Racial Differences in Suicide and Undetermined Deaths in Maryland

Are there racial differences in the classification and health care utilization patterns of suicide and undetermined deaths in Maryland?In this cohort study involving 15 832 Black and White decedents, Black decedents were disproportionately classified as having an undetermined manner of death (82.2%) compared with White decedents (63.6%) despite similar characteristics. White decedents had significantly higher outpatient, psychiatric, and emergency department utilization prior to death.Findings suggest possible systemic misclassification and limited health care access for Black decedents, highlighting the need for greater consistency in classification procedures, improved access to mental health care, and strategies to mitigate racial bias in death investigations.

Corresponding Author: Leslie B. Adams, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, 1070 Arastradero Rd, Palo Alto, CA 94304 (lesliea1@stanford.edu).

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