Major discriminatory events and suicidal thoughts and behaviors amongst Black Americans: Findings from the National Survey of American Life

Examining the Impact of Social Connectedness on Depression and Suicide Ideation Among Black Youth Experiencing Discrimination: A Path Analysis

Research has found that experiences of racial discrimination among Black youth contribute to adverse behavioral health outcomes, including depression and suicide ideation. This study is guided by social support theory and the stress buffering model to further understand how social connectedness can influence the effect of everyday discrimination on depression symptoms and suicide ideation. Using survey data from a sample of 362 Black youth (18 to 24 years of age) in the Midwest, the current study conducted path analyses to examine the direct and indirect effects of everyday discrimination on depressive symptoms and suicide ideation, mediated by social connectedness. The average age of the sample was 21 (SD = 1.96), and the majority of the sample self-identified as female (70%). Fifty-one percent of the sample reported suicide ideation. Study results found that everyday discrimination was directly associated with an increase in depression symptoms and suicide ideation. Results also indicated that social connectedness explained lower suicide ideation and depression symptoms through everyday discrimination. Implications for behavioral health practices addressing race-based psychosocial stress, and directions for future research are discussed.

'Constantly invalidated by an intolerant and uncaring world': Perceived etiology of suicidal thoughts among transgender, nonbinary, and gender expansive black, indigenous, and other people of color

BACKGROUND

Transgender, nonbinary, gender-expansive (TNGE) Black, Indigenous, and Other People of Color (BIPOC) have one of the highest rates of suicidal ideation and suicide attempts. As recommended by the cultural framework of suicide, examining culturally relevant lay beliefs and attitudes, such as community perspectives on where suicidal ideation originates, is integral for suicide prevention. Doing so may aide in identifying avenues of support for TNGE BIPOC with chronic suicidal ideation.

AIMS

This study aimed to examine how TNGE BIPOC community members perceive the etiological foundation of suicidal ideation.

METHOD

Short-answer responses were collected from 110 participants in a national cross-sectional survey within the United States. Data were analyzed utilizing a directed content analysis approach to thematically categorize etiological factors.

RESULT

Participants described four major areas regarding perceived etiology of suicidal thoughts including: (1) chronic trauma and stress; (2) societal and cultural expectations; (3) biological factors; and (4) structural oppression. The most salient etiological factor was structural oppression which was endorsed by 60% of the sample.

CONCLUSIONS

Results suggest that experiences of structural oppression should be incorporated in assessing TNGE BIPOC clients' beliefs about suicide and suicide prevention, given its relative saliency within this sample. Further research is needed to adequately understand how cumulative stress and social-cultural expectations impact the development of suicidal ideation among TNGE BIPOC.

The Relationship between Major and Everyday Discrimination and Suicide Thoughts and Behaviors among a Sample of Socially Anxious Job Seekers

Discrimination predicts psychopathology, including suicide risk. Few studies have examined broad effects of major and everyday discrimination. This study examined whether major and everyday discrimination predicted suicide thoughts and behaviors in a diverse sample of socially anxious adults (N = 295). Exploratory analyses assessed the moderating role of identity and mediating role of depressive symptoms. Everyday discrimination predicted suicide thoughts and behaviors (p = .04). This relationship was reduced to non-significance after controlling for depression (p = .16). Identity characteristics did not moderate this relationship (p > .05). Depressive symptoms mediated the relationship between everyday discrimination and suicide thoughts and behaviors (95% CI [.001, .006]). Major events did not predict suicide thoughts and behaviors before or after controlling for depression (ps > .12). Findings highlight the relevance of repeated instances of discrimination to suicide risk and relatedly, the importance of comprehensive discrimination assessments in research and clinical practice.

