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State Policy & Veteran Suicide

Written by Dr. Sarah Anderson
Published on March 28, 2024
Research Highlights

NJ veteran suicide rate is the lowest in the nation (16.3 per 100,000).

HI is the only state where the veteran suicide rate is roughly equal to the state total population suicide rate and lower than the national veteran rate.

Protective factors against suicide include better physical and mental health, limited access to guns, community connection, and crisis intervention services.

NJ and HI have the lowest veteran suicide rates.

Table 1. Statistics about veterans and suicide nationally, in MO, in NJ, and in HI. Data from VA 2023; VA MO 2021 a, b; VA HI a, b; VA NJ a, b.

Among veterans nationally, suicide is most common among men aged 18-34 (VA 2023).

In MO and nationally, the veteran suicide rate is 1.8x higher than the total population suicide rate (Table 1; VA MO 2021).

NJ has the lowest veteran suicide rate and total population suicide rate. In NJ, the veteran suicide rate is 1.7x greater than the general suicide rate (VA NJ 2021).

HI has the second-lowest veteran suicide rate. The HI veteran suicide rate is lower than the national veteran suicide rate, and the HI veteran suicide rate is roughly equal to the HI total population suicide rate. HI is the only state that meets both these metrics (VA HI 2021).

 

Mental illness is only one of many risk factors for suicide.

In 2021, a mental health or substance use disorder diagnosis was reported in 60% of veterans who died by suicide (VA 2023). With or without a mental health condition, there are several other risk factors for suicide (Table 2).

Table 2. Issues within a person’s life, health, or community are correlated with higher suicide risk. Data from VA 2023, CDC 2018, Stone 2018

 

NJ and HI have some protective factors that MO lacks.

Why NJ and HI have the lowest veteran suicide rates has not been studied. However, both states have suicide prevention programs in line with VA recommendations. Also, their populations have unique risk and protective factors.

Better health. Fewer NJ and HI residents report poor or fair health compared to MO residents (15% vs 18% respectively (DATA USA MO, NJ, HI).

Compared to NJ and HI, MO has higher rates of frequent physical and mental distress, which is two weeks or more of poor physical health or poor mental health. The percentage of adults who experience physical and mental distress respectively are:

  • MO 12% and 16%
  • NJ 11% and 11%
  • HI 11% and 10%

NJ and HI have lower mental illness rates (28% and 27%, respectively) compared to MO (34%; KFF HI, MO, NJ). The percentage of unmet mental health needs is also lower: 28% in MO, 22% in NJ, and 24% in HI.

Differences in health insurance status, access to healthcare and healthy food, physical inactivity, and use of alcohol, drugs, and tobacco could explain the improved health markers in HI and NJ compared to MO (DATA USA MO, NJ, HI).

Gun access. Guns are more lethal than other suicide methods (85-90% vs 5-10%; VA 2023).

In HI and NJ, 9% of households have a firearm compared to 48% of MO households (RAND 2016). Nationally and in MO, firearms are the most common suicide method (VA 2023, VA MO 2021). In NJ and HI, suffocation is the most common method (VA NJ 2021, VA HI 2021).

Community. Community connectedness is protective against suicide (CDC 2022). About 75% of HI residents report being connected to place, neighbors and family, religious communities, and cultural communities (Lili’uokalini Trust 2021). There are no studies that evaluate social connectedness in MO or NJ.

Nationally, time spent in social isolation has increased from 4.7 hours to 5.5 hours between 2003-2020. The COVID-19 pandemic exacerbated this ongoing trend (Kannan 2022).

Crisis intervention service. The VA has a national veterans crisis line that is accessible through the national 988 crisis line.

In NJ, 5 lifeline centers handle 988 calls and a NJ Vet2Vet peer support line assists veterans with everything from health concerns to education. Statewide screening centers, certified community behavioral health clinics, early in-tervention support services, and crisis residential service programs provide various levels of needs-based mental health care (NJ DHS).

In HI, crisis services include the 988 line, crisis mobile outreach, temporary case management, shelter and support for those in crisis for 10-14 days, and a dashboard showing use of these resources (HI DOH 2024).

