Descriptive Epidemiology of Female Suicides by Race and Ethnicity.

Each year millions of females develop serious mental illnesses (SMI), which are major risk factors for suicides. Using the Web-Based Injury Statistics Query and Reporting System (WISQARS) for the years 2000, 2010 and 2020, we found in 2020 9,428 females (almost 190/week) committed suicide, losing 328,653 years off potential life before age 80 years. There were pronounced increases in female suicides from 2000 to 2020 across all racial and ethnic groups. The greatest number of suicides were in non-Hispanic white females, but the highest rate of suicides was in non-Hispanic American Indians /Alaska Natives, and in females 15-24 years of age. The West had the highest female suicide rates, with methods used to commit suicides varying by census regions and race and ethnicity. Suffocation to commit suicide increased for most racial and ethnic groups and poisonings decreased for most groups between 2000 and 2020, These underscore the need for targeted primary prevention of suicides for females based on age, geographic location and method of suicide, to mitigate female suicides improved access (e.g. geographically and financially) to mental health care services is essential.

Firearm Mortality of Non-Hispanic Black Americans by Law Enforcement, 2011-2020.

Law enforcement officers in the U.S. are more likely to use lethal force against non-Hispanic Black citizens than on their non-Hispanic White counterparts. The purpose of this study was to assess estimates of the national prevalence of fatal firearm violence by law enforcement officers (LEOs) against non-Hispanic Black Americans. The Web-Based Injury Statistics Query and Reporting System (WISQARS) from the Centers for Disease Control and Prevention (CDC) were analyzed using descriptive statistics and joinpoint regression from 2011 to 2020. During the decade (2011-2020) LEOs fatally shot 5,073 citizens and 1,170 were non-Hispanic Black (23%). The vast majority (96%) were males and two-thirds (66%) of those killed were ages 20-39 years. The region with the highest number of LEO fatal shootings was the Western U.S. Firearm deaths of non-Hispanic Blacks were the dominant (82%) method of LEO-induced deaths. Non-Hispanic Black Americans experience LEO firearm-related injuries and deaths at a much higher rate than their non-Hispanic White counterparts. In the context of the racial disparities among people who die following LEO-related gunshot wounds, changes to police training systems and an examination of implicit biases among LEOs should be investigated as the next step in reducing the use of lethal force practices.

Fatal Firearm Violence Among American Indians and Alaska Natives.

There is a dearth of population-based studies regarding firearm-related deaths and years of potential life lost among American Indians and Alaska Natives (AI/AN). Using the Centers for Disease Control and Prevention's (CDC) We Based Injury Statistics Query and Reporting System (WISQARS) data for the three most recent years (2018-2020), we analyzed the demographic characteristics of AI/ANs who succumbed to firearm violence. AI/ANs averaged almost 500 firearm-related deaths per year. The majority of these deaths were observed among individuals 20-39 years of age (53%), males (84.4%), and in the West (55.3%). A plurality of these firearm-related deaths were suicides (48.9%) followed by homicides (43.5%). During the 3-year study period, the age-adjusted firearm death rate increased almost 5 times the growth of the AI/AN population. Also, a staggering 67,050 years of potential life were lost before the age of 80 years (YPLL80) during this period. Firearm suicides were responsible for the largest proportion of YPLL80s (48.5%). Traditional legal interventions [e.g., child access prevention (CAP) laws and extreme risk protection orders (ERPO)], if expanded to more states could potentially help reduce AI/AN firearm mortality. None of the 10 states with the highest firearm mortality of AI/AN have ERPOs and 8 of the 10 do not have CAP laws. Also, a renewed focus on cultural continuity and indigenous protective factors is essential to ameliorate the level of firearm violence in AI/ANs.

Descriptive Epidemiology of Fatal Law Enforcement Interactions with Teenagers, 2010-2020.

There is a dearth of population studies regarding law enforcement officers (LEOs) use of fatal force against teenagers. The purpose of this cross-sectional study was to characterize the teens most likely to be killed, the methods used to fatally injure teenagers, the geographic distribution of the killings, and the years of potential life lost before the age of 80 years (YPLL80) due to LEO interactions. Data from the Web-based Injury Statistics Query and Reporting System (WISQARS) from the Center for Disease Control and Prevention (CDC) were analyzed for the years 2010-2020. LEOs killed 330 teenagers; most were males (94.2%) and 6 of 7 teens (84.5%) were shot. The teens killed were disproportionately older teens ages 18-19 years (64.2%) and non-Hispanic Blacks (45.8%) who were usually killed in metropolitan areas (90.0%). The rate of teenage killings by LEOs significantly increased (267%) over the time frame studied. A total of 20,575 YPLL80 were lost and they significantly increased over time (263%). Mitigation of teenagers killed by LEOs will require transforming policing through policy changes (e.g. hiring and training) over an extended period of time. Also, the public needs education, (e.g. funding, interactions) regarding policing.

