Geographic disparities and predictors of suicide mortality risk in Florida: spatial scan statistics and negative binomial modeling

Abstract

Background. Florida ranks 17th in suicide mortality risk in the United States, with 14.8 suicide deaths per 100,000 persons. Geographic disparities in suicide mortality across the US are well-documented and are partly attributed to the uneven distribution of risk factors. However, limited data exist on such disparities and associated predictors within Florida, despite their importance for guiding targeted prevention efforts. This study aimed to investigate county-level geographic disparities in suicide mortality risk in Florida and identify predictors of these disparities. Methods. This retrospective ecological study used data from the Florida Department of Health. County-level age-adjusted suicide mortality risks and spatial empirical Bayesian-smoothed risks were calculated for three time periods: 2011–2013, 2014–2016, and 2017–2019. Tango’s spatial scan statistics were applied to identify high-risk clusters. A negative binomial regression model was used to examine county-level predictors of suicide mortality risk for the 2017–2019 period. Results. Statewide age-adjusted suicide mortality risk increased from 22.6 to 24.3 per 100,000 persons over the study period. Counties in the northwest, northeast, southwest, and parts of central Florida consistently exhibited high mortality risks. Suicide mortality risk was significantly higher in counties with larger proportions of residents aged 45–64 years and ≥65 years, those reporting excessive drinking, frequent mental distress, or veteran status. Conclusion. This study identified geographic disparities and key predictors of suicide mortality risk across Florida counties. These findings can inform policymakers, healthcare providers, and community organizations in designing and implementing targeted suicide prevention programs tailored to the specific needs of high-risk communities.