Injuries/Violence
Suicide and overdose mortality among victims and defendants in felony domestic violence criminal cases Warren Szewczyk* Warren Szewczyk Szewczyk Szewczyk Szewczyk Public Health Seattle & King County
Domestic violence (DV), death by suicide, and death by overdose are major public health concerns in the United States. While existing studies have documented associations of DV with both suicide and overdose, most studies utilize nonfatal outcomes and lifetime DV exposure. In this population-based case-control study, we aimed to estimate the association of both suicide death and overdose death with involvement in a DV case, either as a victim or defendant, referred for felony charges in the year prior to death. All deaths in King County, Washington, USA or deaths occurring elsewhere among King County residents from 2016–2022 were included (N=113,388). Felony DV referral records from 2016–2021 were sourced from the King County Prosecuting Attorney’s Office and included both victims and alleged perpetrators of DV. All people with DV referral records had at least one year of observation after referral. Suicide deaths (n=2,246) and overdose deaths (n=3,588) were separately matched to deaths of all other causes based on age, gender, year of death, and calendar year quarter of death. Conditional logistic regression was used to estimate associations of case status with DV referral in the year prior to death. Suicide cases had nearly 4 times greater odds of being a defendant in a DV referral within the year prior to death than matched controls (OR=3.68, 95% CI: 2.33–5.81, p<0.01). No association was found for suicide and being a victim in a felony DV case (OR=0.74, 95% CI: 0.18–3.02, p=0.42). Overdose cases had greater odds of both being a defendant (OR=2.47, 95% CI: 1.67–3.66, p<0.01) and being a victim (OR=4.36, 95% CI: 2.76–6.87, p<0.01) in the year prior to death. These findings highlight a need for a public health approach to implementing evidence-based suicide and overdose prevention efforts among people involved in DV cases. Future research could examine mediating links between DV and both suicide and overdose and evaluate the efficacy of prevention strategies.