Daily Hassles, Self-Esteem, and Depressive Symptoms in African American Women Exposed to Intimate Partner Violence

The present cross-sectional study was aimed at investigating the mediating role of self-esteem on the relation between daily hassles and depressive symptoms among traumatized women. The sample, which was drawn from a large public, inner city healthcare system, consisted of 154 low-income African American women with a mean age of 36.66 (SD = 11.43) with a recent history of both one or more suicide attempt(s) and exposure to interpersonal violence in the form of intimate partner violence (IPV). A series of scales were administered to the women including the Survey of Recent Life Events (SRLE), Beck Self-Esteem Scales (BSES), and Beck Depression Inventory - II (BDI-II). Mplus v8.8 was used to estimate the total, direct, and indirect effects simultaneously for other type of self-esteem (views of self [self-esteem: self], perceptions of others' views of them [self-esteem: other]). As predicted, daily hassles were associated positively and significantly with depressive symptoms and negatively and significantly with both forms of self-esteem. In addition, lower levels of self-esteem: self, but not self-esteem: other, was associated positively and significantly with depressive symptoms. Partial support was obtained for the mediational hypothesis; self-esteem according to one's self-evaluation (self-esteem: self), but not projected evaluations of others (self-esteem: other), mediated the daily hassles-depressive symptoms link. Thus, depressive symptoms in African American female suicide attempters exposed to IPV appear to vary based on how these women appraise their own self-worth in the context of managing daily stressors and hassles.

Psychotic Experiences and Risk of Suicidal Thoughts and Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Population Studies

BACKGROUND AND HYPOTHESIS

Since a prior systematic review and meta-analysis reported an association between psychotic experiences (PEs) and suicidal thoughts and behaviors, a large number of new studies have been published on the topic, including several novel studies on the association between PEs and transition from suicidal ideation to attempt.

STUDY DESIGN

Two authors independently searched PubMed, Embase, CINAHL, and PsycINFO databases from inception until July 2023, conducted data extraction, and assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. Random-effects models were used to calculate pooled odds ratios (ORs) for the association of PEs and subsequent suicide ideation, suicide attempts, suicide death, and transition from suicidal ideation to attempt, first for the total population, and second stratified by age group. Secondary analyses assessed the mediating role of co-occurring psychopathology.

STUDY RESULTS

Twenty studies from 18 different samples (n = 81,861) were identified. Individuals who reported PEs had increased odds of subsequent suicidal ideation (k = 12, OR = 1.90, 95% CI = 1.65-2.19), suicide attempt (k = 13, OR = 2.95, 95% CI = 2.21-3.94), transition from suicidal ideation to suicide attempt (k = 3, OR = 2.83, 95% CI = 1.60-4.99), and suicide death (k = 1, OR = 4.39, 95% CI = 1.63-11.80). This heightened risk was stable across childhood, adolescence, and adulthood. PEs predicted suicide attempts over and above co-occurring psychopathology (k = 8, OR = 2.85, 95% CI = 2.06-3.95).

CONCLUSIONS

Individuals reporting PEs are at increased risk of all types of suicidal thoughts and behaviors. In addition, PEs are particularly important risk markers for future suicidal behaviors, including in individuals already reporting suicidal ideation. This risk is in excess of what is explained by co-occurring psychopathology.

Racial Socialization and Black Adolescent Mental Health and Developmental Outcomes: A Critical Review and Future Directions

OBJECTIVE

Black American adolescents are beleaguered with the most frequent and severe experiences of racial discrimination (RD) among their peers. To protect Black adolescents' mental health and developmental outcomes from the pernicious impact of discrimination, parents and other proximal adults and peers often utilize racial socialization (RS), or communications and behaviors emphasizing the importance of race and the harms of racism. While several recent RS reviews have been conducted across ethnicity, a modern review investigating RS practices related to and predictive of Black adolescent psychosocial outcomes is needed.

METHOD

To ground our critical systematic review of 45 articles, we first highlighted the ways RD impacts the lives of Black adolescents. Then, drawing from integrative models for Black youth development, we synthesized recent psychological, academic, and sociocultural literatures to describe the role of RS in Black adolescents' wellness.

RESULTS

The impact of various tenets of RS was seen most clearly as a protective factor against RD with respect to adolescents' mental health (e.g. depression), academic achievement (e.g. GPA), and sociocultural identity (e.g. public and private racial regard) development. Cultural socialization, a strategy related to extolling pride for one's race, was the most consistent RS protective factor, with novel RS constructs (e.g. parental competency) emerging as a method to buffer youth internalizing and externalizing problems.

