Suicide in Georgia: 2000, state and county statistics, strategic plans [June 2000]

Suicide in Georgia: 2000
State and County Statistics Strategic Plans

About 850 Georgians die every year from suicide
More Georgians die from suicide than homicide

Georgia County Suicide Rates, 1994 - 1998

Rome

Gainesville

Atlanta

Athens

County rate significantly higher t

rate

County rate higher than US rate

County rate lower than US rate

County rate unreliable

Augusta

Columbus

Macon Dublin

Albany

Savannah
Brunswick Waycross Valdosta

AFSP
American Foundation for Suicide Prevention, Southeastern Division

GEORGIA DEPARTMENT OF HUMAN RESOURCES | DIVISION OF PUBLIC HEALTH

Contents
page
Faces of Suicide .............................................................................................................................................................................. 2

Highlights ........................................................................................................................................................................................... 4

Introduction ...................................................................................................................................................................................... 4

Table 1.

10 Leading Causes of Death by Age Group, Georgia, 1994-1998

Suicide in Georgia ........................................................................................................................................................................ 5

Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6.

Age-Adjusted Suicide Rates, Georgia and the United States, 1984-1998 Age-Adjusted Suicide Rates by Race and Sex, Georgia, 1994-1998 Suicide Rates by Age Group, Georgia, 1994-1998 Average Annual Number of Suicides by Age Group, Georgia, 1994-1998 Suicide Rates for Youth 15-24 Years of Age by Race, Georgia, 1984-1998 Percent of Suicides by Method, Georgia and the United States, 1994-1998

Suicide Statistics by County ................................................................................................................................................. 7

Figure 7. Table 2.
Figure 8.

Age-adjusted Suicide Rates by County, Georgia, 1994-1998 Age-adjusted Suicide Rates, Number of Suicides, Number and Percent of Firearm Suicides by County, Georgia, 1994-1998 Age-Adjusted Suicide Rates in Urban and Non-Urban Counties, Georgia, 1994-1998

Risk Factors and Protective Actions ........................................................................................................................... 10

Table 3.

Risk Factors and Protective Actions for Suicide

The Surgeon General's Call to Action to Prevent Suicide, 1999 ................................................................ 10

Summary and Recommendations .................................................................................................................................. 11

Appendix .......................................................................................................................................................................................... 12
Data Sources Methods Definitions
For More Information ........................................................................................................................................................... 13

Acknowledgments ..................................................................................................................................................................... 14

Suicide In Georgia 2000 | 1

Faces of Suicide
from Lifekeeper Memory Quilts

Suicide In Georgia 2000 | 2

www.lifekeeper.org

Rank

Table 1. Leading Causes of Death, Georgia, 1994 - 1998
Age Groups

0 - 4 (N = 6,325)

5 - 9 (N = 613)

10 - 14 (N = 708)

15 - 24

25 - 34

35 - 44

45 - 54

55 - 64

65 +

Total

(N = 5,275) (N = 8,743) (N = 15,697) (N = 23,676) (N = 35,204) (N = 196,773) (N = 293,014)

Suicide In Georgia 2000 | 3

1

Perinatal Unintentional Unintentional Unintentional Unintentional Malignant Malignant Malignant

