Objective: To determine whether physicians have similar rates of suicide to the general population, and the role of firearms.
Design: Cross-sectional study (2010-2021).
Setting: 46 US states.
Participants: The population from states participating in the National Violent Death Reporting System.
Exposures: State-level household gun ownership from 2007 to 2016.
Main outcomes and measures: Age/sex standardised firearm and non-firearm suicide rates.
Results: Across 46 states and 1.93 billion person-years, there were 1387 suicides among physicians and 267 714 suicides among non-physicians. Physicians and non-physicians had similar sex-standardised and age-standardised rates of total (and firearm) suicide. The sex-standardised total suicide rate for physicians was 1.10 (95% CI 0.98 to 1.22) times that of non-physicians and the age-standardised total suicide rate was 0.97 (95% CI 0.86 to 1.09) times that for non-physicians. Female, younger (<30 years) and older (>60 years) physicians had significantly higher suicide rates compared with non-physicians. Firearms were the most common cause of suicide in both physicians (48.2%) and non-physicians (51.7%). In high gun ownership states compared with low, physicians had 5.1 (95% CI 4.25 to 6.02) and 4.87 (95% CI 4.09 to 5.83) times more sex and age-standardised firearm suicides and no significant differences in non-firearm suicides. The percentage of suicides that were firearm suicides (FS/S), and the demographic patterns of FS/S, were largely similar for physicians and non-physicians. FS/S was highest among those who were older, white non-Hispanic, men and living in the South.
Conclusions and relevance: Physicians in high gun states have higher suicide rates than physicians in low gun states, because of their higher rates of firearm suicide. This evidence may support suicide prevention efforts in addressing physician attitudes and behaviours related to firearms, to minimise risks to both physicians and their patients.
Keywords: Epidemiology; Mental Health; Public Health.
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