Perpetration of Interpersonal Violence, Incarceration, and Subsequent Risk for Firearm Suicide

Abstract

Suicide is a major public health concern in the United States. The recent growth in the burden of suicide has disproportionately impacted marginalized communities and those of lower socioeconomic status. This dissertation uses administrative data across public health and public safety sectors to assess whether individuals have a heightened risk of suicide after release from custody of a state prison with a goal of highlighting opportunities for intervention and prevention within vulnerable populations. This research primarily focuses on suicide by firearm as these make up the majority of suicide deaths in the United States and can be influenced by unique policy interventions not applicable to other mechanisms of suicide. Furthermore, this dissertation seeks to reduce the burden on public health practitioners as they investigate specific events preceding suicide. These aims are addressed through the construction of a cohort of Washington State prison inmates from 1990 through 2017 linked to death certificates, as well as the application of machine learning techniques to medical examiner investigation narratives.