Heart

Heart

Conditions

Injury

Injury

Injury

Injury

Neoplasm Neoplasm Neoplasm

Disease

Disease

2,654

310

341

2,354

2,082

2,556

6,779

11,946

67,458

87,509

2

Congenital Malignant

Malignant Homicides

HIV

Anomalies Neoplasm Neoplasm

980

1,786

1,062

65

65

HIV 2,439

Heart Disease 6,071

Heart Disease 10,439

Malignant Neoplasm
41,155

Malignant Neoplasm
63,570

3

Unintentional Congenital Homicide

Suicide

Homicide

Heart

Unintentional

Stroke

Injury

Anomalies

52

648

964

Disease

Injury

1,778

571

32

2,439

1,635

Stroke 16,821

Stroke 20,594

Heart

Heart

Heart

Malignant

Suicide Unintentional Stroke

COPD

COPD Unintentional

4

Disease

Disease

Disease Neoplasm

821

Injury

1,193

1,553

10,404

Injury

168

24

42

226

2,208

14,916

Homicide

HIV

5

107

13

Suicide 30

Heart Disease
204

Malignant Neoplasm
716

Suicide 933

HIV

Unintentional Pneumonia & COPD

956

Injury

Influenza

12,671

1,159

8,892

Pneumonia & Pneumonia & Congenital

HIV

6

Influenza

Influenza

Anomalies

113

107

13

20

Heart Disease
664

Homicide 755

Chronic Liver Disease 711

Diabetes 955

Diabetes 4,351

Pneumonia & Influenza 10,548

Septicemia Homicide Pneumonia & Congenital

Stroke

Stroke

Suicide Chronic Liver Unintentional Diabetes

7

73

10

Influenza Anomalies

158

534

690

Disease

Injury

6,242

12

59

699

4,256

Malignant

Stroke

COPD Pneumonia & Pneumonia & Chronic Liver Diabetes Pneumonia & Septicemia

HIV

8

Neoplasm

10

12

Influenza

Influenza

Disease

532

Influenza

3,237

5,717

62

50

125

416

613

9

Stroke 58

Septicemia 8

Stroke 9

Stroke 33

Diabetes Pneumonia &

95

Influenza

COPD 475

Septicemia 410

Nephritis & Nephrosis

Suicide 4,242

302

3,049

COPD,

10

HIV

Anemia,

Anemia

Diabetes, Chronic Liver Diabetes Pneumonia & Suicide

Alzheimer's Septicemia

39

Benign Tumor

6

Anemia

Disease

278

Influenza

400

Disease

4,187

7 each

28 each

69

420

2,874

Highlights



From 1994 through 1998, an average of 848

In Georgia, from 1994-1998, nearly three out

Georgians per year died from suicide.

of four suicides (73%) involved a firearm.



Suicide is the ninth most common cause of



The suicide rate for Georgia's non-urban

death in Georgia.

counties is nearly 18% higher than the rate for

urban counties.



From 1994 through 1998, 18% more Geor-

gians died from suicide than homicide.



Appropriate clinical care for mental health,

substance abuse, and physical health can



Suicide rates are five times higher for males

reduce the frequency of suicide.

than for females in Georgia.



Restricted access to highly lethal or common



Suicide rates are two times higher for whites

than for blacks in Georgia.

methods, such as firearms or sedatives, can reduce the frequency of suicide.



15% of suicide deaths in Georgia occur among

The Surgeon General's Call to Action to

people 15-24 years of age.

Prevent Suicide, 1999 provides a framework

and 15 recommended actions to prevent



The suicide rate among young blacks, 15-24

suicide.

years of age, was 40% higher in 1996-1998

than it was in 1984-1986.

Introduction

Suicide is a leading cause of death in Georgia.
From 1994-1998, 4,242 Georgians died of suicide, an average of 848 per year, making it the ninth most common cause of death in the state (Table 1). For younger people suicide ranks even higher as a cause of death. Among those 15-24 years of age, for example, it is the third most common cause of death. Overall, suicide is more common than homicide, causing in recent years nearly 20% more deaths each year. Suicide attempts are also costly. Nationwide, for each suicide death approximately five people are hospitalized and 20 visit emergency departments for injuries related to a suicide attempt.
Suicide rates in Georgia differ by sex, race, and age. Rates are five times higher for males than for females and two times higher for whites than for blacks. Suicide rates in Georgia are highest among residents 75 years of age and older. In Georgia, three out of four (73%) suicide deaths involved a firearm.

The large number of deaths and the potential preventability of suicide have established it as a public health priority. Governor Barnes and the Georgia Legislature set aside $250,000 to develop a plan to prevent suicide in Georgia. The recently released U.S. Surgeon General's Call to Action to Prevent Suicide provides guidelines to increase the public's awareness of suicide and its risk factors, to enhance clinical services and prevention programs, and to advance the science of suicide prevention.
This report, Suicide in Georgia: 2000, provides information about the burden of suicide in Georgia. It describes the sex, race, and age characteristics of those who die from suicide, the methods they most commonly use, and death rates for each county. The report combines deaths during the five year period 1994-1998 to provide more stable estimates.