CONCLUSIONS

Recommendations are made for future research on understudied components of RS and multiple methods and reporters to capture a more holistic depiction of RS practices. We emphasize preventative and intervening approaches to reduce the impetus for RS and its impact, including burgeoning clinical and community-level programs and the importance for provider training to yield positive mental health outcomes for Black adolescents.

Identifying unique subgroups in suicide risks among psychiatric outpatients

BACKGROUND

The presence of psychiatric disorders is widely recognized as one of the primary risk factors for suicide. A significant proportion of individuals receiving outpatient psychiatric treatment exhibit varying degrees of suicidal behaviors, which may range from mild suicidal ideations to overt suicide attempts. This study aims to elucidate the transdiagnostic symptom dimensions and associated suicidal features among psychiatric outpatients.

METHODS

The study enrolled patients who attended the psychiatry outpatient clinic at a tertiary hospital in South Korea (n = 1, 849, age range = 18-81; 61% women). A data-driven classification methodology was employed, incorporating a broad spectrum of clinical symptoms, to delineate distinctive subgroups among psychiatric outpatients exhibiting suicidality (n = 1189). A reference group of patients without suicidality (n = 660) was included for comparative purposes to ascertain cluster-specific sociodemographic, suicide-related, and psychiatric characteristics.

RESULTS

Psychiatric outpatients with suicidality (n = 1189) were subdivided into three distinctive clusters: the low-suicide risk cluster (Cluster 1), the high-suicide risk externalizing cluster (Cluster 2), and the high-suicide risk internalizing cluster (Cluster 3). Relative to the reference group (n = 660), each cluster exhibited distinct attributes pertaining to suicide-related characteristics and clinical symptoms, covering domains such as anxiety, externalizing and internalizing behaviors, and feelings of hopelessness. Cluster 1, identified as the low-suicide risk group, exhibited less frequent suicidal ideation, planning, and multiple attempts. In the high-suicide risk groups, Cluster 2 displayed pronounced externalizing symptoms, whereas Cluster 3 was primarily defined by internalizing and hopelessness symptoms. Bipolar disorders were most common in Cluster 2, while depressive disorders were predominant in Cluster 3.

DISCUSSION

Our findings suggest the possibility of differentiating psychiatric outpatients into distinct, clinically relevant subgroups predicated on their suicide risk. This research potentially paves the way for personalizing interventions and preventive strategies that address cluster-specific characteristics, thereby mitigating suicide-related mortality among psychiatric outpatients.

Trends in Adolescent Suicide by Method in the US, 1999-2020

Importance

Adolescent suicide in the US is a major public health problem, yet temporal trends in suicide methods by demographics are understudied.

Objective

To examine national trends in suicide mortality by method (firearm, poisoning, hanging and asphyxiation, and all other means) from 1999 to 2020 by demographic characteristics.

Design, Setting, and Participants

This serial cross-sectional study used national death certificate data of adolescent (aged 10-19 years) suicide decedents compiled by the National Center for Health Statistics from January 1, 1999, to December 31, 2020. Data analysis was performed from April 1, 2023, to July 9, 2023.

Exposures

Age, sex, and race and ethnicity.

Main Outcomes and Measures

Trends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated by age, sex, and race and ethnicity for each suicide method.

