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. 2022 Sep;61(9):1131-1140.e5.
doi: 10.1016/j.jaac.2021.12.012. Epub 2022 Jan 11.

Racial Disparities in Spatial and Temporal Youth Suicide Clusters

Jonathan M Platt  1 , John R Pamplin 2nd  2 , Catherine Gimbrone  3 , Caroline Rutherford  3 , Sasikiran Kandula  3 , Mark Olfson  4 , Madelyn S Gould  4 , Gonzalo Martínez-Alés  3 , Jeffrey Shaman  3 , Katherine Keyes  3
Affiliations

Racial Disparities in Spatial and Temporal Youth Suicide Clusters

Jonathan M Platt et al. J Am Acad Child Adolesc Psychiatry. 2022 Sep.

Abstract

Objective: Deaths by suicide correlate both spatially and temporally, leading to suicide clusters. This study aimed to estimate racial patterns in suicide clusters since 2000.

Method: Data from the US National Vital Statistics System included all International Classification of Diseases, Tenth Revision (ICD-10)-coded suicide cases from 2000-2019 among American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (A/PI), Black, or White youth and young adults, aged 5-34 years. We estimated age, period, and cohort (APC) trends and identified spatiotemporal clusters using the SaTScan space-time statistic, which identified lower- and higher-than-expected suicide rates (cold and hot clusters) in a prespecified area (150 km) and time interval (15 months). We also calculated the average proportion of deaths by suicide contained in clusters, to quantify the relative importance of spatiotemporal patterning as a driver of overall suicide rates.

Results: From 2010-2019, suicide rates increased from between 37% among AI/AN (95% CI = 1.22, 1.55) to 81% among A/PI (95% CI = 1.65, 2.01) groups. Suicide clusters accounted for 0.8%-10.3% of all suicide deaths, across racial groups. Since 2000, the likelihood of detecting cluster increased over time, with considerable differences in the number of clusters in each racial group (4 among AI/AN to 72 among White youth). Among Black youth and young adults, 27 total clusters were identified. Hot clusters were concentrated in southeastern and mid-Atlantic counties.

Conclusion: Suicide rates and clusters in youth and young adults have increased in the past 2 decades, requiring attention from policy makers, clinicians, and caretakers. Racially distinct patterns highlight opportunities to tailor individual- and population-level prevention efforts to prevent suicide deaths in emerging high-risk groups.

Keywords: age-period-cohort analysis; child and adolescent health; racial health disparities; spatiotemporal analysis; suicide clusters.

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Conflict of interest statement

Disclosure: Drs. Platt, Pamplin II, Olfson, Gould, Martínez-Alés, Shaman, Keyes, Mss. Gimbrone and Rutherford, and Mr. Kandula have reported no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Color-Graduated Hexagonal Grids Representing the Suicide Rate for a Unique Age, Period, and Cohort By Race, Through 2019 Among Ages 5–34
Figure 2.
Figure 2.
Age-Period-Cohort Estimates of Completed Suicides by Race, Through 2019 Among Ages 5–34
Figure 3.
Figure 3.
Temporal Clusters in Suicide Rates by Race, From 2000–2019 Among Ages 5–25 Note: Spatiotemporal parameters: ≤ 150km and ≤ 15 months
Figure 4.
Figure 4.
Spatial Clusters in Suicide Rates by Race, From 2000–2019 Among Ages 5–25 Note: Spatiotemporal parameters: ≤ 150km And ≤ 15 months
See this image and copyright information in PMC

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