Suicide In Georgia 2000 | 4

Suicide in Georgia
Suicide is a leading cause of death in Georgia. From 1994-1998, 4,242 Georgians died of suicide, an average of 848 per year and an age-adjusted death rate of 11.8 per 100,000 population. Suicide was the ninth most common cause of death (Table 1). For younger people it ranked even higher. Among those 15-24 years of age, suicide was the third most common cause of death.
Since 1984 suicide rates in Georgia and the United States have been fairly stable (Figure 1). In most years, the Georgia rate exceeded the U.S. rate. Between 1984 and 1991, suicide rates rose slightly, peaking in 1991 at an age-adjusted rate of 13.9 deaths per 100,000 Georgia residents. Since 1991, suicide rates in Georgia have declined an average of 3% per year.
From 1994-1998, 18% more Georgians died from suicide than homicide. In recent years both suicide and homicide rates have declined. However, the rate of decline has been smaller for suicide than for homicide. Since 1991, Georgia suicide rates have decreased an average of only 3% per year, but homicide rates have decreased 6% per year.
Men have higher suicide rates than women, and whites have higher rates than blacks. From 19941998, the age-adjusted suicide rate for males was five times higher than for females (21.0 per 100,000 persons versus 4.2); and two times higher for whites than for blacks (13.8 per 100,000 persons versus 6.2). In Georgia the risk for dying from suicide was twice as high for white males as for black males and 3.5 times higher for white females than for black females (Figure 2). The death rates for men exceed the rates for women in part because men typically choose more lethal means to commit suicide, such as firearms, when compared to women. Racial differences are more difficult to explain and seem to involve many interacting factors.

Figure 1. Age-Adjusted Suicide Rates, Georgia and the United States, 1984-1998
Figure 2. Age-Adjusted Suicide Rates by Race and Sex, Georgia, 1994-1998
Figure 3. Suicide Rates by Age Group, Georgia, 1994-1998

Suicide In Georgia 2000 | 5

Figure 4. Average Annual Number of Suicides by Age Group, Georgia, 1994-1998
Figure 5. Suicide Rates for Youth 15-24 Years of Age by Race, Georgia, 1984-1998
Figure 6. Percent of Suicides by Method, Georgia and the United States, 1994-1998

Suicide rates are highest among older Georgia residents. Persons 75 years of age and older have the highest rate (20.8/100,000 persons) (Figure 3). Suicide rates may be higher among older adults because they are more likely to live alone, to be widowed, and to have a physical illness.
Despite the higher risk of suicide for an older person than a younger person (Figure 3), more younger Georgians die from suicide than older adults (Figure 4) because there are more younger Georgians than older. Between 1994 and 1998, 58% of suicide deaths were among persons younger than 45 years of age.
Suicide is the third most common cause of death for Georgians 15-24 years of age, exceeded only by unintentional injury and homicide (Table 1). This young age group accounts for 15% of all suicide deaths. Between 1984 and 1995, suicide rates among young blacks (ages 15-24) more than doubled; during the same time period, rates among young whites were stable (Figure 5). The suicide rate among young blacks fell in the most recent time period, 1996-1998, but remained 1.4 times higher than for the period from 1984-1986. Risk factors associated with suicides among youth include hopelessness, depression, family history of suicide, impulsive and aggressive behavior, social isolation, a previous suicide attempt, and ready access to alcohol, illicit drugs, and lethal suicide methods.
In Georgia, from 1994-1998 nearly three out of four suicides (73%) involved a firearm (Figure 6). In contrast, for the United States as a whole 58% of suicide deaths involved a firearm. The next most common methods in both Georgia and the United States were poisoning and strangulation.

Suicide In Georgia 2000 | 6

Suicide Statistics by County

For the period from

1994 through 1998, thirteen

Georgia counties (Fannin,

Lumpkin, Pickens, Polk,

Rome

Carroll, Harris, Wilkinson,

Twiggs, Bleckley, Bryan, Tattnall, Wayne, and Ware) had

Atlanta

suicide rates that were signifi-

cantly higher (p < .10) than the

national rate (Figure 7). Another

57 counties had rates higher than

the national rate but the difference

was not statistically significant.

Columbus

Rates were not calculated for 64

Georgia counties because less than 10

residents died of suicide during the

five year period.

Gainesville Athens

Figure 7. Age-Adjusted Suicide Rates by County, 1994 - 1998.

