarians. PROCEDURES Information for veterinarians who died during 1979 through 2015 was obtained from AVMA obituary and life insurance databases and submitted to a centralized database of US death records to obtain underlying causes of death. Decedent data that met records-matching criteria were imported into a software program for calculation of PMRs for suicide stratified by sex and indirectly standardized for age, race, and 5-year calendar period with 95% confidence intervals. RESULTS 398 deaths resulted from suicide; 326 (82%) decedents were male, 72 (18%) were female, and most (298 [75%]) were ≤ 65 years of age. The PMRs for suicide for all veterinarian decedents (2.1 and 3.5 for males and females, respectively), those in clinical positions (2.2 and 3.4 for males and females, respectively), and those in nonclinical positions (1.8 and 5.0 for males and females, respectively) were significantly higher than for the general US population. Among female veterinarians, the percentage of deaths by suicide was stable from 2000 until the end of the study, but the number of such deaths subjectively increased with each 5-year period. CONCLUSIONS AND CLINICAL RELEVANCE Results of the study indicated that PMRs for suicide of female as well as male veterinarians were higher than for the general population. These data may help to inform stakeholders in the creation and implementation of suicide prevention strategies designed for veterinarians.

Figure 1—

Flow diagram depicting selection, inclusion, and exclusion of records for use in a study to assess PMRs for suicide among male and female veterinarians in the United States from 1979 through 2015. The initial dataset for deceased US veterinarians was collected by examination of records for obituary information submitted to the JAVMA, terminated life insurance policies obtained through AVMA membership, and computerized searches for obituaries of veterinarians. For study purposes, the date of graduation from veterinary school was considered the exposure start date.

Figure 2—

Graphic depictions of the number of deaths by suicide among male and female veterinarians (A) and the percentage of deaths by suicide among female veterinarians (B) in the seven 5-year calendar periods of the study. Calendar periods were standardized by LTAS software into 5-year periods; data for 2015 are not shown because data for only 1 year were available for the 5-year calendar period. In panel A, white and black bars represent suicide deaths of males and females, respectively. In panel B, stacked black and white bars represent the percentage deaths among females that resulted from suicide and from all other causes, respectively.

Figure 3—

Proportionate mortality ratios for suicide of male (solid line) and female (dashed line) veterinarians by calendar period during the study. The PMRs were calculated by use of LTAS software; values > 1.0 indicate that the proportion of deaths by suicide is greater than that for the general US population during the same 5-year period. All PMRs were significant (P < 0.05) except those for males in the 1985–1989 calendar period.

Figure 4—

Percentages of suicides among male (A) and female (B) veterinarians classified by occupational position type and means of death during 1979 through 2015. Black, white, and gray stacked bars indicate deaths incurred by pharmaceutical poisoning, firearm injury, and other methods, respectively. Occupational positions were classified as clinical if decedents had general practice listed as their employment facility type or their primary function was listed as clinical medicine. The category of all included clinical (261 males and 52 females), nonclinical (56 males and 11 females), and unknown (9 males and 9 females) position types.