Results

This study assessed data from 47 217 adolescent suicide decedents. From 1999 to 2020, suicide by firearm (AAPC, 1.0; 95% CI, 0.1-1.9), poisoning (AAPC, 2.7; 95% CI, 1.0-4.4), hanging and asphyxiation (AAPC, 2.4; 95% CI, 0.2-4.6), and other means (AAPC, 2.9; 95% CI, 1.2-4.6) increased. Rapidly increasing rates were observed among female adolescents for poisoning (AAPC, 4.5; 95% CI, 2.3-6.7) and hanging and asphyxiation (AAPC, 5.9; 95% CI, 5.0-6.8) suicides. From 2007 to 2020, firearm suicides sharply increased among female (annual percent change [APC], 7.8; 95% CI, 6.0-9.5) and male (APC, 5.3; 95% CI, 4.3-6.3) adolescents. Firearm suicide rates increased among Black adolescents from 2012 to 2020 (APC, 14.5; 95% CI, 9.7-19.5), Asian and Pacific Islander adolescents from 2008 to 2020 (APC, 12.0; 95% CI, 9.7-14.5), American Indian and Alaska Native adolescents from 2014 to 2020 (APC, 10.6; 95% CI, 2.6-19.3), and Hispanic or Latino adolescents from 2011 to 2020 (APC, 10.2; 95% CI, 6.3-13.8). During the study period, Black adolescents had the highest average increase in hanging and asphyxiation suicides (AAPC, 4.2; 95% CI, 3.2-5.2). From 2011 to 2020, poisoning suicide deaths increased (APC, 12.6; 95% CI, 8.5-16.7) among female adolescents.

Conclusions and Relevance

Suicide rates increased across all methods from 1999 to 2020. Differences were noted by sex, age, and race and ethnicity. Increasing suicide rates among racial and ethnic minoritized youth are especially concerning, and effective prevention strategies are urgently needed.

Factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States: A 13-year retrospective analysis of the National Inpatient Sample database

BACKGROUND

Suicide is a significant cause of mortality in the United States, accounting for 14.5 deaths/100,000. Although there are data on gender disparity in suicide/self-inflicted injury rates in the United States, few studies have examined the factors associated with suicide/self-inflicted injury in females.

OBJECTIVE

To determine factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States.

METHODS

Hospitalizations for suicide or self-inflicted injuries were identified using the National Inpatient Sample database from 2003-2015 using sample weights to generate national estimates. Independent predictors of suicide/self-inflicted injuries were identified using multivariable regression models. Interaction term analysis to identify the interaction between race/ethnicity and income were conducted.

RESULTS

There were 1,031,693 adult women hospitalizations in the U.S. with a primary diagnosis of suicide/self-inflicted injury in the study period. The highest suicide/self-inflicted injury risk was among women aged 31-45years (OR = 1.23, CI = 1.19-1.27, p < 0.05). Blacks in the highest income strata had a 20% increase in the odds of suicide/self-inflicted injury compared to Whites in the lowest socioeconomic strata (OR = 1.20, CI = 1.05-1.37, p <0.05). Intimate partner violence increased suicide/self-inflicted injury risk 6-fold (OR = 5.77, CI = 5.01-6.65, p < 0.05).

CONCLUSION

Suicide risk is among women aged 31-45 years, higher earning Black women, intimate partner violence victims, uninsured, and current smokers. Interventions and policies that reduce smoking, prevents intimate partner violence, addresses racial discrimination and bias, and provides universal health coverage are needed to prevent excess mortality from suicide deaths.

Identifying latent themes in suicide among black and white adolescents and young adults using the National Violent Death Reporting System, 2013-2019

Suicide rates for adolescents and young adults (AYA) have risen dramatically in recent years - by almost 60% for Americans aged 10-24 years between 2007 and 2018. This increase has occurred for both whites and Blacks, with the rise in suicide among Black youth of particular note. Blacks historically exhibit lower rates of suicide relative to whites and thus, less is known about the etiology of Black suicide. To gain insight into the underlying causes of suicide among AYA, we examine medical examiner reports from the National Violent Death Reporting System (NVDRS) from 2013 to 2019 for over 26,000 Black and white suicide decedents ages 10-29. We apply structural topic modeling (STM) approaches to describe the broad contours of AYA suicide in the United States today. Our findings reveal distinct patterns by race. Guns, violence and the criminal justice system are prominent features of Black suicide, whether through the mechanism used in the suicide, either by firearm or other violent means such as fire or electrocution, the existence of criminal or legal problems/disputes, the location of death in a jail, or the presence of police. In contrast, the narratives of white AYA are more likely to reference mental health or substance abuse problems. Access to resources, as measured by county median household income, overlay these patterns. Themes more prevalent among Blacks are more common in poorer counties; those more prevalent among whites tend to be more common in wealthier counties. Our findings are consistent with other studies that suggest Black people experience greater exposure to violence and other traumas, systemic racism and interpersonal discrimination that may elevate the risk for suicidal behavior.