Augusta

Macon

Dublin

Savannah

Table 2 shows the district or county name (column 1), the ageadjusted suicide rates for the five-year period between 1994 and 1998 (column 2), the number of suicide deaths between 1994 and 1998 (column 3), the number of firearm suicides (column 4), and the percent of suicides which were firearm suicides (column 5). Counties with suicide rates significantly higher than the overall suicide rate for the United States are shown in bold. Caution should be used when comparing county death rates because counties with small populations are more likely to have wide variations in death rates from year to year.

Albany Valdosta

Waycross

Brunswick

County rate significantly higher than US rate County rate higher than US rate County rate lower than US rate County rate unreliable
Figure 7. Age-Adjusted Suicide Rates in Urban and Non-Urban Counties, Georgia, 1994-1998

Suicide rates in Georgia are significantly higher in non-urban counties compared to urban counties (Figure 8). The suicide rate for Georgia's 117 non-urban counties combined is 18% higher than the rate for Georgia's 42 urban counties (12.9 per 100,000 people versus 10.9).*

Suicide In Georgia 2000 | 7
* see definitions, page 12, for a list of urban counties

Table 2. Georgia District and County Suicides, 1994 - 1998 Combined.

District/County Name

AgeAdjusted Suicide
Rate1

Georgia District 1-1: Northwest

11.8 12.4

Bartow

12.5

Catoosa

10.1

Chattooga

13.6

Dade

10.6

Floyd

11.5

Gordon

15.2

Haralson

17.7

Paulding

10.8

Polk

19.6

Walker

9.2

District 1-2: Dalton

12.3

Cherokee

7.6

Fannin

23.9

Gilmer

15.1

Murray

14.0

Pickens

20.1

Whitfield

13.2

District 2: Gainesville

12.3

Banks

14.9

Dawson

3.5

Forsyth

11.4

Franklin

17.5

Habersham

15.3

Hall

11.3

Hart

16.2

Lumpkin

22.8

Rabun

14.6

Stephens

8.0

Towns

11.7

Union

8.2

White

13.1

District 3-1: Cobb-Douglas 11.0

Cobb

10.7

Douglas

12.4

District 3-2: Fulton

11.6

Fulton

11.6

District 3-3: Clayton

11.1

Clayton

11.1

District 3-4: East Metro 10.9

Gwinnett

10.8

Newton

9.8

Rockdale

12.9

District 3-5: DeKalb

10.2

DeKalb

10.2

Number Number of Suicide of
Deaths Firearm Suicides

4,242 284

3,097 214

Percent of
Suicides by
Firearm 73 75

41

30

73

25

16

64

16

11

69

8

6

75

49

41

84

29

21

72

21

16

76

33

30

91

34

22

65

28

21

75

175

129

74

49

34

69

21

14

67

13

12

92

21

17

81

18

15

83

53

37

70

232

180

78

9

5

56

1

1

100

37

25

68

16

14

88

24

18

75

65

50

77

17

12

71

19

16

84

11

9

82

10

9

90

5

5

100

7

6

86

11

10

91

320

218

68

272

183

67

48

35

73

411

264

64

411

264

64

111

74

67

111

74

67

296

209

71

230

165

72

25

18

72

41

26

63

297

199

67

297

199

67

District/County Name

AgeAdjusted Suicide
Rate1

District 4: LaGrange

13.2

Butts

16.4

Carroll

18.3

Coweta

14.8

Fayette

10.6

Heard

14.8

Henry

13.8

Lamar

12.8

Meriwether

8.9

Pike

8.6

Spalding

12.1

Troup

13.4

Upson

10.7

District 5-1: South Central 11.9

Bleckley

25.1

Dodge

10.4

Johnson

13.2

Laurens

12.9

Montgomery

7.4

Pulaski

5.5

Telfair

13.7

Treutlen

3.4

Wheeler

3.5

Wilcox

10.5

District 5-2: North Central 13.7

Baldwin

12.7

Bibb

13.4

Crawford

13.9

Hancock

3.8

Houston

12.0

Jasper

6.8

Jones

16.0

Monroe

16.4

Peach

13.8

Putnam

17.9

Twiggs

23.8

Washington

15.5

Wilkinson

26.4

District 6: Augusta

10.3

Burke

12.8

Columbia

6.0

Emanuel

17.9

Glascock

17.6

Jefferson

13.0

Jenkins

2.4

Lincoln

17.7

Number Number Percent

