Racial/Ethnic Differences in Preceding Circumstances of Suicide and Potential Suicide Misclassification Among US Adolescents

J Racial Ethn Health Disparities. 2022 Feb;9(1):296-304. doi: 10.1007/s40615-020-00957-7. Epub 2021 Jan 7.


Purpose: There is a paucity of research on racial/ethnic differences in preceding circumstances of suicide among adolescents aged 10-19 years and consequential potential misclassification of suicide deaths (i.e., manner of death classified as injury of undetermined intent). This study (1) examined preceding circumstances of suicide among non-Hispanic White, non-Hispanic Black, non-Hispanic Asian/Pacific Islander (A/PI), non-Hispanic American Indian/Alaskan Native (AI/AN), and Hispanic adolescent decedents; and (2) investigated potential suicide misclassification of racial/ethnic minority decedents.

Methods: We used data from the 2006-2015 National Violent Death Reporting System Restricted Access Database. Multivariable logistic regression analyses examined differences in depressed mood, mental health problem and treatment, crisis in the past 2 weeks, problems with school, intimate partner, family relationship, and other relationships (e.g., friend) among racial/ethnic minority decedents compared to White decedents. A separate logistic regression analysis assessed potential suicide misclassification of racial/ethnic minority decedents relative to White counterparts.

Results: Adjusting for sex and suicide history and circumstances, all racial/ethnic minority decedents had significantly lower odds of documented mental health problem and treatment compared to White decedents. Racial/ethnic differences in relationship problems were also identified. Black decedents had significantly higher odds of manner-of-death classification as undetermined intent than did White decedents, suggesting greater likelihood of suicide misclassification.

Conclusions: Circumstances contributing to suicide among adolescents differ by race/ethnicity, indicating the need for culturally tailored suicide prevention efforts.

Keywords: Intentional injury death; NVDRS; Race/ethnicity; Self-injury; Youth.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Cause of Death
  • Ethnicity
  • Homicide*
  • Humans
  • Minority Groups
  • Population Surveillance
  • Suicide*
  • United States / epidemiology
  • Violence