New research indicates that blacks in the U.S. have a lifetime prevalence of attempted suicide of about 4 percent, a rate comparable with the general population, but higher than previous estimates, according to a study in the November 1 issue of JAMA.
Among all Americans, suicide is the 11th leading cause of death and the rates range across specific demographic subgroups. In recent years, suicide and nonfatal suicidal behavior have emerged as crucial health issues for blacks, particularly among older adolescents and young adults, according to background information in the article. Although suicide has traditionally been viewed as a problem that affects more whites, the rates of suicide among blacks have increased significantly since the mid 1980s. Lack of data on the lifetime prevalence and age at onset of suicidal thoughts, plans, and attempts among blacks in the United States have limited the development and evaluation of interventions to reduce suicide among black Americans.
Sean Joe, M.S.W., Ph.D., of the University of Michigan, Ann Arbor, and colleagues conducted a study to determine national estimates of the lifetime prevalence and risk factors for suicidal thoughts, plans, and attempts among blacks of African American and Caribbean ethnicity in the U.S. The researchers used data from the National Survey of American Life (NSAL), a national sample of 5,181 black respondents age 18 years and older, conducted between Feb. 2001 and June 2003.
The estimated lifetime prevalence of suicide attempts among blacks in the United States was 4.1 percent; for suicidal thoughts, 11.7 percent. Among those who reported suicidal thoughts, 34.6 percent made a suicide plan and 21 percent made an unplanned attempt. Significant differences were found between men and women, with attempts being more prevalent for women, 4.9 percent, than for men, 3.1 percent. The prevalence of suicide attempts was highest for Caribbean black men (7.5 percent), followed by African American women (5.0 percent). Risk of a suicide attempt and risk of suicidal thoughts were significantly associated with being younger, having a low education level, residing in the Midwest region of the U.S., and having one or more psychiatric disorders.
"The NSAL results provide evidence that black Americans have levels of suicidal thought and behaviors that are comparable with the general population," the authors write.
"The results of the study should influence clinicians who screen patients for risk for suicide. For instance, clinicians should focus on modifiable risk factors (e.g., anxiety, depression) and should engage blacks in aggressive treatment in the high-risk period of the first year after ideation onset and continue to observe patients who attempt suicide after making a plan. Clinicians must also consider, when screening blacks, the strong association of [psychiatric] disorders with the risk for suicide attempts, the greater likelihood for young adults to be impulsive, and for older adults to engage in planned suicide attempts. It is also important that black patients at risk for impulsive attempts do not have access to firearms or medications that can be used to attempt suicide."
(JAMA. 2006;296:2112-2123. Available pre-embargo to the media at www.jamamedia.org.)
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