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Abstract
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INTRODUCTION: Nationally, suicide ideation prevalence is comparable among White, American Indian/Alaska Native (AI/AN), Black, and Hispanic adults experiencing alcohol use disorder (AUD). This study examines whether such comparability extends to the probability of receiving a suicide ideation diagnosis when presenting with AUD at emergency departments (EDs). The probability of hospitalization following such diagnosis is examined as well.
METHODS: National Emergency Department Sample (2019) data were used. Logistic and multi-level logistic regression analyses were performed in 2022-2023 with suicide ideation diagnosis and subsequent hospitalization as the outcome variables. Control variables included demographics, payor, AUD level, comorbidities, and ED facility. Adjusted probabilities were computed.
RESULTS: Age-adjusted probabilities of suicide ideation diagnoses for AI/AN, Black, and Hispanic patients with AUD were 5.4%, 6.7%, and 4.9% (95% CIs: 3.7-7.1, 6.0-7.4, and 4.4-5.4), respectively: all less than that for White counterparts-8.7% (95% CI: 8.2-9.2). Among patients with AUD plus suicide ideation diagnoses, the age-adjusted probability of hospitalization for AI/AN-32.4% (95% CI: 20.9-44.0) was less than that for Whites, Blacks, and Hispanics-49.8%, 52.3%, and 49.9% (95% CIs: 46.7-52.8, 47.1-57.5, and 43.9-55.8), respectively. In regressions with multiple control variables, the racial/ethnic differences remained statistically significant (p<0.05).
CONCLUSIONS: Diagnosis of suicide ideation, a key step in ED suicide prevention care, occurred significantly less often for patients of color with AUD than for White counterparts. AI/AN, the racial/ethnic group known to have the nation's highest suicide rate, had the lowest probability of being hospitalized following diagnosis of AUD plus suicide ideation.
Language: en |