Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data

Abstract Background Veterans are at elevated risk for suicide compared to non-Veteran U.S. adults. Data sources and analyses to inform prevention efforts, especially for those who do not use Department of Veterans Affairs (VA) healthcare services, are needed. This study aimed to link VA and CDC’s Na...

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Main Authors: Claire A. Hoffmire, Alexandra L. Schneider, Laurel A. Gaeddert, Joseph Logan, Julie A. Kittel, Ryan Holliday, Lindsey L. Monteith
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Injury Epidemiology
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Online Access:https://doi.org/10.1186/s40621-024-00559-5
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author Claire A. Hoffmire
Alexandra L. Schneider
Laurel A. Gaeddert
Joseph Logan
Julie A. Kittel
Ryan Holliday
Lindsey L. Monteith
author_facet Claire A. Hoffmire
Alexandra L. Schneider
Laurel A. Gaeddert
Joseph Logan
Julie A. Kittel
Ryan Holliday
Lindsey L. Monteith
author_sort Claire A. Hoffmire
collection DOAJ
description Abstract Background Veterans are at elevated risk for suicide compared to non-Veteran U.S. adults. Data sources and analyses to inform prevention efforts, especially for those who do not use Department of Veterans Affairs (VA) healthcare services, are needed. This study aimed to link VA and CDC’s National Violent Death Reporting System (NVDRS) data to create a novel data source to characterize the circumstances precipitating and preceding suicide among Veterans, including among those who did not use VA healthcare. Methods Multi-variable, multi-stage, deterministic linkage of VA-Department of Defense (DoD) Mortality Data Repository (MDR) and NVDRS-Restricted Access Database suicide and undetermined intent mortality records within 189 state-year strata (42 states, 2012–2018). Three linkage stages: (1) exact (matched on: age, sex, death date, underlying cause of death, day of month of birth, first initial of last name); (2) probable (all but one variable matched); (3) possible (all but 2 variables matched). Linkage success and accuracy of NVDRS-documented military history were assessed. Results Across all state-years, 22,019 matches (89.20% of 24,685 MDR Veteran records) were identified (65.47% exact). When high missingness (2 + matching variables in > 10% of records; n = 23) or incomplete reporting (n = 12) state-years were excluded, match rate increased to 94.29% (77.15% exact). NVDRS-documented military history (ever served) was accurate for 87.79% of matched records, with an overall sensitivity of 84.62%. Sensitivity was lower for female (61.01%) and younger (17–39 years; 77.51%) Veterans. Conclusions Accurate linkage of VA-DoD and NVDRS data is feasible and offers potential to improve understanding of circumstances surrounding suicide among Veterans.
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spelling doaj-art-604f6293c8ff40929ac65bed0f1b5ffa2025-01-26T12:09:58ZengBMCInjury Epidemiology2197-17142025-01-0112111210.1186/s40621-024-00559-5Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System DataClaire A. Hoffmire0Alexandra L. Schneider1Laurel A. Gaeddert2Joseph Logan3Julie A. Kittel4Ryan Holliday5Lindsey L. Monteith6VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionDivision of HIV Prevention, Centers for Disease Control and PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionVA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide PreventionAbstract Background Veterans are at elevated risk for suicide compared to non-Veteran U.S. adults. Data sources and analyses to inform prevention efforts, especially for those who do not use Department of Veterans Affairs (VA) healthcare services, are needed. This study aimed to link VA and CDC’s National Violent Death Reporting System (NVDRS) data to create a novel data source to characterize the circumstances precipitating and preceding suicide among Veterans, including among those who did not use VA healthcare. Methods Multi-variable, multi-stage, deterministic linkage of VA-Department of Defense (DoD) Mortality Data Repository (MDR) and NVDRS-Restricted Access Database suicide and undetermined intent mortality records within 189 state-year strata (42 states, 2012–2018). Three linkage stages: (1) exact (matched on: age, sex, death date, underlying cause of death, day of month of birth, first initial of last name); (2) probable (all but one variable matched); (3) possible (all but 2 variables matched). Linkage success and accuracy of NVDRS-documented military history were assessed. Results Across all state-years, 22,019 matches (89.20% of 24,685 MDR Veteran records) were identified (65.47% exact). When high missingness (2 + matching variables in > 10% of records; n = 23) or incomplete reporting (n = 12) state-years were excluded, match rate increased to 94.29% (77.15% exact). NVDRS-documented military history (ever served) was accurate for 87.79% of matched records, with an overall sensitivity of 84.62%. Sensitivity was lower for female (61.01%) and younger (17–39 years; 77.51%) Veterans. Conclusions Accurate linkage of VA-DoD and NVDRS data is feasible and offers potential to improve understanding of circumstances surrounding suicide among Veterans.https://doi.org/10.1186/s40621-024-00559-5Data linkageVeteranSuicide
spellingShingle Claire A. Hoffmire
Alexandra L. Schneider
Laurel A. Gaeddert
Joseph Logan
Julie A. Kittel
Ryan Holliday
Lindsey L. Monteith
Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
Injury Epidemiology
Data linkage
Veteran
Suicide
title Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
title_full Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
title_fullStr Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
title_full_unstemmed Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
title_short Harnessing national data systems to understand circumstances surrounding veteran suicide: linking Department of Veterans Affairs and National Violent Death Reporting System Data
title_sort harnessing national data systems to understand circumstances surrounding veteran suicide linking department of veterans affairs and national violent death reporting system data
topic Data linkage
Veteran
Suicide
url https://doi.org/10.1186/s40621-024-00559-5
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