Summary: Study reports a disproportionate increase in suicide rates for females relative to males, especially in those aged between 10-14.
Source: Nationwide Children’s Hospital
New research from Nationwide Children’s Hospital finds a disproportionate increase in youth suicide rates for females relative to males, particularly in younger youth aged 10-14 years. The report, which describes youth suicide trends in the United States from 1975 to 2016, appears this week in JAMA Network Open.
Suicide is the second leading cause of death among youth aged 10-19 years in the U.S., with rates historically higher in males than females. However, recent reports from the Centers for Disease Control and Prevention reveal female youth are experiencing a greater percent increase in suicide rates compared to males.
Donna Ruch, PhD, a post-doctoral researcher in the Center for Suicide Prevention and Research at the Research Institute at Nationwide Children’s Hospital, examined these trends by investigating suicide rates among U.S. youth aged 10-19 years from 1975 through 2016.
The researchers found that following a downward trend in suicide rates for both sexes in the early 1990s, suicide rates increased for both sexes since 2007, but suicide rates for females increased more. There was a significant and disproportionate increase in suicide rates for females relative to males, with the largest percentage increase in younger females. These trends were observed across all regions of the country.
“Overall, we found a disproportionate increase in female youth suicide rates compared to males, resulting in a narrowing of the gap between male and female suicide rates,” said Dr. Ruch.
When the researchers looked at the data by method, they found the rates of female suicides by hanging or suffocation are approaching those of males. This is especially troubling in light of the gender paradox in suicidal behavior, according to Jeff Bridge, PhD, director of the Center for Suicide Prevention and Research at Nationwide Children’s and co-author of the new study.
Dr. Bridge said females have higher rates of non-fatal suicidal behavior, such as thinking about and attempting suicide, but more males die by suicide than females.
“One of the potential contributors to this gender paradox is that males tend to use more violent means, such as guns or hanging,” said Dr. Bridge. “That makes the narrowing of the gender gap in suicide by hanging or suffocation that we found especially concerning from a public health perspective.”
The researchers called for future work to examine whether there are gender-specific risk factors that have changed in recent years and how these determinants can inform intervention.
“From a public health perspective, in terms of suicide prevention strategies, our findings reiterate the importance of not only addressing developmental needs but also taking gender into account,” said Dr. Ruch.
Dr. Bridge emphasized that asking children directly about suicide will not trigger subsequent suicidal thinking or behavior.
“Parents need to be aware of the warning signs of suicide, which include a child making suicidal statements, being unhappy for an extended period, withdrawing from friends or school activities or being increasingly aggressive or irritable,” he said. “If parents observe these warning signs in their child, they should consider taking the child to see a mental health professional.”
Responsible reporting on suicide and the inclusion of stories of hope and resilience can prevent more suicides. You can find more information on safe messaging about suicide here. If you or someone you know is feeling suicidal, it’s important to talk to somebody. The National Suicide Prevention Lifeline is available at 1-800-273-8255 or by texting “START” to the Crisis Text Line at 741-741.
Because kids don’t wear their thoughts on their sleeves, we don’t know what they might be going through. That’s why Nationwide Children’s Hospital launched On Our Sleeves to build a community of support for children living with mental illness through advocacy, education and fundraising for much-needed research. For more information about children’s mental health and to help break the silence and stigma around mental illness, visit OnOurSleeves.org.
Nationwide Children’s Hospital
Shreya Bhola – Nationwide Children’s Hospital
The image is in the public domain.
Original Research: Open access
“Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016”. Donna A. Ruch, PhD; Arielle H. Sheftall, PhD; Paige Schlagbaum, BS; Joseph Rausch, PhD; John V. Campo, MD; Jeffrey A. Bridge, PhD.
JAMA Network Open. doi:10.1001/jamanetworkopen.2019.3886
Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016
Importance Suicide is a leading cause of death among youth aged 10 to 19 years in the United States, with rates traditionally higher in male than in female youth. Recent national mortality data suggest this gap may be narrowing, which warrants investigation.
Objective To investigate trends in suicide rates among US youth aged 10 to 19 years by age group, sex, race/ethnicity, and method of suicide.
Design, Setting, and Participants Cross-sectional study using period trend analysis of US suicide decedents aged 10 to 19 years from January 1, 1975, to December 31, 2016. Data were analyzed for periods defined by statistically significant changes in suicide rate trends. Suicide rates were calculated using population estimates.
Main Outcomes and Measures Period trends in suicide rates by sex and age group were assessed using joinpoint regression. Incidence rate ratios (IRRs) were estimated using negative binomial regression comparing male and female suicide rates within periods.
Results From 1975 to 2016, we identified 85 051 youth suicide deaths in the United States (68 085 male [80.1%] and 16 966 female [19.9%]) with a male to female IRR of 3.82 (95% CI, 3.35-4.35). Following a downward trend until 2007, suicide rates for female youth showed the largest significant percentage increase compared with male youth (12.7% vs 7.1% for individuals aged 10-14 years; 7.9% vs 3.5% for individuals aged 15-19 years). The male to female IRR decreased significantly across the study period for youth aged 10 to 14 years (3.14 [95% CI, 2.74-3.61] to 1.80 [95% CI, 1.53-2.12]) and 15 to 19 years (4.15 [95% CI, 3.79-4.54] to 3.31 [95% CI, 2.96-3.69]). Significant declining trends in the male to female IRR were found in non-Hispanic white youth aged 10 to 14 years (3.27 [95% CI, 2.68-4.00] to 2.04 [95% CI, 1.45-2.89]) and non-Hispanic youth of other races aged 15 to 19 years (4.02 [95% CI, 3.29-4.92] to 2.35 [95% CI, 2.00-2.76]). The male to female IRR for firearms increased significantly for youth aged 15 to 19 years (χ2 = 7.74; P = .02 for sex × period interaction). The male to female IRR of suicide by hanging or suffocation decreased significantly for both age groups (10-14 years: χ2 = 88.83; P < .001 for sex × period interaction and 15-19 years: χ2 = 82.15; P < .001 for sex × period interaction). No significant change was found in the male to female IRR of suicide by poisoning across the study period.
Conclusions and Relevance A significant reduction in the historically large gap in youth suicide rates between male and female individuals underscores the importance of interventions that consider unique differences by sex. Future research examining sex-specific factors associated with youth suicide is warranted.