of Suicide of

of

Deaths Firearm Suicides

Suicides by

Firearm

352

255

72

14

13

93

71

55

77

52

33

63

40

26

65

7

6

86

58

45

78

9

5

56

10

5

50

5

4

80

34

26

76

38

30

79

14

7

50

74

61

82

14

12

86

9

6

67

5

3

60

27

23

85

3

3

100

2

2

100

8

6

75

1

1

100

1

1

100

4

4

100

300

239

80

26

25

96

102

74

73

7

7

100

2

2

100

60

43

72

3

3

100

16

12

75

15

14

93

15

11

73

15

13

87

11

10

91

15

13

87

13

12

92

206

161

78

13

10

77

24

20

83

18

15

83

2

2

100

11

11

100

1

1

100

7

3

43

Suicide In Georgia 2000 | 8

Table 2. Georgia District and County Suicides, 1994 - 1998 Combined.

District/County Name

AgeAdjusted Suicide
Rate1

McDuffie

7.5

Richmond

10.8

Screven

13.4

Taliaferro

31.3

Warren

12.8

Wilkes

8.0

District 7: West Central

12.1

Chattahoochee

23.4

Clay

22.2

Crisp

9.3

Dooly

21.9

Harris

20.2

Macon

15.7

Marion

6.9

Muscogee

10.7

Quitman

11.0

Randolph

10.3

Schley

4.7

Stewart

26.1

Sumter

11.9

Talbot

14.1

Taylor

10.2

Webster

0.0

District 8-1: Valdosta

13.3

Ben Hill

10.6

Berrien

18.7

Brooks

13.4

Cook

16.3

Echols

22.9

Irwin

16.0

Lanier

0.0

Lowndes

13.5

Tift

12.6

Turner

16.2

District 8-2: Southwest

12.1

Baker

12.3

Calhoun

10.7

Colquitt

14.0

Decatur

11.8

Dougherty

10.3

Early

3.1

Grady

16.7

Lee

15.1

Number Number of Suicide of
Deaths Firearm Suicides

8

6

101

75

10

9

3

1

4

4

4

4

200

143

8

5

4

3

9

8

11

7

21

14

10

7

2

2

94

63

2

2

4

2

1

1

7

6

18

15

5

4

4

4

0

0

135

100

9

6

14

11

10

8

11

9

2

2

7

5

0

0

53

38

22

15

7

6

196

161

2

2

3

3

27

25

15

11

47

36

2

2

18

15

15

12

Percent of
Suicides by
Firearm 75 74 90 33 100 100 72 63 75 89 64 67 70 100 67 100 50 100 86 83 80 100 0 74 67 79 80 82 100 71 0 72 68 86 82 100 100 93 73 77 100 83 80

Bold are statistically significantly higher than the United States rate.

District/County Name

AgeAdjusted Suicide
Rate1

Number Number of Suicide of
Deaths Firearm Suicides

Miller

13.0

4

4

Mitchell

12.7

12

7

Seminole

5.9

3

2

Terrell

12.8

7

7

Thomas

13.1

27

23

Worth

13.2

14

12

District 9-1: Savannah

12.3

154

109

Chatham

12.1

133

94

Effingham

13.9

21

15

District 9-2: Southeast

13.5

193

148

Appling

6.5

5

4

Atkinson

13.0

4

3

Bacon

16.2

8

7

Brantley

12.3

8

7

Bulloch

8.2

19

15

Candler

17.0

7

6

Charlton

0.0

0

0

Clinch

6.0

2

1

Coffee

13.4

21

17

Evans

17.5

8

6

Jeff Davis

12.6

8

6

Pierce

7.1

5

5

Tattnall

27.3

25

19

Toombs

14.1

17

14

Ware

19.0

34

25

Wayne

18.3

22

13

District 9-3: Coastal

12.5

119

91

Bryan

19.6

20

16

Camden

8.3

16

10

Glynn

13.4

45

36

Liberty

10.8

27

20

Long

7.3

3

3

McIntosh

16.5

8

6

District 10: Athens

12.5

119

91

Barrow

13.2

24

17

Clarke

10.0

46

36

Elbert

13.9

13

11

Greene

7.8

5

5

Jackson

14.5

25

17

Madison

15.0

18

12

Morgan

8.4

6

6

Oconee

8.4

9

9

Oglethorpe

15.1

8

7

Walton

13.7

32

22

1 Age-adjusted to the United States Standard Population 2000

Percent of
Suicides by
Firearm 100 58 67 100 85 86 71 71 71 77 80 75 88 88 79 86 0 50 81 75 75 100 76 82 74 59 76 80 63 80 74 100 75 76 71 78 85 100 68 67 100 100 88 69

Suicide In Georgia 2000 | 9

Risk Factors and Protective Actions

Risk factors are associated with a greater potential for suicide and suicidal behavior. For many of the risk factors for suicide, protective actions can be taken that will reduce risk (Table 3).