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org

 

Works Cited

Center for Disease Control and Prevention. (2018, November 27). Vital Signs: Suicide rising across the US. Retrieved from CDC Archive: https://archive.cdc.gov/#/details?url=https://www.cdc.gov/vitalsigns/suicide/index.html

Delloite and Datawheel. (2021). Hawaii. Retrieved from Data USA: https://datausa.io/profile/geo/hawaii

Delloite and Datawheel. (2021). New Jersey. Retrieved from Data USA: https://datausa.io/profile/geo/new-jersey

Deloitte and Datawheel. (2021). Missouri. Retrieved from Data USA: https://datausa.io/profile/geo/missouri

Hawai'i Department of Health. (2024). Hawai'i CARES Crisis Line Statistics. Retrieved from State of Hawai'i, Department of Health Behavioral Health Dashboard: https://bh808.hawaii.gov/behavioral-crisis/

Kamehameha Schools’ Strategy & Transformation Group, Lili’uokalani Trust, & Office of Hawaiian Affairs. (2021). ‘Imi Pono Hawai’i Wellbeing Survey 2021: Community Resilience. www.ksbe.edu/research/imi_pono_hawaii_wellbeing_survey

Kannan, V. D., & Veazie, P. J. (2022). US trends in social isolation, social engagement, and companionship ⎯ nationally and by age, sex, race/ethnicity, family income, and work hours, 2003-2020. SSM - population health21, 101331. https://doi.org/10.1016/j.ssmph.2022.101331

KFF. (2023, March 20). Mental Health in Hawaii. Retrieved from KFF: https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/hawaii/

KFF. (2023, March 20). Mental Health in Missouri. Retrieved from KFF: https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/missouri/

KFF. (2023, March 20). Mental Health in New Jersey. Retrieved from KFF: https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/new-jersey/

New Jersey Department of Human Services. (2022). Inventory and Need Assessment for New Jersey Behavioral Health. Retrieved from New Jersey Department of Human Services: https://nj.gov/humanservices/dmhas/publications/need/

Reducing Military and Veteran Suicide. (2022, June 15). Retrieved from CDC: https://www.cdc.gov/washington/testimony/2022/t20220615.htm

Stone, D., Simon, T., Fowler, K., Kegler, S., Yuan, K., Holland, K., . . . Crosby, A. (2018, June 8). Vital Signs: Trends in state Suicide RAtes - United States, 1999-2016 and Cricumstances Contributing to Suicide - 27 States, 2015. Morbidity and Mortality Weekly Report, 617-624. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w

U.S. Department of Vetearns Affairs. (2021). Missouri Veteran Suicide Data Sheet. Retrieved from Veterans Affairs: https://www.mentalhealth.va.gov/docs/data-sheets/2021/2021-State-Data-Sheet-Missouri-508.pdf

U.S. Department of Veteran Affairs. (2021). Hawaii. Retrieved from U.S. Department of Veteran Affairs: https://www.data.va.gov/stories/s/kndj-bxzs

U.S. Department of Veteran Affairs. (2021). New Jersey Veteran Suicide Data Sheet. Retrieved from U.S. Department of Veteran Affairs: https://www.mentalhealth.va.gov/docs/data-sheets/2021/2021-State-Data-Sheet-New-Jersey-508.pdf

U.S. Department of Veteran Affaris. (2021). New Jersey. Retrieved from U.S. Department of Veteran Affaris: https://www.data.va.gov/stories/s/6484-2sq8

US Department of Veteran Affairs. (2021). Hawaii Veteran Suicide Data Sheet. Retrieved from US Department of Veteran Affairs: https://www.mentalhealth.va.gov/docs/data-sheets/2021/2021-State-Data-Sheet-Hawaii-508.pdf

US Department of Veterans Affairs. (2021). Missouri. Retrieved from US Department of Veterans Affairs: https://www.data.va.gov/stories/s/hveu-jiru

Veteran Affairs Office of Mental Health and Suicide Prevention. (2023, November). National Veteran Suicide Report Annual Report. Retrieved from Veteran Affairs: https://www.mentalhealth.va.gov/docs/data-sheets/2023/2023-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf

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