Longitudinal analysis of suicide mortality in Puerto Rico (2000–2024): Insights from negative binomial regression modeling

Title : Longitudinal analysis of suicide mortality in Puerto Rico (2000–2024): Insights from negative binomial regression modeling

Abstract:

Analysis of long-term suicide mortality trends is essential for informing public health strategies and assessing intervention effectiveness. Through this study, a detailed and comprehensive temporal analysis of age-adjusted suicide rates in Puerto Rico from 2000 to 2024 was achieved through the implementation of advanced statistical models that revealed key patterns. Annual suicide counts were modeled using Negative Binomial regression; the log of the population was used as an offset to adjust for population size. Rates were age-adjusted using the direct method; the 2000 U.S population was used as a reference. Trends were visualized with the predicted rates and 95% confidence intervals (CIs), while year-over-year changes were quantified using Rate Ratios (RRs) and their CIs. The analysis revealed a statistically significant decline in suicide mortality across the 25-year period. The regression coefficient for year was β = -0.0083 (p = 0.0036), corresponding to an annual RR of 0.992 (95% CI: 0.986–0.997), a roughly 0.8% average annual decline. These results highlight that the potential benefits of sustained public health efforts may be contributing to the observed reduction in suicide rates. Future work should prioritize epidemiological studies to identify mediating factors that may explain this decline. Strengthening data-driven approaches and maintaining disaggregated surveillance by sex, age, and region remain essential to advancing mental health outcomes across Puerto Rico.
Keywords: Suicide Mortality, Temporal Trends, Puerto Rico, Negative Binomial Regression

Biography:

Viviani Lopez Rivera holds a bachelor’s degree in science with a concentration in Biology with an emphasis in Biomedical Sciences from the University of Puerto Rico in Aguadilla, and a master’s degree in Public Health in Epidemiology from Ponce Health Sciences University. Her professional career in public health began in 2019, working in various areas of epidemiology, including syndromic, passive, and active surveillance systems for infectious diseases, intervention and prevention of communicable diseases and infections, injury epidemiology, and the review of abstracts and short films presented at the Public Health Film Festival hosted by the American Public Health Association. Currently, Viviani serves as the Senior Epidemiologist for the Surveillance Component of the Commission for Suicide Prevention, from the Puerto Rico Department of Health, under the federal grant "Puerto Rico Expansion of a Comprehensive Approach to Suicide Prevention," awarded by the Centers for Disease Control and Prevention (CDC). She is also pursuing her Doctor of Public Health (DrPH) degree at the Celia Scott Weatherhead School of Public Health at Tulane University, further deepening her expertise and commitment to advancing public health initiatives.