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American Indian/Alaska Natives who commit suicide younger, live in rural areas

American Indians/Alaska Natives suicide decedents were more likely to commit suicide at a younger age and live in a nonmetropolitan area compared with non-Hispanic white residents of 18 states, according to a Morbidity and Mortality Weekly Report.

“Suicide disproportionately affects American Indians/Alaska Natives,” Rachel A. Leavitt, MPH, of Oak Ridge Institute for Science and Education, Oak Ridge Associated Universities, and the division of violence prevention, National Center for Injury Prevention and Control, CDC, and colleagues wrote. “The suicide rate among [American Indians/Alaska Natives] has been increasing since 2003, and in 2015, [American Indians/Alaska Natives] suicide rates in the 18 states participating in the National Violent Death Reporting System (NVDRS) were 21.5 per 100,000, more than 3.5 times higher than those among racial/ethnic groups with the lowest rates.”

Researchers analyzed data from 2003 to 2014 from the 18 states participating in the National Violent Death Reporting System to compare suicide characteristics and circumstances among deceased American Indians/Alaska Natives and non-Hispanic whites aged 10 years and older. Leavitt and colleagues examined suicide rates by geographic area and race/ethnicity.

The National Violent Death Reporting System reported 1,531 suicides among American Indians/Alaska Natives and 103,986 among whites during this 11-year span.

In total, 35.7% of American Indians/Alaska Natives suicides occurred among young people aged 10 to 24 years compared with 11.1% among whites in the same age group. While 69.4% of American Indians/Alaska Natives decedents lived in nonmetropolitan areas, 72.7% of white decedents lived in metropolitan areas (adjusted OR = 6.6; 95% CI, 5.9-7.3). Furthermore, American Indians/Alaska Natives were 2.4 times more likely to be affected by the suicide of a friend or family member compared with whites (95% CI, 1.9-3.1). Firearm was the most common method of suicide among both American Indians/Alaska Natives and whites.

American Indians/Alaska Natives were less likely to report diagnosed mental health issues (adjusted OR = 0.4; 95% CI, 0.4-0.5), depressed mood (adjusted OR = 0.9; 95% CI, 0.8-1) and mental health treatment (adjusted OR = 0.5; 95% CI, 0.4-0.5) compared with whites. American Indians/Alaska Natives decedents were also 1.8 times more likely to report an alcohol problem compared with white decedents (95% CI = 1.6-2.1); however, other substance abuse problems were similar among the two groups. They were also more likely to have used alcohol in the hours before death (adjusted OR = 2.7; 95% CI, 2.4-3) and to have a positive alcohol toxicology result (adjusted OR = 2.1; 95% CI, 1.9-2.5)

“The high prevalence of suicide among [American Indians/Alaska Natives] and the comparative differences in suicide circumstances among this group are illustrative of the inequities faced by this population,” Leavitt and colleagues wrote. “This study highlights the importance of focused suicide prevention and intervention efforts that incorporate culturally relevant, evidence-based strategies at the individual, interpersonal, and community levels.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.