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Suicide in Canadian veterans living in Ontario: a retrospective cohort study linking routinely collected data
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  • Published on:
    Quantifying and describing burden of suicide mortality in Canadian Veterans
    • Linda VanTil, Senior Epidemiologist Veterans Affairs Canada
    • Other Contributors:
      • Kristen Simkus, Epidemiologist
      • Alexandra Heber, Chief of Psychiatry
      • Elizabeth Rolland-Harris, Senior Epidemiologist
      • Diane Lu, Section Head, Epidemiology
      • Rakesh Jetly, Mental Health Advisor, Directorate of Mental Health
      • Jim Thompson, Faculty, School of Public Health
      • Nathan Svenson, Director, Research Directorate

    Dear Editor-in-Chief,

    We are writing to you in response to Mahar et al.’s (2019) recent publication in your journal (“Suicide in Canadian veterans living in Ontario: a retrospective cohort study linking routinely collected data”).

    The authors found a lower risk of suicide in Canadian Armed Forces (CAF) Veterans (former members) using Ontario Health Insurance Plan coverage, in contrast to the findings of higher CAF Veteran suicide risk in the Canadian Forces Cancer and Mortality Study (CF CAMS) and the Veteran Suicide Mortality Study (VSMS), which use nation-wide Vital Statistics and cancer registry data collected by Statistics Canada. We strongly feel that there is synergistic value in having different studies by different investigator groups using different data sources, but it is essential to understand the limitations in these different approaches and their findings.

    Mahar et al. state that their study was the “...first study of suicide risk in Canadian veterans...” However, CF CAMS, which looked at suicide risk in Canadian Veterans, was published eight years prior to the Mahar et al. study (Statistics Canada, 2011). This was followed by the Veteran Suicide Mortality Study (VSMS) Technical report was published in 2017 (Simkus et al., 2017), its accompanying peer-reviewed publication (VanTil et al., 2018), and the 2018 VSMS Technical report (Simkus et al., 2018).

    We have questions about the authors’ choice of covariates for the adjusted an...

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    Conflict of Interest:
    None declared.