Lethal Force Usage by Law Enforcement Officers Against Hispanics, 2011-2020.

Most research on lethal force by law enforcement officers (LEOs) has focused on firearm deaths by LEOs among certain racial groups (e.g., African Americans). Specifically, not much is known about LEOs-induced lethal injuries among Hispanics. The purpose of this study was to characterize LEOs induced fatal injuries, the methods used, among various demographic groups of Hispanics, and the years of potential life lost before the age of 80 years due to lethal force by LEOs. Data from the Web-Based Injury Statistics Query and Reporting System (WISQARS) were analyzed for the years 2011-2020. LEOs killed 1,158 Hispanics; most were males (96.2%) with the majority being shot (89.9%). Two-thirds (66.9%) of those killed were Hispanics 20-39 years of age and from the Western U.S. These Hispanic deaths resulted in 53,320 YPLLs. Males and those ages 20-39 years lost the most YPLLs. The rate of fatal encounters with LEOs for Hispanics grew by 44.4% over the decade, with the highest rate in 2020. Mitigation of unnecessary Hispanic deaths by LEOs needs to include changes in law enforcement agency policies, hiring practices for LEOs, improved data collection for LEOs use of lethal force, improved mental healthcare and training for LEOs, use of less lethal strategies for citizen control by law enforcement, deference education for all young adults, and long-term changes in social forces that have created and maintained disenfranchised communities of color.

Firearm Mortality Among Pre-school Age Children, 2010-2020.

Firearms are a substantial cause of death for pre-school children (ages 0-5 years). The purpose of this study was to characterize fatal firearm violence in this age group. The Web-Based Injury Statistics Query and Reporting System (WISQARS) data from the Centers for Disease Control and Prevention (CDC) were analyzed for the years 2010-2020. There were 1,220 firearm deaths during the study period with a 75% increase in the rate of deaths per 100,000 population. Most deaths (two-thirds) were among males. Non-Hispanic Blacks comprised 56.4% of all deaths in 2020, a 172% increase from 2010 and the rate for non-Hispanic Whites increased by 15.4% from 2010 to 2020. The majority of the deaths occurred in the South. Almost two-thirds (65.9%) of all firearm deaths were homicides, 30% were unintentional, and 4.1% were undetermined. Homicides were also the majority of deaths for non-Hispanic Blacks (64.9%), non-Hispanic Whites (60.8%), and Hispanics (81.3%). The years of potential life lost before 80 years of age were 94,105, with a plurality (43.3%) of losses occurring among non-Hispanic Black children. Sustained awareness campaigns should be implemented to make parents and guardians aware of the profound dangers of unlocked and loaded or unsafely stored firearms in the home. Child healthcare providers should counsel parents and guardians on firearm safety in households. Public health professionals should advocate for laws that can help protect children from firearm violence (e.g., Domestic Violence Restraining Orders, Child Access Prevention laws, and Extreme Risk Protection Order laws).

Child Access Prevention Laws and Non-Hispanic Black Youth Firearm Mortality.

Firearm injuries are the leading cause of death for youths 19 and younger in general and the third leading cause of death for non-Hispanic Black youths. Child Access Prevention (CAP) laws have been explored concerning their impact on firearm mortality reduction among heterogenous groups of youth, but not specifically among non-Hispanic Black youths. We analyzed data related to non-Hispanic Black youth firearm mortality, non-Hispanic Black poverty rates, firearm dealer density, and CAP laws for each state to ascertain the impact of CAP laws from 2015 to 2019. During the study period, a total of 6778 non-Hispanic Black youths died due to firearm trauma with the leading causes of death being homicides (85.8%); mostly seen among males (96%), and in the South (53.2%). When compared by CAP laws, the states with the strongest laws had statistically significantly lower rates of firearm mortality than states with the weakest laws. After adjusting for state poverty and firearm dealer density, the differences were not statistically significant but still, stronger CAP laws were associated with lower rates of firearm mortality among non-Hispanic Black youth. CAP laws alone can have a modest impact on non-Hispanic Black youth firearm mortality. To adequately reduce firearm mortality among non-Hispanic Black youths, the state and local governments should, along with CAP laws, enact policies to reduce poverty, crime, access to firearms by criminals, and neighborhood dysfunction among non-Hispanic Black communities.

