A historical comparison of U.S. Army & U.S. civilian suicide rates, 1900-2020.

Studies examining the perceived association of war time and increasing suicide rates in the U.S. military and U.S. civilian populations have proliferated since the beginning of the Global War on Terror (GWOT). However, additional historical analysis is needed to better place the recent surge in active-duty U.S. Army and U.S. civilian suicide rates into context and better inform researchers, healthcare providers, and policy makers. To do so, a cross sectional study that extracted empirical data from U.S. government websites, publications, and journal articles published from 1900 to 2022 was conducted to identify longitudinal trends. From 1900 to 2020, active-duty U.S. Army soldier and U.S. civilian suicide rates appear to fluctuate similarly, but with soldier rates often displaying more dramatic changes. Since 1900, active-duty U.S. Army soldier and similarly aged U.S. civilian male suicide rates have gradually converged, with the differences in rates narrowing over time. War does not historically appear to increase suicide rates in active-duty U.S. Army soldiers or U.S. civilians. More recently, given the apparent convergence of U.S. Army and similarly aged U.S. civilian male annual suicide rates, larger more universal factors than combat may be similarly affecting both populations.

A Historical Examination of Military Records of US Army Suicide, 1819 to 2017.

Importance: Suicide rates among active-duty personnel in the US military have increased substantially since 2004, and numerous studies have attempted to contextualize and better understand this phenomenon. Placing contemporary examinations of suicides among active-duty personnel in the US Army in historical context provides opportunities for joint historical and epidemiological research to inform health care professionals and policy makers. Objectives: To consolidate data on suicide rates among active-duty personnel in the US Army as far back as historical records allow and to identify historical trends to separate them from more acute causal factors. Design, Setting, and Participants: This cross-sectional study included all active-duty service members in the US Army from 1819 to 2017 as identified and detailed in US government publications, studies, and journal articles. Empirical data were extracted from US government publications and journal articles published from 1819 to 2017. Data collection and analysis were completed between July and August of 2019. Exposure: Suicide. Main Outcomes and Measures: Suicide rates per 100 000 individuals. Results: Starting in 1843, the overall trend in annual suicide rates among active-duty service members in the US Army increased, with a peak rate of 118.3 per 100 000 in 1883. From that historical high point, the rate decreased in 3 successive waves, each corresponding to the end of the following wars: the Spanish-American War (1898), World War I (1914-1918), and World War II (1939-1945). The latter had the historically lowest rate of 5 per 100 000 in 1944 to 1945. During the Cold War (approximately 1945-1991), the rate generally stabilized in the low teens to midteens (ie, 10-15 per 100 000). The rate increased again during the Afghanistan and Iraq Wars, increasing to 29.7 per 100 000 in 2012. From 2008 to present, the annual rate has remained within the range of 20.2 to 29.7 per 100 000. Conclusions and Relevance: This study represents the most extensive historical examination of suicides in the US Army to date. By taking a long-term historical approach to suicide among active-duty personnel in the US Army, this study affords future researchers a new analytical tool and an additional perspective from which to better differentiate long-term and historical trends from more short-term and temporary causal factors.