ASPPH logo


Member Research & Reports

Member Research & Reports

West Virginia: Self-injury Ties with Diabetes as 7th Leading Cause of Death in U.S.

A new study finds self-injury – suicide and drug self-intoxication – ties with diabetes as the seventh leading cause of death in the U.S. and ranks ahead of influenza and pneumonia combined and kidney disease.

Dr. Ian Rockett, professor in the West Virginia University School of Public Health’s Department of Epidemiology and affiliate of the Injury Control Research Center, led the study reported in JAMA Psychiatry online.

He collaborated with researchers from seven other universities. They analyzed death certificate data from the Centers for Disease Control and Prevention and found that self-injury mortality increased by 65 percent over a 15-year period – from an estimated 40,289 deaths in 1999 to 76,227 in 2014. The self-injury death rate rose from 14 to 24 for every 100,000 people, and it continually exceeded the kidney disease mortality rate, surpassed the influenza and pneumonia rate by 2006 and matched the diabetes rate in 2014.

The study combined estimated deaths from drug self-intoxication with registered suicides to better represent the true death toll from self-injury. Self-injury caused 1.4 times more deaths than suicide alone in 1999, but 1.8 times more by 2014.

Gender and age matter.

The study also suggests escalating rates of self-injury death are disproportionately impacting women more than men. The ratio of male-to-female self-injury deaths shrank from 3.7 to 2.6 during the 15-year period. Females accounted for approximately 8,900 (22 percent) of the self-injury deaths in 1999 compared to 21,950 (29 percent) in 2014.

And Dr. Rockett and his team noted gender differences when it came to years of life lost. In 2014, self-injury deaths resulted in 32 lost years for males and 37 for females; this compared to 16 years of life lost from diabetes for males and 17 for females.

Age also made a difference. Self-injury caused six times more deaths among people under age 55 than did diabetes.

“Although researchers, clinicians and medical examiners and coroners acknowledge that repeated opioid and other drug self-intoxication is a form of self-injury, death arising from such behavior continues to be labeled either as an ‘accident’ or ‘unintentional’ – despite the presence of individuals’ clinical history of deliberate, repeated substance misuse that fundamentally increases the probability of later death,” Dr. Rockett and his team reported.