1. A cross-sectional analysis of self-reported suicidal thoughts, behavior, attempt, and injury among high school students showed a significant annual decrease in suicide attempts between 1991 and 2017 among adolescents identifying as white, Hispanic, Asian American, and American Indian.
2. Black adolescents had a statistically significant linear increase in suicide attempts, and black boys had a significant increase in injury by suicide attempt over the same time period.
Evidence Rating Level: 2 (Good)
Study Rundown: Previous research has found racial and ethnic disparities in suicide deaths among adolescents, but trends in racial and ethnic differences in suicidal ideation, plans, and attempts remain understudied. In this cross-sectional study, researchers used anonymous survey data from high school students between 1991 to 2017 to examine racial disparities in self-reported suicidal thoughts, behavior, and injury. During that time period, there were statistically significant annual declines in suicide attempts among adolescent girls, and among adolescents identifying as white, Hispanic, Asian American, and American Indian. There was a statistically significant increase in self-reported suicide attempts for black adolescents and in injury by suicide attempt for black boys.
These findings are limited by voluntary and self-reported data, as well as by the inclusion of only adolescents enrolled in high school. Nonetheless, the study is strengthened by its large, nationally representative sample and examination of multiple subgroups. For physicians, these findings highlight an important area to focus prevention and intervention efforts to curb the trends found in racial and ethnic disparities in suicide.
In-Depth [cross-sectional study]: Researchers used survey data from the 1991 to 2017 Youth Risk Behavior Survey from the Centers for Disease Control and Prevention. A nationally representative sample of 9th- through 12th-grade students in public and private schools completed an anonymous self-administered questionnaire assessing race, suicidal thoughts and behaviors, suicide attempts, and injury resulting from attempts. The sample included 198 540 adolescents with a 60-71% overall response rate across the surveys. Logistic regression analyses were used to examine racial and ethnic differences in trends in suicide. All analyses were adjusted for grade levels.
Results indicated that between 1991 and 2017, there was a statistically significant annual decline in suicide attempts among adolescent girls (odds ratio [OR] = 0.98; 95% confidence interval [CI] 0.98-0.99; P < .001), and among adolescents who identified as white, Hispanic, Asian American, and American Indian. Black adolescents had a significantly linear increase in self-reported suicide attempts (OR = 1.02; 95%CI 1.01-1.04; P < .001). There was also a significant linear increase in injury by suicide attempt for black boys (OR = 1.04; 95%CI 1.00-1.08; P = .048).
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