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Citation
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Joseph VA, Martínez-Alés G, Olfson M, Shaman J, Gould MS, Keyes KM. JAMA Netw. Open 2022; 5(10): e2236049. |
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Abstract
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Introduction
Deaths due to suicide increased 45.2% in the past 10 years among adolescents in the US,1 with disproportionate increases among youths who are members of minority groups.2,3 Method of suicide is a strong determinant of suicide fatality, and research on temporal trends in suicide methods among decedents is scarce, especially by race. To address concerns regarding increasing suicide rates, we examined temporal trends in suicide methods among adolescents, with attention to variation by sex and race.
Methods
This cross-sectional time series followed the STROBE reporting guideline. Owing to the use of publicly available data from the Centers for Disease Control and Prevention WONDER database, institutional review board approval and informed consent were not necessary according to the Common Rule.
Suicide death data for adolescents aged 10 to 19 years and stratified by sex and race were drawn from the National Center for Health Statistics’ Multiple Cause of Death files from 1999 to 2020.1 Racial data were collected owing to increasing suicide rates among members of minority groups. Racial categories included American Indian or Alaska Native, Asian or Pacific Islander, Black or African American, and White. Ethnicity data were not included in the present study. Method of suicide was categorized as firearm, asphyxiation (including hanging, strangulation, and suffocation), and a single category comprising other methods (poisoning, drowning, fall, fire, and cuts) due to lower base frequency. Locally estimated scatterplot smoothing regression curves with 95% CIs and logistic regression models were used to evaluate the interaction of time (5-year periods) on the association between race and suicide method. Statistical significance was set at P < .05.
From 1999 to 2020, 47 276 adolescents aged 10 to 19 years (3.0% American Indian or Alaska Native, 4.0% Asian or Pacific Islander, 11.0% Black or African American, and 82.0% White; 23.0% female and 77.0% male) died by suicide in the US. Suicide rates increased steadily for male adolescents, from 7.4 to 9.7 per 100 000 population; for female adolescents, from 1.6 to 3.6 per 100 000 population. Among male adolescents who died by suicide, firearms remained the leading suicide method (Figure), but trends differed substantially by race, with firearms increasingly accounting for deaths among racial minority youths. From 2011 to 2020, the proportion of suicide deaths involving firearms increased from 40.0% to 51.0% among Black male adolescents compared with 49.0% to 52.0% among White male adolescents (Table). Among female adolescents, asphyxiation was the leading method since 2000 (Figure). Suicide death by asphyxiation increased from 53.0% in 1999 to 2001 to 74.0% in 2017 to 2020 among American Indian or Alaska Native female adolescents compared with 37.0% to 52.0% among their White counterparts ...
Language: en |