The Effect of Access to Lethal Methods of Injury on Suicide Rates

doi:10.1001/archpsyc.1992.01820060031005

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Vol. 49 No. 6, June 1992

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The Effect of Access to Lethal Methods of Injury on Suicide Rates

Peter M. Marzuk, MD; Andrew C. Leon, PhD; Kenneth Tardiff, MD, MPH; Edward B. Morgan, MPH; Marina Stajic, PhD; J. John Mann

Arch Gen Psychiatry. 1992;49(6):451-458.

Abstract

• The relationship between the availability of lethal methodsof injury and suicide rates is an important, but unresolvedquestion. We investigated this relationship by prospectivelyclassifying lethal methods according to their accessibilityin the five counties of New York City. These counties have bothsimilarities and differences in the proportion of their populationswith access to specific lethal means. We then compared the age-and gender-adjusted method-specific suicide rates of these counties.There were marked differences in overall crude suicide ratesamong the five counties. The counties had similar suicide ratesinvolving methods that were equally accessible to all personsin each county (eg, hanging, laceration, suffocation, and burns)as well as methods that were accessible to a smaller, but similarproportion of the population in each county (eg, firearms anddrowning in waterways). Virtually all of the differences inoverall suicide risk among counties were explained by differencesin rates involving methods that were differentially availablein the counties, principally fall from height, overdose of prescriptionmedications, and carbon monoxide poisoning. We conclude thatdifferences in suicide rates between communities are, in largepart, due to differences in accessibility to lethal methodsof injury. Therefore, systematic studies should evaluate theeffect of reducing accessibility to specific lethal means onsuicide rates.

Author Affiliations

From the Laboratory of Psychopharmacology, Department of Psychiatry (Drs Marzuk, Leon, and Mann), and Department of Psychiatry and Public Health (Dr Tardiff), Cornell University Medical College, and the Office of Chief Medical Examiner (Mr Morgan and Dr Stajic), New York, NY. Mr Morgan is now with the Human Resources Administration, New York, NY. Dr Mann is now with the Clinical Research Center for the Study of Suicidal Behavior, Department of Psychiatry, University of Pittsburgh (Pa) School of Medicine.

Footnotes

Accepted for publication March 3, 1992.

Reprint requests to Department of Psychiatry, Cornell UniversityMedical College, 1300 York Ave, New York, NY 10021 (Dr Marzuk).

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