Table 3. Risk Factors and Protective Actions for Suicide*

Risk Factors

Protective Actions

Mental disorders - particularly mood disorders such as depression and bi-polar disorder

Appropriate clinical care for mood disorders

Substance abuse

Appropriate clincal care for substance abuse

Physical illness

Appropriate clinical care for physical illness

Barriers to appropriate clinical care

Improved access and coverage for mental health, substance abuse, and physical health problems

Easy access to highly lethal (e.g., firearms) or common methods (e.g., sedatives) of suicide

Restricted access to highly lethal or common methods of suicide

Family history of suicide or previous suicide attempt

Recognition and referral

Hopelessness or depression

Recognition and referral

Financial loss or social isolation

Family and community support

Cultural or religious beliefs that suicide is a noble resolution Cultural or religious beliefs that discourage suicide *Adapted from The Surgeon General's Call to Action to Prevent Suicide, 1999.

The Surgeon General's Call to Action to Prevent Suicide, 1999

The recently released The Surgeon General's Call to Action to Prevent Suicide, 1999 is a framework for action at the local, state, and federal level. The Call to Action includes 15 recommendations for preventing suicide by reducing risk factors and promoting protective actions. The recommendations are grouped under three headings, Awareness, Intervention, and Methodology, or AIM. The three categories and their accompanying recommendations are presented here.
Awareness: Appropriately broaden the public's awareness of suicide and its risk factors.
Promote public awareness that suicide is a public health problem and that many suicides are preventable.
Expand awareness of and enhance resources in communities for suicide prevention programs

and mental and substance abuse disorder assessment and treatment. Develop and implement strategies to reduce the stigma associated with mental illness, substance abuse, and suicidal behavior and with seeking help for such problems.
Intervention: Enhance services and programs, both population-based and clinical care.
Extend collaboration with and among public health and private sectors to complete a National Strategy for Suicide Prevention and a Georgia Strategy for Suicide Prevention.
Improve the ability of primary care providers to recognize and treat depression, substance abuse, and other major mental health illnesses associated with suicide risk.
Eliminate barriers in public and private insur-

Suicide In Georgia 2000 | 10

ance programs for provision of quality mental

portrayals of suicide and its associated risk

and substance abuse disorder treatments and

factors including mental illness and substance

create incentives to treat patients with coexist-

abuse disorders and approaches to prevention

ing mental and substance abuse disorders.

and treatment.

Institute training for all health, mental health,

substance abuse, and human service profession- Methodology: Advance the science of suicide

als concerning suicide risk assessment and

prevention.

recognition, treatment, management, and after-

care interventions.

Enhance research to understand risk and protec-

Develop and implement effective training

tive factors related to suicide, their interaction,

programs for family members of those at risk

and their effects on suicide and suicidal behav-

and for natural community helpers (educators,

iors. Additionally, increase research on effective

coaches, hairdressers, and faith leaders, etc.) on

suicide prevention programs, clinical treatments

how to recognize, respond to, and refer people

for suicidal individuals, and culture-specific

showing signs of suicide risk and associated

interventions.

mental and substance abuse disorders.