A trauma-informed approach to suicide prevention for the COVID-19 pandemic

During the COVID-19 pandemic, researchers have questioned how the devastation of the pandemic might impact suicide rates. While initial evidence on suicide rates during the early stages of the pandemic is mixed, there are signs we should still remain vigilant. One way of conceptualizing the long-term effects of the pandemic is as a source of multiple traumatic events: the collective trauma of widespread illness and death and social upheaval, individual traumas from the virus itself (e.g., serious illness and disability, traumatic grief, vicarious trauma), traumas from the social and economic consequences (e.g., domestic violence, unemployment), and its intersections with pre-pandemic traumas and oppression. Given trauma is a well-established risk factor for suicide, this carries significant implications for suicide prevention in the wake of the pandemic. Yet access to trauma-informed care, education, and research remains limited. The pandemic presents a unique opportunity to address these gaps and implement a trauma-informed approach to suicide prevention. Building on existing frameworks, we describe how effective suicide prevention for the pandemic must incorporate trauma-informed and trauma-specific services, strategies, and policies; capacity building; collaborative research; and knowledge exchange. Attending to the traumatic effects of the pandemic may reduce the long-term impact on suicide rates.

High suicidality predicts overdose events among people with substance use disorder: A latent class analysis

Introduction

Suicide is the tenth leading cause of death in the United States and continues to be a major public health concern. Suicide risk is highly prevalent among individuals with co-occurring substance use disorders (SUD) and mental health disorders, making them more prone to adverse substance use related outcomes including overdose. Identifying individuals with SUD who are suicidal, and therefore potentially most at risk of overdose, is an important step to address the synergistic epidemics of suicides and overdose fatalities in the United States. The current study assesses whether patterns of suicidality endorsement can indicate risk for substance use and overdose.

Methods

Latent class analysis (LCA) was used to assess patterns of item level responses to the Concise Health Risk Tracking Self-Report (CHRT-SR), which measures thoughts and feelings associated with suicidal propensity. We used data from 2,541 participants with SUD who were enrolled across 8 randomized clinical trials in the National Drug Abuse Treatment Clinical Trials Network from 2012 to 2021. Characteristics of individuals in each class were assessed, and multivariable logistic regression was performed to examine class membership as a predictor of overdose. LCA was also used to analyze predictors of substance use days.

Results

Three classes were identified and discussed: Class (1) Minimal Suicidality, with low probabilities of endorsing each CHRT-SR construct; Class (2) Moderate Suicidality, with high probabilities of endorsing pessimism, helplessness, and lack of social support, but minimal endorsement of despair or suicidal thoughts; and Class (3) High Suicidality with high probabilities of endorsing all constructs. Individuals in the High Suicidality class comprise the highest proportions of males, Black/African American individuals, and those with a psychiatric history and baseline depression, as compared with the other two classes. Regression analysis revealed that those in the High Suicidality class are more likely to overdose as compared to those in the Minimal Suicidality class (p = 0.04).

Conclusion

Suicidality is an essential factor to consider when building strategies to screen, identify, and address individuals at risk for overdose. The integration of detailed suicide assessment and suicide risk reduction is a potential solution to help prevent suicide and overdose among people with SUD.

Impact of Online Racism on Suicide Ideation Through Interpersonal Factors Among Racial Minority Emerging Adults: The Role of Perceived Burdensomeness and Thwarted Belongingness

While a growing number of studies have documented significant links between online racism (e.g., racist interactions, contents on racial violence) and comorbid factors (e.g., depression) associated with suicide risk, no studies have examined whether online racism predicts suicide ideation and if interpersonal factors can help explain this link. Thus, the current study examined the direct relationship between online racism and suicide ideation among racial minority emerging adults, and the indirect relationships via the interpersonal factors (perceived burdensomeness and thwarted belongingness). Using data from a convenience sample of 338 racial minority emerging adults, we conducted a path analysis with online racism predicting suicide ideation through thwarted belongingness and perceived burdensomeness. Online racism significantly predicted suicide ideation via perceived burdensomeness but not thwarted belongingness. Post hoc multi-group analysis found that this pathway was consistent across Black, Asian, and Latinx groups but was completely mediated for the Asian group. The findings suggest that online racism can increase feelings of being a burden to society, which can trigger thoughts of suicide. This process may be particularly salient among Asian individuals. Implications for future research are discussed.

