Effect of Altitude on Veteran Suicide Rates.

Sabic, Hana, Brent Kious, Danielle Boxer, Colleen Fitzgerald, Colin Riley, Lindsay Scholl, Erin McGlade, Deborah Yurgelun-Todd, Perry F. Renshaw, and Douglas G. Kondo. Effect of altitude on veteran suicide rates. High Alt Med Biol. 00:000-000, 2019. Aims: Suicide rates in the general population in the United States are correlated with altitude. To explore factors contributing to suicide among military veterans, we examined the relationship between veteran state-level suicide rates and altitude for 2014, including firearm-related and nonfirearm-related rates. Methods: Pearson's coefficients were calculated for altitude and each outcome. Mixed linear models were used to determine the association between suicide and altitude while adjusting for demographic confounds. Results: State mean altitude was significantly correlated with total veteran suicide rate (r = 0.678, p < 0.0001), veteran firearm-related suicide rate (r = 0.578, p < 0.0001), and veteran nonfirearm suicide rate (r = 0.609, p < 0.0001). In mixed models, altitude was significantly correlated with total veteran suicide rate (beta = 0.331, p < 0.05), veteran firearm suicides (beta = 0.282, p < 0.05), and veteran nonfirearm suicides (beta = 0.393, p < 0.05). Conclusion: This study adds to evidence linking altitude and suicide rates, arguing for additional research into the relationship between altitude and suicide among veterans.