Circumstances Preceding Firearm Suicide Deaths in a Large Sample of Hispanic/Latino Adults: Findings From a Content Analysis.

Introduction: Rates of suicide deaths involving firearms have been increasing among Hispanic/Latino adults in the U.S. The high lethality of firearm suicide attempts and critical gaps in characterizing firearm suicide deaths among Hispanic/Latino adults may pose challenges to suicide prevention. However, there is little systematic knowledge about the circumstances that manifest among Hispanic/Latino suicide decedents who die by firearms or about how those circumstances may differ between female and male Hispanic/Latino firearm suicide decedents. This study aimed to descriptively characterize recurring circumstances preceding firearm suicide deaths among a large sample of Hispanic/Latino adults in the U.S. and to examine sex differences in the occurrence of these circumstances. Methods: This study analyzed deidentified data from the National Violent Death Reporting System. The analysis included a large sample of 1,170 Hispanic/Latino adult firearm suicide decedents who died from 2013 to 2021 in the U.S. Given the limited etiologic characterization of firearm suicide among Hispanic/Latino adults, a qualitative content analysis with quantification was conducted to systematically review and code recurring circumstances experienced prior to death using free-text coroner/medical examiner and law enforcement narratives abstracted by the National Violent Death Reporting System. This study grounded circumstance definitions inductively, directly in the language and contextual descriptions present in the narrative data. Results: Six major categories emerged to organize the recurring circumstances preceding firearm suicide deaths among the individuals included in the study sample: behavioral health, physical health, relationship dynamics, socioeconomic instability, scene of death, and firearm access and storage. Behavioral health circumstances were commonly noted among the decedents in the sample, including known mental health conditions and depressed or melancholy mood. Relationship and socioeconomic stressors were noted for a meaningful portion of the decedents in the sample, including romantic relationship challenges, interpersonal arguments, and legal issues. Notable sex differences were observed; female decedents in the sample were more frequently documented as having prior suicide attempts and accessing another person's firearm. Conclusions: Although descriptive, these findings provide population-specific context on the circumstances preceding firearm suicide among Hispanic/Latino adults, a group historically underrepresented in the firearm suicide literature. Several findings extend existing knowledge to a population for whom such evidence remains limited. Many identified circumstances are consistent with prior research on suicide broadly, underscoring their relevance within this population. In addition, this study's findings align with existing National Violent Death Reporting System variables, offering insight into the quality and utility of National Violent Death Reporting System data. This study provides a foundation for subsequent hypothesis-driven research on circumstances and risk factors preceding firearm suicide among Hispanic/Latino adults.