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FCW : February 2015
2013 by acquiring mortality data from the CDC on veterans and active-duty service members. VA had been working with the CDC since 2006 to collect suicide data on users of Veterans Health Administra- tion services, said Robert Bossarte, co-director of the SDR and director of the Epidemiology Program in VA’s Office of Public Health. But that approach gave a startling- ly incomplete picture of the problem because many veterans do not use VHA services. When you run a veteran’s name and Social Security number through the nascent repository, it matches that information up with the CDC’s National Death Index and then returns a probabilistic score of matching records. A 99 percent score would indicate a near-certain match. “The clinical and public health importance [of data from the reposi- tory] can’t be understated,” Bossarte said. “Understanding...increased risk following separation from service, understanding the impact of VA and DOD prevention and transition pro- grams, and understanding new oppor- tunities for intervention [are] only [possible] if we understand the epi- demiology of risk in this population.” “One of the things that [the reposi- tory] did was allow for VA and DOD to agree upon a matching algorithm to identify when a case is a case,” he added. Bossarte said the SDR current- ly holds about 25 million personal records, including some duplicates. Of those, the system has identified 2 million veteran deaths since 1979, which is how far back the data goes. Bossarte said he and his colleagues are looking for other sources of data to track veterans who died before 1979. That is another chapter in the endless hunt for data to help prevent future suicides. DOD and VA will open the SDR to public viewing when they release the first annual report on the database in the coming months, Bossarte said, adding that he hopes the report will help researchers understand what per- centage of the total veteran population has been included in suicide data over the years. For independent researchers like Ramchand who want to review the data, that annual report can’t come soon enough. He said he would like to see those in charge of the SDR be more specific and public about their goals for the database and a timeline for achieving them. SDR data has been made available to researchers for 51 studies, but all those researchers are affiliated with VA or DOD. Key piece of DOD/VA repository untapped DOD and VA have given the cause of suicide prevention significant atten- tion and resources in recent years. “Increasing data fidelity” was one of the nine priorities identified by the Suicide Prevention General Officer Steering Committee, a group of flag officers, Senior Executive Service members and other officials in charge of implementing DOD’s suicide- prevention strategy. At times, the challenges of harness- ing the two vast bureaucracies of DOD and VA toward a common goal have been plain. In August 2010, a DOD task force recommended a revised, standardized suicide-reporting meth- odology. But it was another three February 2015 FCW.COM 25 *Rates per 100,000 service members per year 30 25 20 15 10 2 010 21.7 17.2 15.5 11. 1 2 011 22.9 14.9 13.3 15.0 2 012 29.7 24.3 15.0 17.8 ARMY USMC USAF NAVY Suicide rates among active-duty service members The most recent data available shows a steady uptick in the number of suicides among service members. Source: Defense Department Suicide Event Report Data Quality Assessment 0215fcw_023-026.indd 25 1/27/15 12:36 PM
March 15, 2015