Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Sabrina Brown

Committee Member

Dr. Michael Singleton

Committee Member

Dr. Kathleen Winter


Background: Suicide has been called the ‘silent crisis’. As rates have increased in recent years, it is now the 10th leading cause of death in the United States. Within the state of Kentucky, females die by suicide most often through the use of firearms, differing from the national trend where poisoning is most common. With a drastic increase in firearm suicides has been observed beginning in 2010. The aim of this study is to investigate why Kentucky females who have died by suicide are using firearms most often, as opposed to other methods, and compare those results to other states in order to further understand this trend.

Methods: All suicides reported to the National Violent Death Reporting System were eligible for this study. Multivariate logistic regression was performed to determine which variables, including demographic, personal circumstance, mental health, and suicide-related, were related to firearm suicide.

Results: Kentucky females who died by suicide were not receiving mental health treatment, only 36% were diagnosed and 24% in current treatment. Within comparison states, increased mental health diagnosis and treatment was associated with decreased odds of firearm suicides. It was found that females living in rural counties, and those who were depressed or had intimate partner problems/violence in Kentucky were more likely to die by firearm suicide.

Conclusion: These results contribute to understanding firearm suicide among females in Kentucky and guides efforts for interventions for at-risk populations and future research. This study specifically highlights mental health care with recommendations to emphasize means reduction counseling as a strategy to eliminate barriers to this care. Advocating for more comprehensive state gun laws and policies is also recommended.

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