Racial disparity in the occurrence of suicides among patients with background intimate partner violence

Abstract

Introduction: The prevalence of Intimate Partner Violence (IPV) continues to increase in the USA. IPV is a major risk factor for suicide and inflicts a substantial economic burden on the United States in terms of health care costs and reduced productivity. The increased racial disparity has been explained in terms of higher prevalence of traditional risk factors of suicide in the white population. Aim: To determine if race/ethnicity is an independent predictor of suicide risk among women with background of intimate partner violence. Method: We queried the National Inpatient Database NIS 2005-2015 using the ICD-9 diagnosis codes to extract data on IPV associated in the study period. We conducted a trend analysis to determine trends of IPV from 2005-2015. A multivariate regression was done to determine the predictors of suicides in the study cohort. Patients with background IPV who attempted suicide was compared with a propensity score generated control group controlling for age, gender, alcohol addiction, schizophrenia, obesity, insurance and median income. The primary outcome was racial disparity among the two groups. Results: There were a total of 18,769 IPV associated hospitalization in the NIS from 2005-2015. The prevalence of self-inflicted injury or suicide in the study population was 2.6%. This is higher than the average prevalence in the general population attesting to the increased prevalence of suicide among people with background IPV. The prevalence of IPV increased between 2000-2015, however, this remained stable at 20%: 80% among men and women with background IPV. Whites experienced suicides more than any other race/ethnicity, even after controlling for age, gender, alcohol addiction, schizophrenia, obesity, insurance and median income (OR=3.87; 95% CI 2.68-5.56, p < 0.05). Conclusion: The prevalence of IPV has continue to increase in the USA. The higher prevalence of suicides among whites with background IPV is independent of traditional risk factors.