Statement of purpose We assessed suicide rates by mechanism within geographic divisions by urbanicity, age, race/ethnicity and sex to inform targeted approaches for suicide prevention strategies. We addressed health equity by highlighting potential disparities and differences between and within demographics, geographic divisions and urbanization levels.

Methods/Approach We will conduct temporal trend analysis using population-based mortality data from the National Vital Statistics System between 2004 and 2018 to estimate trends in suicide rates. We will tabulate national annual counts of suicide deaths among U.S. residents, by injury mechanism, stratified by Census Divisions, 2013 NCHS urban-rural classification scheme for counties, age, race/ethnicity, and sex.

Results In preliminary analysis using CDC WONDER we found certain mechanisms of suicide increasing. We found females had statistically significant higher crude rates of suicide by suffocation than by firearm in large central metro areas in New England (1.3; 0.3) and Middle Atlantic (1.2; 0.3) and in large fringe metro areas in New England (1.6; 0.4) and Middle Atlantic (1.3; 0.6). Males had statistically significant higher crude rates of suicide by suffocation than by firearm in large central metro areas in New England (6.0; 3.7) and Middle Atlantic (4.2;3.5) and in large fringe metro areas in New England (6.4; 4.3). Suicide rates by firearm are highest in most other geographic and urbanization areas for sex. Further analyses will highlight trends in suicide rates by mechanism and by sex, age, race/ethnicity within geographic areas and urbanicity to elucidate differences between and within demographic groups.

Conclusions Results may inform suicide prevention strategies for different populations based on overlapping demographics, geographic areas and urbanicity.

Significance Using a health equity lens, we will provide nuanced suicide data needed for a multifaceted approach to inform suicide prevention strategies in the US.