Race/ethnicity and potential suicide misclassification: window on a minority suicide paradox?

<p>Abstract</p> <p>Background</p> <p>Suicide officially kills approximately 30,000 annually in the United States. Analysis of this leading public health problem is complicated by undercounting. Despite persisting socioeconomic and health disparities, non-Hispanic Blacks and Hispanics register suicide rates less than half that of non-Hispanic Whites.</p> <p>Methods</p> <p>This cross-sectional study uses multiple cause-of-death data from the US National Center for Health Statistics to assess whether race/ethnicity, psychiatric comorbidity documentation, and other decedent characteristics were associated with differential potential for suicide misclassification. Subjects were 105,946 White, Black, and Hispanic residents aged 15 years and older, dying in the US between 2003 and 2005, whose manner of death was recorded as suicide or injury of undetermined intent. The main outcome measure was the relative odds of potential suicide misclassification, a binary measure of manner of death: injury of undetermined intent (includes misclassified suicides) versus suicide.</p> <p>Results</p> <p>Blacks (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 2.22-2.57) and Hispanics (1.17, 1.07-1.28) manifested excess potential suicide misclassification relative to Whites. Decedents aged 35-54 (AOR, 0.88; 95% CI, 0.84-0.93), 55-74 (0.52, 0.49-0.57), and 75+ years (0.51, 0.46-0.57) showed diminished misclassification potential relative to decedents aged 15-34, while decedents with 0-8 years (1.82, 1.75-1.90) and 9-12 years of education (1.43, 1.40-1.46) showed excess potential relative to the most educated (13+ years). Excess potential suicide misclassification was also apparent for decedents without (AOR, 3.12; 95% CI, 2.78-3.51) versus those with psychiatric comorbidity documented on their death certificates, and for decedents whose mode of injury was "less active" (46.33; 43.32-49.55) versus "more active."</p> <p>Conclusions</p> <p>Data disparities might explain much of the Black-White suicide rate gap, if not the Hispanic-White gap. Ameliorative action would extend from training in death certification to routine use of psychological autopsies in equivocal-manner-of-death cases.</p

Investigation Into Water Quality and Engineering Problems Associated With the Development of Springfield, Missouri, Including a Teachers Guide For Tracing Underground Drainage Systems Such as Jones and Sequiota Springs Using Fluorescein Dyes

The value of out-of-classroom experiences in science education has been recognized in education literature. A review of the literature shows that the development of scientific attitudes, increased understanding of scientific methodology, and gains in critical thinking were achieved using outdoor class experiences. This study was designed as a handbook to aid teachers in helping students define and solve an outdoor classroom problem. The study investigates the problems associated with karst topography, including rapid transfer of surface water to groundwater, rapid passage of the water from the point of entry to the point of discharge, the lack of effective filtering action during the passage, and the lowering of water quality by the expansion of a large urban area (Springfield, Missouri). The study traced the underground drainage system of the two largest springs in Springfield (Jones and Sequiota) by using fluorescein dyes. Four new sources of Jones Spring were located which were all sinkholes that are being used for the disposal of storm runoff. The locations are the corner of Cherry Street and Cavalier Avenue, the corner of Barnes and Madison Street, six hundred feet (183 meters) north of the corner of Cherry Street and Patterson Avenue, and the corner of Cherry Street and Grandview Avenue. The effects on water quality of both springs because of the expansion of Springfield were apparent from the increased nitrate concentrations. This resulted from the introduction of low quality storm runoff and septic tank effluent entering the groundwater. These problems could be solved by stricter zoning regulations