An Examination of Suicidal Behavior among Black College Students with Exposure to Police Violence

There is limited research about suicidal behaviors among Black emerging adults (peak age of suicide risk) who report exposure to police violence. The current study applies an integrated approach to examine individual, immediate environment, and community-based risk and protective factors of suicide among Black college students who reported previous exposure to police violence. A purposive sample of Black college students (N = 300) was analyzed using bivariate analyses and binary logistic regression. Outcome variables investigated were lifetime suicidal ideation and suicide attempt. Twenty-eight percent of participants reported lifetime suicidal ideation and 14 percent reported lifetime attempts. Female students were significantly more likely to report lifetime suicidal ideation and recent symptoms of anxiety and to engage in emotional social support than male peers. Logistic regression results demonstrated that higher income and greater depression symptoms were associated with lower reporting of lifetime suicidal ideation. Reporting of more grit, the trait of perseverance and passion for long-term goals, was associated with a lower reporting of both lifetime suicidal ideation and suicide attempt. Findings have implications for how social workers in higher education are encouraged to address suicidal behavior among Black students, including the cultivation of grit.

Superwoman Schema: a context for understanding psychological distress among middle-class African American women who perceive racial microaggressions

Objective: Current racial mental health disparities among African American women have been attributed to chronic experiences of race-related stressors. Increased exposure to racism in predominately White spaces may increase reliance on culturally normative coping mechanisms. The objective of this study was to investigate the relationship between psychological distress, perceived racial microaggressions, and an obligation to show strength/suppress emotions among educated, middle-class African American women.Design: A sample of 243 African American women aged 19-72 years (M = 39.49 years) participated in an online study. Participants completed self-report measures of psychological distress (PHQ-8 and GAD-7), racial microaggressions (IMABI), and modified items from the Stereotypical Roles for Black Women (SRBWS) to assess an obligation to show strength/suppress emotions. Factor analyses were conducted to assess the reliability of the obligation to show strength/suppress emotions subscale in our sample. Descriptive statistics, multiple linear regression, and mediation analyses were also conducted to examine variable associations.Results: Statistical analyses revealed educated, middle-class African American women who endorse an obligation to show strength/suppress emotions with perceived racial microaggressions experienced increased psychological distress.Conclusion: Obligation to show strength/suppress emotion may increase risk for psychological distress among African American women who perceive racial microaggressions. Future research and clinical implications are discussed.

Racial/ethnic discrimination as race-based trauma and suicide-related risk in racial/ethnic minority young adults: The explanatory roles of stress sensitivity and dissociation

Objective: Drawing on race-based trauma models, the present study examined common reactions to trauma exposure (i.e., stress sensitivity, dissociative symptoms, depressive symptoms), as potential explanatory factors in the relation between racial/ethnic discrimination and suicide-related risk among racial and ethnic minority young adults. Method: A group of racial and ethnic minority (N = 747; 61% women; 63% U.S.-born; 34% Asian American) young adults, ages 18-29 (M = 19.84; SD = 2.22), completed a battery of self-report measures online. Accounting for demographics and other trauma exposures, direct and indirect associations between racial/ethnic discrimination and suicide attempt (SA) through stress sensitivity, dissociative symptoms, depressive symptoms, and suicide ideation (SI) were examined using hierarchical linear regression models and bootstrapping methods. Results: There was a direct association between racial/ethnic discrimination and stress sensitivity, dissociative symptoms, and depressive symptoms, but not SI or SA, after accounting for demographics and trauma exposures. There was also an indirect association between racial/ethnic discrimination and SI and SA through stress sensitivity, dissociative symptoms, and depressive symptoms. Conclusion: Experiences of racial/ethnic discrimination may function as a source of traumatic stress in racial and ethnic minority young adults to confer risk for SI and SA via stress sensitivity, dissociation, and depressive symptoms. Addressing racial/ethnic discrimination may help reduce suicide-related risk by targeting stress-related exposures particularly relevant to racial and ethnic minority young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Bibliometric Analysis of Suicide Research Among Black Youth

