Thursday, May 16, 2013

Undercounting Suicide in the Military

In Calculation of Suicide Rates, Numbers Not Always Straightforward:

An analysis of Pentagon data shows that the Department of Defense uses numbers that may underestimate its suicide rate. A different methodology, like one employed by the Centers for Disease Control and Prevention, would result in a military rate equivalent to or above the comparable civilian rate, experts say.

Bob Anderson, head statistician for mortality statistics at the C.D.C., said the Pentagon’s approach resulted in a suicide rate that “will be lower than it should be.” 

“It will underestimate the mortality rate,” he said. 

The difference is about more than math. The suicide rate is perhaps the most important data point for tracking trends in suicide and comparing different populations. 

To determine the rate, statisticians divide the number of suicides in a year by the total population.
The first number is fairly straightforward: for the entire military, there were 309 active-duty suicides in 2009, the most recent year for which comparable civilian data is available. (The military number includes National Guard and reserve troops who were on active duty when they killed themselves.)
But the total military population is not as simple to estimate. Not only are service members joining and leaving the military constantly, National Guard and reserve troops are also continuously flowing on and off active-duty rosters. How one estimates the number of Guard and reserve troops on active duty at any one time clearly affects the total military population. 
Population discrepancies are not just limited to the military either. One of the biggest problems with the UCR and other crime statistics and suicide rate measurements is that they fail to take into account populations shifts and mobility (though the CDC does us the "one day snapshot" average in some cases as a control).

Also, this article makes it sound like counting the first part, the suicide itself, is a given. It isn't. Law enforcement, medical examiners and other organizations (like the Military) may "unfound" reported suicides for a variety of reasons (request of the family, to make the organization look better, to downplay its extent, etc.). As Jack Douglas warned years ago, we should always be leery of "official statistics" and what methodologies are being used to arrive at these figures.

Nonetheless, the problem is worse than the official numbers have indicated for a long time.
There is no dispute on one issue: the military rate has been climbing faster than the civilian rate. According to the Pentagon, the military rate of 18.5 suicides per 100,000 service members in 2009 was up from 10.3 suicides per 100,000 in 2002 — an 80 percent increase. A comparable civilian suicide rate rose by about 15 percent in the same period. 
An accompanying article in the Times makes the point even more salient, and makes it clear that after decades of research, we're nowhere near understanding the causes of the "never ending war."
Though the Pentagon has commissioned numerous reports and invested tens of millions of dollars in research and prevention programs, experts concede they are little closer to understanding the root causes of why military suicide is rising so fast. 

“Any one variable in isolation doesn’t explain things,” said Craig J. Bryan, associate director of the National Center for Veterans Studies at the University of Utah. “But the interaction of all of them do. That’s what makes it very difficult to solve the problem. And that’s why we haven’t made advances.”
Intersectionality (reciprocal attachments among variables) is a growing field within suicidology these days and its growth should be applauded. The only way we are ever going to get to the root cause of suicide is to recognize the fact that it's rarely ever one single variable that causes it, but instead a perfect storm of tribulations which increase the risk of mortality.

Cross posted to: The Cranky Sociologists

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