Crisis Circumstances in Adult U.S. Suicide Deaths: A Latent Class Analysis.

Abstract

Suicide is a critical public health issue in the U.S., where it ranks as the 11th leading cause of death. Precipitating crises are life events that occur prior to a suicide and increase risk. This study aimed to identify distinct groupings of precipitating crises in adults who died by suicide. Data from the National Violent Death Reporting System included 55,448 suicides from 2013 to 2021, where the decedent had experienced a precipitating crisis in the 2 weeks surrounding death. Crisis variables were used to model latent classes of circumstances through Latent Class Analysis. Models were fit with 2-10 classes, and the optimal solution was selected through fit statistics, entropy, and interpretability. Logistic regression was used to assess the associations between demographic characteristics (age, sex (male/female), race, ethnicity, military status, rurality) and class membership. All analyses were performed in 2024. A 6-class model best fit the data, including (1) co-occurring substance use, alcohol, relationship, and eviction; (2) physical health; (3) other; (4) criminal legal; (5) co-occurring job, financial, and intimate partner; and (6) intimate partner crises. There was significant variation in class membership by demographic characteristics. For example, adults aged 55-65 years had higher odds of belonging to Class 2 than younger adults (AOR=18.53; 95% CI=13.12, 26.93). This study identified 6-crisis profiles with patterns of life events that can be recognized by healthcare providers. Individuals experiencing single-circumstance crises may benefit from addressing the specific stressor, whereas those in multifaceted-crisis profiles likely require comprehensive interventions that tackle overlapping stressors simultaneously.