Historically, Black youth have had lower rates of suicide attempts in comparison to their peers; however, in recent years this rate has changed, with self-reported suicide attempts for Black adolescents rising by 73%. The purpose of this study was to analyze the characteristics of research on Black youth and suicide using bibliometric techniques. To conduct our analysis, we developed a search strategy utilizing the Scopus database for the time period from 1980 to 2020. Results indicated an increasing trend in the number of articles published each year related to Black youth and suicide. The most highly productive journals were the Suicide and Life Threatening Behavior, Pediatrics, and Journal of Youth and Adolescence. Authors who frequently published in this area include Nadine Kaslow, Rheeda Walker, and Sean Joe. While this research area is growing, there is a lack of published articles focused on interventions for suicide prevention and non-comparative race specific research focused on Black youth.

Perceived skin tone discrimination and suicidal ideation Black Americans: Findings from the National Survey of American Life

BACKGROUND

To examine the association between skin tone discrimination and lifetime suicidal ideation and suicide attempt among Black Americans.

METHODS

We analyzed the National Survey of American Life (NSAL), which is a national probability sample of Black American adults residing in the general population of the United States. Using multivariable logistic regression, we examined the associations between skin tone discrimination (from Blacks and from whites) and suicidal ideation and suicide attempt, adjusting for sociodemographic characteristics.

RESULTS

While respondents on average reported higher frequency of inter-group skin tone discrimination, only intra-group skin tone discrimination was significantly associated with greater odds of lifetime suicidal ideation [aOR: 1.21; 95% CI: 1.08-1.36] and suicide attempt [aOR: 1.22; 95% CI: 1.22; 95% CI: 1.04-1.44] adjusting for sociodemographic characteristics. Inter-group skin tone discrimination was not significantly related to suicidal ideation or suicide attempt. When stratifying by ethnicity, the effect of intra-group skin tone discrimination on suicidal ideation and attempt was stronger among Caribbean Black Americans than it was for African Americans.

LIMITATIONS

All measures in the sample were self-reported and thus vulnerable to recall bias.

CONCLUSIONS

Intra-group skin tone discrimination is a risk factor for suicidal ideation among Black Americans, and especially among Caribbean Black Americans.

Discrimination and Multimorbidity Among Black Americans: Findings from the National Survey of American Life

OBJECTIVES

There is a notable lack of research on the risk factors for multimorbidity, which has become more common over recent decades. Black Americans experience discrimination more often than their White counterparts, and also have significantly higher prevalence of multimorbidity. This paper examines the associations between discrimination and multimorbidity among Black Americans.

METHODS

We analyzed data from the National Survey of American Life to calculate the prevalence of two types of discrimination (everyday discrimination, major discriminatory events) and multimorbidity (physical, psychiatric, mixed, any). Using multivariable logistic regression, we examined the associations between discrimination and multimorbidity, adjusting for age, sex, years of education, income-to-poverty ratio, and ethnicity. The everyday discrimination scale was discretized into five categories (none, low, medium, high, very high), but was also treated as a continuous variable. The major discriminatory events were analyzed in separate adjusted models, and as a count of events.

RESULTS

When compared with those who did not experience any discrimination, people who experienced everyday discrimination were significantly more likely to report all types of multimorbidity in a dose-response fashion at a conventional level of statistical significance. Most major discriminatory events were associated with greater odds of reporting all types of multimorbidity, as were the counts of major discriminatory events, in a dose-response fashion.

CONCLUSIONS

We found strong evidence to suggest that discrimination was associated with greater odds of reporting multimorbidity. Future studies can expand on these findings using longitudinal data to capture the relations between discrimination and health over time, or by testing preventive interventions that allay the damaging health effects of discrimination.