Suicides Among Non-Elderly Adult Hispanics, 2010-2020.

Most research on suicides focuses on youth or the elderly and dominant groups of a population. The purpose of this study was to assess suicide trends for non-elderly adult Hispanics (age 20-64 years) over the past decade (2010-2020). Data from the Web-Based Injury Statistics Query and Reporting System (WISQARS) were analyzed for the study period. Suicides for Hispanics in 2010 were the 7th leading cause of death and became the 5th leading cause of death by 2020. During the decade of analyses, suicide rates increased 35.7% for males and 40.6% for females. Non-elderly Hispanic males were most likely to die by hanging/suffocation (2010 = 42%, 2020 = 41%), or firearms (2010 = 39%, 2020 = 42%). Whereas, Hispanic adult females were most likely to use hanging/suffocation (2010 = 36%, 2020 = 43%) or poisoning (2010 = 27%, 2020 = 19%) for completed suicides. In 2020, the top three states for non-elderly Hispanic adult suicides (per 100,000 population) were Colorado (25.52), New Mexico (23.99), and Utah (21.73). The Hispanic population continues to grow, but also faces chronicity of prejudice, underemployment, lack of healthcare access, multiple stressors, and rising levels of suicide. The reduction of adult Hispanic suicides would require additional resources, interventions, and research to understand prevention and risk factors.

Hispanic Child Suicides in the United States, 2010-2019.

Suicides in Hispanic adolescents have been increasing significantly. Less clear is the extent of suicides in Hispanic children younger than 12 years of age. The purpose of this study was to explore the trends and methods of suicides in Hispanic children from 2010 to 2019 (latest data available across the United States). Suicide is the 7th leading cause of death for Hispanic children. Hispanic child suicides statistically significantly increased during the decade. From 2010 to 2019, Hispanic child suicide rates increased by 92.3%. The suicide deaths were primarily in boys (59.6%) and among those 10-12 years of age (94.9%). Hispanic child suicides were most common in the West and South and least common in the Northeastern US The method used to commit suicide was overwhelmingly (76-85%) hanging/strangulation/suffocation. To help assure Hispanic children flourish and mature into healthy adults, it is essential that policymakers commit more resources for access to healthcare for all youths and that research funding for minorities include research regarding Hispanic children's suicide risk factors, protective factors, and effective interventions to reduce suicides of Hispanic children.

COVID-19 pandemic and weight gain in American adults: A nationwide population-based study.

BACKGROUND: The COVID-19 pandemic has affected the lives of people in many ways. However, little is known about weight gain in American adults during the pandemic. AIMS AND METHODS: The purpose of this study was to conduct a national assessment of weight gain in adult Americans after the first year of the pandemic. An online questionnaire was employed to explore perceptions of adults regarding pandemic weight gain and the relationship between weight gain and sociodemographic characteristics, pre-pandemic weight status, and psychological distress. Multiple methods were used to assess the psychometric properties of the questionnaire (i.e., face validity, content validity, and internal consistency reliability testing). Chi-Square tests and logistic regression analysis were used to assess group differences and predictors of weight gain in the study participants. RESULTS: A total of 3,473 individuals participated in the study with weight changes distributed as: gained weight (48%), remained the same weight (34%), or lost weight (18%). Those who reported being very overweight before the pandemic were most likely to gain weight (65%) versus those who reported being slightly overweight (58%) or normal weight (40%) before the pandemic. Weight gain was statistically significantly higher in those with anxiety (53%), depression (52%), or symptoms of both (52%). The final multiple regression model found that the statistically significant predictors of pandemic weight gain were psychological distress, pre-pandemic weight status, having children at home; and time since last bodyweight check. CONCLUSIONS: Population health promotion strategies in the pandemic should emphasize stress reduction to help individuals manage body weight and avoid chronic diseases in the future.

Childhood Suicide Trends in the United States, 2010-2019.

