“How many have done more than this generation in uniform? The war on terror is the longest military engagement in U.S. history. So many have served in Iraq and Afghanistan. Tens of thousands wounded. More than 6,800 dead. The strain on military and their families, it is enormous…. The longer someone is deployed and redeployed, the more likely they will suffer PTSD…. They suffer disproportionate unemployment numbers…. And worse, oh friends, worse, the suicide rate among our best and our brightest is 23 a day. As we gather here — we’re safe, we’re secure, we’re having fun — four days together at a conference, in these four days, 92 of our veterans will have taken their lives.”
— Former Alaska governor Sarah Palin (R), speech at Conservative Political Action Conference, Feb. 26, 2015
Palin took the stage at the Conservative Political Action Conference to a standing ovation and delivered an impassioned speech about taking care of veterans. She described the challenges veterans have in getting access to quality health care, obtaining jobs after returning from deployment and other issues — including this statistic about veteran suicide rates.
Palin used a figure that 23 veterans commit suicide a day — 92, over the course of CPAC. It is a derivative of a claim that we have previously fact-checked and found to be based on a partially completed study with unreliable methods. And since Palin cited it again in front of thousands at what is billed “the nation’s largest gathering of conservatives” — we will revisit it, especially because she included it in a long section related to the veterans of the wars of Iraq and Afghanistan.
Is Palin correct that 23 veterans commit suicide a day, adding up to 92 in four days? And how relevant is that statistic to veterans of the nation’s most recent wars?
The claim that there are 22 veteran suicides a day is a figure widely used by lawmakers and veterans groups.
At best, this figure is a very rough estimate. The Department of Veterans Affairs has estimated that 18 to 22 veterans die from suicide each day, by using data from the Centers for Disease Control and Prevention. Officials took the percentage of veteran suicides (20 percent) of all suicides in the United States and applied the rate to the number of suicides that occurred in 2009 and 2010.
The main source of this figure is the VA’s 2012 Suicide Data Report, which arrived at the same range of 18 to 22 daily veteran suicides by using death certificates filed at the state level. Researchers analyzed death certificates from 21 states, from 1999 to 2011. They took the percentage of suicides identified with veterans out of all suicides from those states in the project period (22 percent). Then they applied it to the number of suicides in the United States in a given year (about 38,000). That comes out to 22 suicides a day.
There are several issues with the 22-a-day figure — or 23, in Palin’s case.
First, researchers, in the study, warned against even using the 22-deaths figure in the first place: “It is recommended that the estimated number of veterans be interpreted with caution due to the use of data from a sample of states and existing evidence of uncertainty in veteran identifiers on U.S. death certificates.”
In addition, the sample size was fewer than half the states, and it did not include some states with the largest veteran populations, such as California, Arizona, North Carolina and Texas. So depending on the death certificates from those states, the rate of suicides may change. Researchers said they believed they reached a point of statistical significance because there was enough demographic and geographical variety in the studies that turned over death certificates.
There also were “significant limitations” in using death certificates, researchers noted. This is mainly due to the inclusion of people who were incorrectly identified as veterans on death certificates. An updated report with data from at least 44 states is scheduled to be released this summer. The VA, CDC and Department of Defense also are working on a larger study that is expected to be the most comprehensive review of veteran suicides rates and trends.
But, more to the point, Palin took this unreliable figure and suggested it was emblematic of the most recent wars in Iraq and Afghanistan. She included it in a long section of statistics about the impact of those wars on recent veterans, mentioning both post-traumatic stress disorder and a high suicide rate. But when it comes to this population, this statistic is inapplicable.
Indeed, the findings in the VA study were more telling of suicide trends among older veterans who were deployed before Operations Enduring Freedom and Iraqi Freedom. The most reliable study for the population Palin mainly refers to is one that was funded by the Army.
That study, published in the February 2015 Annals of Epidemiology, analyzed suicide rates among veterans who were on active duty during the Iraq and Afghanistan wars. It found that between 2001 and 2009, 351 out of 1,650 deployed veterans’ deaths and 1,517 out of 7,703 non-deployed veterans’ deaths were suicides. That means there was not quite one veteran suicide a day over the nine-year period. In other words, she’s off by a factor of 23.
The Army study was the first large population-based research that compared suicide risks among Iraq and Afghanistan war veterans and non-deployed veterans. This is the population that Palin is referring to in the portion of the speech — those who were wounded, whose deployments put a strain on their families. It specifically studied the suicide risk among veterans who suffer long-term health consequences of being in combat in Iraq and Afghanistan.
The larger issue with the figure that Palin used is that it provides no context, and has little meaning.
It is a catchy number that doesn’t tell you whether suicides among veterans happen at a higher rate than Americans in general. It doesn’t tell you there are consistently higher rates of male and female veteran suicides compared to non-veterans, but the difference is greater among males.
It doesn’t tell you that, by using the same division of estimates, there are 104 Americans who commit suicide a day. It doesn’t say how there has been a spike in suicides among veterans 18 to 24 years old in recent years. It doesn’t tell you that veteran suicide is a difficult issue to tackle, because there are risk factors that apply differently among subsections of the veteran population — by age, gender, whether they were deployed, whether they received help through the VA once they returned, and so much more.
All it tells you is a raw number: 23.
The Pinocchio Test
Suicide is a serious concern among veterans and Americans at large. The statement that there are 23 veteran suicides a day and that 92 veterans will have taken their lives over the course of CPAC is an alarming one; there was a flurry of tweets using those numbers as soon as Palin cited them during her speech.
But they offer no context or meaning. The actual number of veteran suicides a day might be higher or lower than 23, given the particular population studied. For the specific population that Palin focused on during her speech, the suicide rate is not quite one a day.
All eyes were on Palin after her bizarre speech at the Iowa Freedom Summit, to see how she would perform at her first major speech since then. It turned out that Palin had a message that was focused — and it was clearly written in advance. It would have done Palin — and the public — a favor to do some extra Google searches about the number or spend a few minutes describing just what exactly it means to have 92 veteran suicides during the conference. Her use of this statistic in the context of Iraq and Afghanistan is almost worthy of Four Pinocchios, but not quite.
(To contact the VA’s Crisis Line: Call 1-800-273-8255 and push “1″ for Veteran services. Veterans Chat can be accessed at www.VeteransCrisisLine.net. Veterans Text is available at 838255.)
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