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Background <p>Intentional self-harm remains a major public health problem, but national mortality trends for injuries involving open wounds of the head are poorly characterized.</p> Objective <p>To evaluate temporal trends in mortality due to intentional self-harm involving open wounds of the head in the United States from 1999 to 2024 and to assess disparities across demographic and geographic subgroups.</p> Methods <p>We conducted a retrospective population-based study of U.S. deaths among persons aged 25 years and older using the CDC WONDER mortality export. Age-adjusted mortality rates (AAMRs) per 100,000 population were examined overall and by sex, race/ethnicity, census region, and urbanization; age-specific analyses used crude rates. Joinpoint regression was used to estimate annual percentage changes (APCs) and average annual percentage changes (AAPCs). Urbanization-stratified data in the provided export were available through 2020.</p> Results <p>Among adults aged 25 years and older, 390,581 deaths were identified. Overall AAMR increased from 6.0 per 100,000 in 1999 to 8.9 in 2024; after a stable 1999–2006 segment (APC 0.28%; <i>p</i> = 0.529), rates rose 2.11% per year during 2006–2024 (<i>p</i> &lt; 0.000001; AAPC 1.59%, <i>p</i> &lt; 0.000001). In 2024, AAMR was highest in males (15.9 vs. 2.2 in females; male AAPC 1.32%, <i>p</i> &lt; 0.000001; female AAPC 1.90%, <i>p</i> = 0.000004), White individuals (11.7; AAPC 2.31%, <i>p</i> &lt; 0.000001), and the South (10.5), while nonmetropolitan areas through 2020 had higher rates than metropolitan areas (12.1 vs. 7.2; AAPC 2.44%, <i>p</i> &lt; 0.000001). American Indian or Alaska Native persons had the fastest race/ethnicity increase (AAMR 8.8 in 2024; AAPC 3.63%, <i>p</i> &lt; 0.000001), the Midwest had the steepest regional increase (AAMR 9.5 in 2024; AAPC 2.59%, <i>p</i> &lt; 0.000001), and the highest 2024 age-specific crude rate occurred among adults aged 85 years and older (13.7; AAPC 1.90%, <i>p</i> &lt; 0.000001). Overall, 63.2% of deaths occurred at the decedent’s home.</p> Conclusions <p>Mortality from intentional self-harm involving open wounds of the head increased after 2006. The largest absolute disparity was by sex, with markedly higher mortality among males, while American Indian or Alaska Native persons and nonmetropolitan areas showed the fastest relative increases, supporting targeted means-safety, crisis-access, and rural mental-health/trauma-access interventions.</p>

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Mortality Trends in Intentional Self-Harm Involving Open Wounds of the Head in the United States, 1999–2024: A Joinpoint Analysis

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Mahmood Ayad Al-Ibadah,
  • Murtadha Abdulridha Ajel,
  • Ghassan Adnan Hashim,
  • Hanan I. Nazar,
  • Sana Shukri Masoud Alaswad,
  • Mohamed Wagdy,
  • Kirolos Hany Shakhlol Gerges,
  • Mostafa Mohamed Abdelmoneam Elsawy

摘要

Background

Intentional self-harm remains a major public health problem, but national mortality trends for injuries involving open wounds of the head are poorly characterized.

Objective

To evaluate temporal trends in mortality due to intentional self-harm involving open wounds of the head in the United States from 1999 to 2024 and to assess disparities across demographic and geographic subgroups.

Methods

We conducted a retrospective population-based study of U.S. deaths among persons aged 25 years and older using the CDC WONDER mortality export. Age-adjusted mortality rates (AAMRs) per 100,000 population were examined overall and by sex, race/ethnicity, census region, and urbanization; age-specific analyses used crude rates. Joinpoint regression was used to estimate annual percentage changes (APCs) and average annual percentage changes (AAPCs). Urbanization-stratified data in the provided export were available through 2020.

Results

Among adults aged 25 years and older, 390,581 deaths were identified. Overall AAMR increased from 6.0 per 100,000 in 1999 to 8.9 in 2024; after a stable 1999–2006 segment (APC 0.28%; p = 0.529), rates rose 2.11% per year during 2006–2024 (p < 0.000001; AAPC 1.59%, p < 0.000001). In 2024, AAMR was highest in males (15.9 vs. 2.2 in females; male AAPC 1.32%, p < 0.000001; female AAPC 1.90%, p = 0.000004), White individuals (11.7; AAPC 2.31%, p < 0.000001), and the South (10.5), while nonmetropolitan areas through 2020 had higher rates than metropolitan areas (12.1 vs. 7.2; AAPC 2.44%, p < 0.000001). American Indian or Alaska Native persons had the fastest race/ethnicity increase (AAMR 8.8 in 2024; AAPC 3.63%, p < 0.000001), the Midwest had the steepest regional increase (AAMR 9.5 in 2024; AAPC 2.59%, p < 0.000001), and the highest 2024 age-specific crude rate occurred among adults aged 85 years and older (13.7; AAPC 1.90%, p < 0.000001). Overall, 63.2% of deaths occurred at the decedent’s home.

Conclusions

Mortality from intentional self-harm involving open wounds of the head increased after 2006. The largest absolute disparity was by sex, with markedly higher mortality among males, while American Indian or Alaska Native persons and nonmetropolitan areas showed the fastest relative increases, supporting targeted means-safety, crisis-access, and rural mental-health/trauma-access interventions.