Suicides are among the 10 leading causes of death in U.S. children 12 years of age and younger. The purpose of this study was to examine trends and methods of suicide in children by race and gender from 2010 to 2019, the most recent years of data available from the Centers for Disease Control and Prevention. Child suicides statistically significantly increased for black (95%), white (158%), male (95%), and female (300%) children during the decade. Additionally, the methods children used to commit suicide did not significantly differ by race or gender. The leading method of suicide used by children was strangulation/suffocation depending on race and gender (67%-85%). The second most common method of suicide was by the use of a firearm, again depending on race and gender (11%-30%). Northeastern states had the fewest child suicides during the decade and Texas and California had the most child suicides. Policymakers need to commit more resources and research funding to better detect risk factors, protective factors, and effective interventions for reducing child suicides.

COVID-19 Morbidity and Mortality in Social Networks: Does It Influence Vaccine Hesitancy?

The impact of COVID-19 morbidity and mortality among family and friends on vaccination preferences is not well explored. A valid and reliable questionnaire was deployed online via mTurk to recruit a national random sample of adult Americans to understand COVID-19 vaccination preferences and its relationship with COVID-19 infection in social networks. A total of 1602 individuals participated in the study where the majority had taken at least one dose of the COVID-19 vaccine (79%) and almost a tenth were planning to do so (10%) or did not want to take the vaccine (11%). Compared to those who knew family members or friends affected by COVID-19, those who did not know anyone infected with (AOR = 3.20), hospitalized for (AOR = 3.60), or died of COVID-19 (AOR = 2.97) had statistically significantly higher odds of refusing the vaccines. Most strategies for reducing COVID-19 vaccination hesitancy focus on highlighting the benefits of COVID-19 vaccines. We suggest that the dangers of not getting the vaccine should also be emphasized as many people who do not know someone who was affected with COVID-19 are also hesitant towards vaccination. These individuals may not fully appreciate the morbidity and mortality impact of COVID-19 infections and the messaging can be tailored to highlight the risk of not having vaccines.

Unintentional firearm mortality in African-American youths, 2010-2019.

BACKGROUND/ PURPOSE: There is a dearth of studies that have examined unintentional firearm-related mortality in African-American (AA) youths. The purpose of this article is to assess the epidemiology of unintentional firearm mortality in AA youth, examine the risk factors associated with unintentional AA youth firearm mortality, and explore the evidence for preventing unintentional firearm-mortality in AA youths. METHODS: In this cross-sectional study, the Web-Based Injury Statistics Query and Reporting System (WISQARS) data from the Centers for Disease Control and Prevention (CDC) was used. Data were analyzed from the years 2010-2019 using descriptive statistics. RESULTS: Between the years 2010 and 2019, the AA youth unintentional firearm mortality rate increased by 48% while the rate for White youths declined by 29%. The decade from 2010 to 2019 saw almost 400 AA youths lose their lives to unintentional firearm trauma. AA male children averaged 87% of all AA unintentional firearm deaths during this time. The years of potential life lost due to unintentional firearm mortality ranged between 21,200 and 24,300 years. The risk factors for unintentional firearm mortality in AA youths include living in states with high rates of firearm ownership, living in a home with firearms, being an older adolescent, and being of lower socioeconomic status. Of all the strategies to prevent unintentional firearm mortality in youths, the most effective include strong (felony penalty) Child Access Prevention laws, the absence of Stand-Your-Ground laws, and physicians engaging in anticipatory guidance with patients regarding safe storage of firearms. CONCLUSIONS: Despite the limited scale of unintentional firearm mortality in AA youths, primary prevention dictates that public health professionals intervene to keep this public health problem from becoming an epidemic and a larger contributor to health disparities.

The Rising Tide of Elderly African-American Suicides: A Call for Action.

Suicides are among the leading causes of death in elderly Americans. The problem is expected to grow with an aging population in the U.S. Suicides in African-American elderly are not well studied. This article enumerates the risk factors for suicidal behaviors in elderly African-Americans; presents an epidemiological assessment of suicides in elderly African-Americans from 2010 to 2018 with gender-specific differences, and explores public health considerations for helping to reduce the growing numbers of suicides in elderly African-Americans. Currently, there are very limited evidence-based interventions to reduce or prevent suicides in older African-Americans. This article also provides implications and recommendations for prevention practice and research that is needed to help alleviate suicides in older African-Americans.

The Nature and Extent of COVID-19 Vaccination Hesitancy in Healthcare Workers.

