New research shows that U.S. children living in counties with the highest poverty rates are 37 percent more likely to die by suicide than those living in the least impoverished counties.
The association is most pronounced for suicide by firearms, according to researchers.
Youth suicide has nearly doubled in the last 10 years, making it the second leading cause of death for children and adolescents between the ages of 10 and 19 in the United States.
“Understanding risk factors for youth suicide is critically needed to inform prevention efforts,” said Jennifer A. Hoffmann, M.D., F.A.A.P., a pediatric emergency medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and an assistant professor of pediatrics at Northwestern University Feinberg School of Medicine.
For the study, researchers conducted a retrospective, cross-sectional analysis of suicides among U.S. children between the ages of 5 and 19 from 2007 to 2016 using data from the Centers for Disease Control and Prevention and the U.S. Census.
Overall, the annual suicide rate was 3.4 per 100,000 children. Of the 20,982 children who died by suicide during that time period, 85 percent were 15 to 19 years old, 76 percent were male, and 69 percent were Caucasian.
The researchers then divided counties into five poverty categories, ranging from 0 percent to 20 percent or more of the population living below the federal poverty level. Controlling for variables — including the demographics of the children who died (age, sex, and race), county rural-urban classification, and community demographics (county age, sex, and racial composition) — the researchers found that counties with greater than 10 percent poverty concentration had a higher incidence of suicide compared to the lowest poverty concentration counties (0-4.9 percent).
Suicide rates continued to rise with increased poverty, with children living in counties with the highest poverty concentration — greater than 20 percent of the population living below the federal poverty level — 37 percent more likely to die by suicide than youth living in the least impoverished counties.
The researchers also analyzed the three most common suicide methods — suffocation (including hanging), firearms, and poisoning. Suicide rates from hanging and overdoses were not different between the different county poverty levels, according to the study’s findings. Among suicides with a gun, the rate increased with increasing poverty concentration, according to the study’s findings.
“We need to figure out why children living in higher poverty communities are at increased risk for suicide,” Hoffman said. “It could be related to unsafe gun storage, limited access to mental health care, or the build up of chronic stressors that children in poverty experience throughout the lifespan.”
The study’s findings also suggest a need to target pediatric suicide prevention strategies in high poverty areas, including firearm suicide prevention, she said.
“The majority of teen suicides by firearm occur in the home with a firearm owned by an adult in the home,” she noted. “Safe firearm storage — keeping the gun unloaded and locked separately from the ammunition — has been shown to decrease youth firearm suicide.”
Safely storing dangerous medications is another proven way to help decrease suicide risk among children, she added.
Hoffmann also recommends that parents keep an open line of communication with their children.
“Parents should not be afraid to have a conversation with their child about mental health and suicide,” she said. “Talking about mental health openly decreases stigma and may allow a child to access help before it’s too late.”
The study was presented at the 2019 American Academy of Pediatrics National Conference & Exhibition.
Source: American Academy of Pediatrics