Spatial and temporal epidemiology of suicides among Alaska Native people

Abstract

Alaska has one of the highest suicide rates among Indigenous populations in the United States. This study used data from the Alaska Violent Death Reporting System (AKVDRS) and applied spatial, temporal, and space-time analyses to identify unusual concentrations—or clusters—of suicide among Alaska Native people. This research identified one low-risk rural cluster and ten high-risk spatial clusters: six in urban boroughs and census areas (BCAs) and four in rural BCAs. Space-time analysis revealed eight clusters, most lasting an average of five years, with one emerging during the final three years of the study period. The study identified notable differences in mental health and demographic characteristics among cluster members. Documented mental health issues were more likely among all female decedents. Exposure to the suicide of someone close, a history of suicidal thoughts, prior attempts, and leaving a note occurred more frequently among urban females . Rural female cluster members were more likely to disclose suicidal intent. Among males, urban cluster members had higher rates of diagnosed mental health conditions and prior treatment compared to rural males. Method of suicide also differed: hanging/strangulation/suffocation (H/S/S) was more common among cluster members, particularly urban males. Despite the concentration of behavioral health services in Alaska’s urban areas, suicide clusters occurred in both urban and rural regions, suggesting geographic access alone does not explain these patterns. These findings underscore the value of spatial and space-time methods in identifying risk and protective factors at the community level. The study proposes culturally informed, data-driven prevention strategies. Collaborations with Alaska Native tribal groups may help contextualize this study’s results.