PS03 - State-of-the-science Sexual and Gender Minority Suicide Research: Empirical Evidence from Europe and North America
Emergency Department Visits for Suicidal Ideation, Self-Poisoning, and Self-Harm Among Sub-Groups of Sexual Minority and Heterosexual Adults in Canada, 2003-2017Introduction: The vast majority of evidence regarding suicide among sexual minorities relies upon self-reported measures of suicide ideation and/or behavior. While some studies have examined suicide deaths and healthcare attendance (e.g., hospitalization) for non-fatal suicide suicide-related behaviors, these have had insufficient sample size to disaggregate by intersecting social characteristics such as gender and rurality. The objective of this study is to use linked national survey and administrative databases from Canada to provide estimates of rates and time-to-event for suicide-related emergency department (ED) visits across sexual orientation and intersecting social groups over a 14-year period. Methods: The Canadian Community Health Survey (CCHS) is a probabilistic national survey that has measured sexual orientation among adults (18-59 years of age) since 2003. CCHS data are linked to ED records from the National Ambulatory Care Reporting System (NACRS), a national database with coverage of approximately 84% of all ED visits in Canada. Incidence rates and Kaplan-Meier curves will be estimated to compare three outcome categories corresponding to reasons for visit (suicidal ideation, self-poisoning, and self-harm) between sexual minorities and heterosexuals. Subgroup comparisons will be conducted by social characteristics associated with suicide-related outcomes including gender, age, rurality, income, and race/ethnicity. Hazard ratios will be used to quantify disparities between groups. Results: A total of N=442,260 CCHS adult respondents provided information enabling data linkage, of which 10,614 were classified as sexual minorities. Data access to NACRS is pending approval by Statistics Canada and is anticipated by April 2024. Discussion: Stratified estimates of ED-attended suicide-related events by sexual orientation and other social characteristics will be interpreted alongside existing sexual minority suicide literature. Methodological opportunities for future analyses exploiting Canadian data linkages will be discussed.