COVID-19 vaccines were approved in late 2020 and early 2021 for public use in countries across the world. Several studies have now highlighted COVID-19 vaccination hesitancy in the general public. However, little is known about the nature and extent of COVID-19 vaccination hesitancy in healthcare workers worldwide. Thus, the purpose of this study was to conduct a comprehensive worldwide assessment of published evidence on COVID-19 vaccine hesitancy among healthcare workers. A scoping review method was adopted to include a final pool of 35 studies in this review with study sample size ranges from n = 123 to 16,158 (average = 2185 participants per study). The prevalence of COVID-19 vaccination hesitancy worldwide in healthcare workers ranged from 4.3 to 72% (average = 22.51% across all studies with 76,471 participants). The majority of the studies found concerns about vaccine safety, efficacy, and potential side effects as top reasons for COVID-19 vaccination hesitancy in healthcare workers. The majority of the studies also found that individuals who were males, of older age, and doctoral degree holders (i.e., physicians) were more likely to accept COVID-19 vaccines. Factors such as the higher perceived risk of getting infected with COVID-19, direct care for patients, and history of influenza vaccination were also found to increase COVID-19 vaccination uptake probability. Given the high prevalence of COVID-19 vaccine hesitancy in healthcare workers, communication and education strategies along with mandates for clinical workers should be considered to increase COVID-19 vaccination uptake in these individuals. Healthcare workers have a key role in reducing the burden of the pandemic, role modeling for preventive behaviors, and also, helping vaccinate others.

Firearm Suicides in the Elderly: A Narrative Review and Call for Action.

Firearm suicides are one of the leading causes of death for older Americans. The purpose of this review is to explore the risk factors associated with suicides in the elderly, provide an overview of the epidemiology of firearm-related suicides in older Americans, and explore methods of preventing firearm suicides in the elderly. The vast majority (70 %) of elderly suicides in the U.S were committed using a firearm. Elderly firearm suicides have increased by 49 % between 2010 and 2018, disproportionately affecting white males. Yearly firearm suicides in the elderly ranged from 4,276 in 2010 to 6,375 in 2018. In 2018, the rate of elderly male firearm suicides was 24.96/100,000 compared to a rate of 1.92/100,000 for elderly females, a rate ratio of 13 to 1 for males compared to females. The primary risk factors for elderly firearm suicides seem to be physical illnesses, mental illnesses, and social factors. Older Americans engage in suicidal behaviors with greater planning and lethality of intent than do young adults. Of all the strategies to prevent suicides with firearms, the most efficacious measures based on current research seem to be state firearm legislation and improving mental healthcare, but these effects are not specific to the elderly. Strengthening state firearm laws and improving mental healthcare for the elderly may have promise in preventing elderly firearm-related suicides. Additional implications for practice and research are discussed in this review.

COVID-19 Vaccination Hesitancy in the United States: A Rapid National Assessment.

Given the results from early trials, COVID-19 vaccines will be available by 2021. However, little is known about what Americans think of getting immunized with a COVID-19 vaccine. Thus, the purpose of this study was to conduct a comprehensive and systematic national assessment of COVID-19 vaccine hesitancy in a community-based sample of the American adult population. A multi-item valid and reliable questionnaire was deployed online via mTurk and social media sites to recruit U.S. adults from the general population. A total of 1878 individuals participated in the study where the majority were: females (52%), Whites (74%), non-Hispanic (81%), married (56%), employed full time (68%), and with a bachelor's degree or higher (77%). The likelihood of getting a COVID-19 immunization in the study population was: very likely (52%), somewhat likely (27%), not likely (15%), definitely not (7%), with individuals who had lower education, income, or perceived threat of getting infected being more likely to report that they were not likely/definitely not going to get COVID-19 vaccine (i.e., vaccine hesitancy). In unadjusted group comparisons, compared to their counterparts, vaccine hesitancy was higher among African-Americans (34%), Hispanics (29%), those who had children at home (25%), rural dwellers (29%), people in the northeastern U.S. (25%), and those who identified as Republicans (29%). In multiple regression analyses, vaccine hesitancy was predicted significantly by sex, education, employment, income, having children at home, political affiliation, and the perceived threat of getting infected with COVID-19 in the next 1 year. Given the high prevalence of COVID-19 vaccine hesitancy, evidence-based communication, mass media strategies, and policy measures will have to be implemented across the U.S. to convert vaccines into vaccinations and mass immunization with special attention to the groups identified in this study.