Develop additional scientific strategies for

Develop and implement safe and effective

evaluating suicide prevention interventions and

programs in educational settings for youth that

ensure that evaluation components are included

address adolescent distress, provide crisis

in all suicide prevention programs.

intervention, and incorporate peer support for

Establish mechanisms for federal, regional, and

seeking help.

state interagency public health collaboration

Enhance community care resources by increas-

toward improving monitoring systems for

ing the use of schools and workplaces as access

suicide and suicidal behaviors and develop and

and referral points for mental and physical

promote standard terminology in these systems.

health services and substance abuse treatment

Encourage the development and evaluation of

programs and provide support for persons who

new prevention technologies, including firearm

survive the suicide of someone close to them.

safety measures, to reduce easy access to lethal

Promote a public/private collaboration with the

means of suicide.

media to assure that entertainment and news

coverage represent balanced and informed

Summary and Recommendations

Information in this report documents that suicide is an important public health issue for the residents of Georgia. Suicide causes about 850 deaths every year in Georgia. Suicide is about five times more common among men than women; two times more common among whites than blacks. Rates among young blacks are 1.4 times higher than 15 years ago. Suicide rates are about 20% higher in nonurban than urban areas; and three out of four suicides in Georgia involve a firearm.

Suicide rates in Georgia and in the nation can be reduced by a combination of 1) increased awareness of the risk factors for suicide, 2) improved services and programs, 3) restricted access to highly lethal and common methods of suicide, and 4) evaluation of new suicide prevention efforts. Combined public and private efforts will be necessary to achieve these goals.

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Appendix

Data Sources Methods Definitions

The source for the number and cause of deaths in Georgia was the Georgia Department of Human Resources, Division of Public Health, Vital Records Branch.
The source for the Georgia population estimates was the US Bureau of the Census; estimates from December 1998 were used.
The source for national suicide death rates was the National Center for Health Statistics, Centers for Disease Control and Prevention.
International Classification of Diseases, 9th Revision, codes for suicide are E950-959.
Suicide death rates were age-adjusted using the direct method. The United States Standard Population 2000 was used as the standard.
Standard errors for age-adjusted rates were calculated as described in: National Center for Health Statistics, CDC, Monthly Vital Statistics Report, volume 45, number 11 (S)2, June 12, 1997, page 77. P < .10 was considered significant.
Age-adjusted death rate - A rate calculated in a manner that allows for the comparison of populations with different age structures.
Risk factor - A habit, characteristic, or finding on clinical examination that is consistently associated with increased probability of a condition or complication from that condition.
Urban - Counties in designated metropolitan statistical areas according to the US Bureau of Census. Urban counties in Georgia are Dougherty and Lee (Albany), Clarke, Madison, and Oconee (Athens), Barrow, Bartow, Carroll, Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Pickens, Rockdale, Spalding, and Walton (Atlanta), Columbia, McDuffie, and Richmond (Augusta), Catoosa, Dade, and Walker (Chattanooga), Chattahoochee, Harris, and Muscogee (Columbus), Bibb, Houston, Jones, Peach, and Twiggs (Macon), and Bryan, Chatham, and Effingham (Savannah).

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For More Information
In Georgia and in the United States many individuals and organizations are working toward the goals of the Surgeon General's Report and, ultimately, toward the goal of preventing suicide in Georgia. Some of these organizations are listed below. Interested persons are encouraged to contact these groups for more information.
For Help In A Suicide Emergency In Georgia Call 911 Or Your Local 7 Digit Emergency Number.
For information about Suicide Survivors Support Groups call 404-256-9797

Agencies Collaborating to Prevent Suicide in Georgia

American Foundation for Suicide Prevention, Southeastern Division Phone: 888-333-2377 (Toll free, no local number)
Georgia Department of Human Resources, Division of Public Health Phone: 404-679-0500
Georgia Mental Health Consumer Network Phone: 404-687-9487
Georgia Parent Support Network Phone: 404-758-4500 Phone: 800-832-8645 (Toll free)
Georgia School Counselors Association Phone: 770-785-9302
The Link Counseling Center Phone: 404-256-9797

National Alliance for the Mentally Ill (NAMI) -Georgia Phone: 770-234-0855 Phone: 800-728-1052 (Toll free)
National Mental Health Association of Georgia Phone: 404-527-7175
National Organization for People of Color Against Suicide Georgia Contact Phone: 404-505-7703
National Resource Center for Suicide Prevention and Aftercare Phone: 404-256-9797
Suicide Prevention Advocacy Network (SPAN) Georgia Contact Phone: 404-505-7703
Time for Community Coalition Phone: 404-687-9891

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National Suicide Prevention Organizations

