The historically large gap in youth suicide rates between male and female individuals has narrowed during the last 40 years because of an increase in suicide incidence in young girls, according to cross-sectional study data published in JAMA Network Open.
Investigators extracted data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) databases, which comprise nationwide public health data. Cross-sectional analyses were conducted using records from 1975 to 2016 in which suicide was listed as the cause of death among youth (aged 10-19 years). Crude rates per 100,000 youths were calculated using WONDER population estimates. Joinpoint regression software was used to identify period trends in suicide rates by sex and age group. Incidence rate ratios (IRRs) were estimated by comparing the incidence rates among girls and boys within each period. Differential analyses were also conducted by age group and race/ethnicity to identify demographic features associated with suicide incidence.
Investigators identified 85,051 youth suicide deaths in the United States between 1975 and 2016, among whom 68,085 (80.1%) were boys (IRR, 3.82; 95% CI, 3.35-4.35). After declining trends for both sexes until 2007, girls experienced the largest annual percentage increase compared with boys through 2016 (12.7% vs 7.1% for youths aged 10-14 years; 7.9% vs 3.5% for youths aged 15-19 years). The male-to-female IRR for suicide among youth aged 10 to 14 years decreased from 3.14 (95% CI, 2.74-3.61) between 1975 and 1991 to 1.80 (95% CI, 1.53-2.12) between 2007 and 2016 (P <.001). A similar trend was observed among youths aged 15 to 19 years, with the male-to-female IRR decreasing from 4.56 (95% CI, 4.18-4.97) in 1988 to 2006 to 3.31 (95% CI, 2.96-3.69) through 2016 (P <.001). During the study period, significant decreases in the male-to-female IRR were observed in non-Hispanic white youth aged 10 to 14 years (3.27 [95% CI, 2.68-4.00] to 2.04 [95% CI, 1.45-2.89]) and non-Hispanic youth of other races aged 15 to 19 years (4.02 [95% CI, 3.29-4.92] to 2.35 [95% CI, 2.00-2.76]).
Regarding suicide rates by method, the male-to-female IRR for firearms increased significantly for youth aged 15 to 19 years (P =.02) and the male-to-female IRR for suicide by hanging or suffocation decreased significantly for both age groups (each P <.001). No significant change was found in the male-to-female IRR of suicide by poisoning.
These data underscore the high rate of suicide among boys and illustrate a sharp increase in suicide among young girls since 2007. Together, these results indicate that intervention methods tailored by sex may be important in curbing suicide risk among youths. Further research to identify sex-specific factors associated with suicide risk is important to developing appropriate intervention methods.
Ruch DA, Sheftall AH, Schlagbaum P, Rausch J, Campo JV, Bridge JA. Trends in suicide among youth aged 10 to 19 years in the United States. JAMA Netw Open. 2019;2(5):e193886.