Association of State Social and Environmental Factors With Rates of Self-injury Mortality and Suicide in the United States

Key Points Question Do state rates of SIM and suicide vary with social factors and administrative reporting systems? Findings This cross-sectional study including 101 325 deaths found that social and administrative factors were associated with interstate variation in SIM and suicide rates, and adjusted SIM rates were higher in medical examiner states with centralized authority, implying better detection of fatal drug poisonings. Meaning These findings suggest that SIM and suicide and related interventions need to address broad social factors from inequity to health care access to injury means.

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