American Association of Suicidology (AAS) 4201 Connecticut Avenue, NW, Suite 408 Washington, DC 20008 Phone: 202-237-2280 E-mail: ssilive16@ixnetcom.com Website: www.suicidology.org
National Alliance for The Mentally Ill (NAMI) 2107 Wilson Boulevard, 3rd Floor Arlington, Virginia 22201 Phone: 800-950-6264(Toll free) Website: www.nami.org
National Depressive and Manic-Depressive Association (NDMDA) 730 North Franklin Street, Suite 501 Chicago, Illinois 60610-3526 Phone: 800-826-3632 (Toll free) Website: www.ndmda.org
National Mental Health Association (NMHA) 1021 Prince Street Alexandria, Virginia 2231-2971 Phone: 800-969-NMHA (Toll free) Website: www.nmha.org
National Organization for People of Color Against Suicide P. O. Box 125 San Marcos, Texas 78667 Phone: 830-625-3576 E-mail: db31@swt.ed

American Foundation for Suicide Prevention (AFSP) 120 Wall Street, 22nd Floor New York, New York 10005 Phone: 888-333-2377 (Toll free) E-mail: rfabrika@asfp.org Website: www.afsp.org
National Center for Injury Prevention and Control (CDC) Division of Violence Prevention Centers for Disease Control and Prevention Mailstop K60, 4770 Buford Highway Atlanta, Georgia 30341-3724 Phone: 770-488-4362 E-mail: dvpinfo@cdc.gov Website: www.cdc.gov
National Institute of Mental Health (NIMH) 6001 Executive Boulevard, Room 8184, MSC 9663 Bethesda, Maryland 20892-9663 Phone: 301-443-4513 E-mail: nimhinfo@nih.gov Website: www.nimh.nih.gov
SA\VE-Suicide Awareness\Voices of Education 7317 Cahill Road, Suite 207 Edina, Minnesota 55439 Phone: 612-946-7998 E-mail: save@winternet.com Website: www.save.org
Suicide Prevention Advocacy Network USA (SPAN USA) 5034 Odins Way Marietta, Georgia 30068 Phone: 888-649-1366 (toll free) E-mail: act@spanusa.org Website: www.spanusa.org

Acknowledgments
Georgia Department of Human Resources .............................................................................. Audrey W. Horne, Commissioner Division of Public Health ............................................................................. Kathleen E. Toomey, M.D., M.P.H., Director Environmental Health and Injury Prevention Branch .............................................................. Michael R. Smith, Director Epidemiology Branch ............................................................................................. Paul A. Blake, M.D., M.P.H., Director Chronic Disease, Injury, and Environmental Health Epi Section ........................ Kenneth E. Powell, M.D., M.P.H., Chief
American Foundation for Suicide Prevention, Southeastern Division Executive Director, National Office ............................................................................................................. Robert Gebbia
Suggested Citation: Anderson MA, Powell KE, Davidson SC. Suicide in Georgia: 2000. Georgia Department of Human Resources, Division of Public Health, Epidemiology Section, June 2000. Publication number DPH00.34H
Further information on this report may be obtained by contacting: Steve Davidson, Director Office of Injury Prevention, Environmental Health and Injury Prevention Branch Division of Public Health, Georgia Department of Human Resources 2600 Skyland Drive, Upper Level, Suite 10, Atlanta, GA 30319 404-679-0500

Suicide In Georgia 2000 | 14

For Help In A Suicide Emergency In Georgia Call 911 Or Your Local 7 Digit Emergency Number.
For information about Suicide Survivors Support Groups call 404-256-9797

Risk Factors and Protective Actions for Suicide*

Risk Factors

Protective Actions

Mental disorders - particularly mood disorders such Appropriate clinical care for mood disorders as depression and bi-polar disorder

Substance abuse

Appropriate clincal care for substance abuse

Physical illness

Appropriate clinical care for physical illness

Barriers to appropriate clinical care

Improved access and coverage for mental health, substance abuse, and physical health problems

Easy access to highly lethal (e.g., firearms) or com- Restricted access to highly lethal or common methods

mon methods (e.g., sedatives) of suicide

of suicide

Family history of suicide or previous suicide attempt Recognition and referral

Hopelessness or depression

Recognition and referral

Financial loss or social isolation

Family and community support

Cultural or religious beliefs that suicide is a noble resolution

Cultural or religious beliefs that discourage suicide

*Adapted from The Surgeon General's Call to Action to Prevent Suicide, 1999.

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