Continuing Alarming Increases in Suicide in American youths: Clinical and Research Challenges - Abstract
Objective: In United States (US) youths suicide has become the second leading cause of premature death among those aged 10 to 24 years and is the leading cause of death among those aged 13 to 14 years. In this original research we explored trends in suicide by sex, race, level of urbanization, census region, month of the year and day of the week among US youths aged 13 to 14 years.
Method: Death certificate data from US Centers for Disease Control and Prevention. Mortality rates and annual percent changes and 95% confidence intervals and joinpoint regression.
Results: From 2008 to 2018, suicide rates among US youths aged 13 to 14 years increased almost 2.5 fold from 2.06 in 2008 to 5.05 per 100,000 population in 2018 following significant declines from 2.29 in 1999 to 1.49 in 2007. These statistically significant increasing trends were similar by sex, race, urbanization and census regions. In rural areas, rates were higher in boys where firearms were used for 46.7% of suicides and 34.7% in metropolitan areas (p<0.001). Suicides occurred significantly more often (p<0.001) between September and May significantly more often (p<0.001) on Monday and the rest of the weekdays.
Conclusions: Among US youths aged 13 to 14 years suicide rates more than doubled from 2008 to 2018 following significant declines from 1999 to 2007. . These trends were similar in urban and rural areas but were more common in boys in rural areas where firearms are more prevalent. Analytic studies are necessary to test the many hypotheses formulated by these descriptive data which include social media, school stress, and firearms. In the meanwhile, increased clinical and public health efforts are also necessary to combat this epidemic of suicide among US youths.