Within-community variation in violence and risk of self-harm in California: A population-based case-crossover study (2019)

Abstract

Self-harm is a leading cause of morbidity and mortality in the United States, ¹ and rates are increasing for reasons that are not well understood. Social environments are recognized to be associated with self-harm, ² but research to identify features of the social environment that matter most is limited.

Although controls drawn from after fatal self-harm are technically no longer at risk, a combination of pre- and postcase exposure is a reasonable approximation for the exposure distribution in the study base (eAppendix 1; http://links.lww.com/EDE/B437). We used conditional logistic regression, adjusting for measured time-varying community-level confounders. See eAppendix 1 (http://links.lww.com/EDE/B437) for further detail on background, methodology, results, and discussion.