Abstract
Suicide rates among active-duty personnel in the US military have increased substantially since 2004, and numerous studies have attempted to contextualize and better understand this phenomenon. Placing contemporary examinations of suicides among active-duty personnel in the US Army in historical context provides opportunities for joint historical and epidemiological research to inform health care professionals and policy makers. To consolidate data on suicide rates among active-duty personnel in the US Army as far back as historical records allow and to identify historical trends to separate them from more acute causal factors. This cross-sectional study included all active-duty service members in the US Army from 1819 to 2017 as identified and detailed in US government publications, studies, and journal articles. Empirical data were extracted from US government publications and journal articles published from 1819 to 2017. Data collection and analysis were completed between July and August of 2019. Suicide. Suicide rates per 100 000 individuals. Starting in 1843, the overall trend in annual suicide rates among active-duty service members in the US Army increased, with a peak rate of 118.3 per 100 000 in 1883. From that historical high point, the rate decreased in 3 successive waves, each corresponding to the end of the following wars: the Spanish-American War (1898), World War I (1914-1918), and World War II (1939-1945). The latter had the historically lowest rate of 5 per 100 000 in 1944 to 1945. During the Cold War (approximately 1945-1991), the rate generally stabilized in the low teens to midteens (ie, 10-15 per 100 000). The rate increased again during the Afghanistan and Iraq Wars, increasing to 29.7 per 100 000 in 2012. From 2008 to present, the annual rate has remained within the range of 20.2 to 29.7 per 100 000. This study represents the most extensive historical examination of suicides in the US Army to date. By taking a long-term historical approach to suicide among active-duty personnel in the US Army, this study affords future researchers a new analytical tool and an additional perspective from which to better differentiate long-term and historical trends from more short-term and temporary causal factors.
Highlights
Since 2004, the suicide rate among active-duty personnel in the US military has risen substantially.[1]
The findings suggest that suicides historically decreased during wartime, but that pattern seems to have changed during the wars in Vietnam, Iraq, and Afghanistan
In a 2012 study using historical medical records,[2] we found that data gathered by the US military during the US Civil War provided a conservative estimated suicide rate of between 8.74 and 14.54 per 100 000 among white individuals who belonged to the active-duty Union Army
Summary
Since 2004, the suicide rate among active-duty personnel in the US military has risen substantially.[1] Because of the recent nature of this phenomenon, current studies generally use relatively little historical perspective or data. Placing today’s medical and military explanations and theories in historical context is fundamental to gaining a deeper understanding of the current phenomenon of increases in suicides among active-duty military personnel. By incorporating historical context and data to a greater degree, researchers, medical professionals, and the US military could draw potentially new inferences that further contextualize contemporary data. Modern models and explanations of suicide among active-duty personnel in the US Army that account for the past may gain greater accuracy in understanding the present and preparing policy makers, officials, and clinicians for the future
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