Flat youth suicide rate hides increase among black boys

The suicide rate for elementary-school aged children appears to be flattening, but a study posted Monday on the JAMA Pediatrics website found those numbers hide an increased rate among young black boys while fewer white boys are committing suicide.

Led by researchers at the Ohio State University College of Medicine and Nationwide Children's Hospital in Columbus, Ohio, the study used Centers for Disease Control and Prevention data from 1993 and 2012. They found that 647 children had committed suicide during the period studied.

This included 160 suicides between 1993 and 1997, and 155 between 2008 and 2012. But for the same periods, the suicide deaths among white children fell from 122 to 84, and grew among black children from 30 to 59. For boys, the suicide rate fell for whites to 1.31 per 1 million from 1.96, while the rate for black youth went up to 3.47 per million from 1.78.

Researchers noted that while this was happening, the rates for suicide by firearms for white boys decreased to 0.31 per million from 0.71, as the suicide by hanging or suffocation among black boys increased to 3.22 per million from 1.14. There were no corresponding changes in hanging-suffocation death among white boys or firearm-associated suicides among black boys.

For the 2008-2012 period, hanging or suffocation accounted for 129 suicides among all groups, followed by 20 by firearm and six by other methods such as poisoning or falling.

Adolescents have much higher suicide rates in general, so there is some speculation that this could explain at least some of the increase among black males since they have a higher rate of early onset puberty.

“Generally, suicide is less common in the black community,” said Dr. David Soglin, chief medical officer at La Rabida Children's Hospital in Chicago, who did not participate in the study. “It's not what you expect to find and, therefore, it's concerning.”

“That would explain why black suicides have gone up,” Soglin said regarding the higher rates of early onset puberty. He also wondered whether increased access and acceptability to mental healthcare services among whites is the reason why that rate decreased.

Exposure to violence in the community can have some impact, and Soglin noted how exposure to adverse childhood events, or ACEs, can actually be seen on imaging of brain activity. ACEs can include witnessing domestic violence, early loss of a loved one though death or incarceration, or witnessing violent acts.

“We know it affects the developing brain in a negative way,” Soglin said, adding that part of the impact is an effect on the brain's normal “fight or flight” impulses.

Soglin explained that a young person dying by hanging or firearm is easier to classify as suicide because it can be difficult to determine whether an overdose or poisoning was an accident or done on purpose.

While the overall suicide rate among the very young is still rare, Soglin said that early childhood mental health is “absolutely” a public health issue and that this study helps shed light on this.

“We have a picture in our head of what someone who is depressed looks like—but it's an adult picture,” he said. “We don't think of suicidality in an 8-year-old. The behavior may be manifested in an entirely different way that we don't recognize. Or it may be in a recognized way, but we don't consider it.”

Behavior problems can be cries for mental health help that often go unrecognized, Soglin said.

National statistics show that Native Americans-Alaskan Natives had the highest suicide rate between 2005 and 2009, 17.5 per 100,000 people, followed by non-Hispanic whites at just under 16. Far below them were Hispanics, with a rate about 7 per 100,000 and non-Hispanic blacks had a rate of about 6.