Sooner Versus Later: Factors Associated with Temporal Sequencing of Suicide


  • This research was undertaken with a grant from the National Institute of Mental Health (MH070520). Data for this study were made available through the Inter-University Consortium for Political and Social Research and the National Center for Health Statistics. The authors thank Dr. Lisa Colpe for her support of this project and Christine Cox for her assistance in obtaining linked data. An earlier version of this paper was presented at the 38th Annual Conference of the American Association of Suicidology, April 2005.

School of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207; E-mail:


There are few (if any) population-based prospective studies that provide information on factors associated with temporal sequencing of suicide. In this prospective population-based study, the National Health Interview Survey (NHIS), 1986–1994, was linked to the National Death Index (NDI), 1986–1997, to assess factors that predict recent (within 12 months of interview, termed sooner) suicide versus suicide further in the future (more than 12 months after interview, termed later). Of the 653 completed suicides in the NHIS cohort, 13.4 percent completed suicide within a year of interview, and 86.6 percent did so after a year. Sooner decedents were more likely to be White, less educated, unemployed, and to use firearms than any other method compared with later decedents. Surprisingly, sooner decedents had higher levels of self-rated health at baseline. These results have substantial implications for clinicians and other professionals who interact with people at highest risk of suicide. Unfortunately, it may be unrealistic to expect that health care providers can modify the behavior of individuals at highest risk of suicide.