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A 25-Year Nationwide Analysis of Mortality Trends due to Intentional Self-Harm by Hanging, Strangulation, and Suffocation

AI Summary
  • Age-adjusted mortality rate for intentional self-harm by hanging, strangulation, and suffocation rose from 2.41 (1999) to 4.57 per 100,000 (2023), peaking at 5.28 in 2018.
  • Men, young adults, and Non-Hispanic White individuals experienced disproportionately higher age-adjusted mortality rates.
  • Rural areas and the West and Midwest bore greatest burden; highest state rates in Hawaii, South Dakota, and New Mexico, necessitating targeted mental health resources.
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Brain Behav. 2026 Oct;16(10):e71838. doi: 10.1002/brb3.71838.

ABSTRACT

INTRODUCTION: Suffocation, strangulation, and hanging are among the deadly forms of intentional self-harm, which is a serious global public health issue. These types of self-harm frequently have high fatality rates and greatly increase the United States’ suicide burden. Analyzing trends over time is essential for noticing evolving patterns, directing preventative measures, and developing successful policy interventions.

METHODS: To assess mortality data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER), ICD-10 codes for intentional self-harm by hanging, strangulation, and suffocation (X70) were utilized. Age-adjusted mortality rates (AAMRs) were considered for analysis. Trends were assessed using the joinpoint regression software, and p < 0.05 was deemed statistically significant.

RESULTS: The overall AAMR per 100,000 rose from 2.41 in 1999 to 4.57 in 2023, peaking at 5.28 in 2018. Men, young adults, and Non-Hispanic Whites had disproportionately higher AAMR, with Hawaii, South Dakota, and New Mexico showing the highest rates. Rural areas and the West and Midwest regions experienced the greatest mortality burden.

CONCLUSION: Targeted mental health policy and resource allocation in vulnerable communities are necessary in light of these disparities.

PMID:42885328 | DOI:10.1002/brb3.71838

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