A JAMA Pediatrics study that highlighted an increase in the suicide rates for elementary school-age black boys has been disparaged by a noted child psychiatrist. He says the increase over-hypes a very small change in statistically insignificant numbers.
The report noted how suicide rates among the very young had remained relatively flat between 1993 and 2012, but the flat line disguised a decrease in the suicide rate to 1.31 per million from 1.96 among white boys between ages 5 and 12 (most notably, a decrease in firearm-related suicides) and a corresponding increase in suicide among black boys of the same age to 3.47 per million from 1.78 (most notably by hanging or suffocation).
“There's nothing there,” said Dr. Carl Bell, a psychiatrist who recently retired as director of the Institute for Juvenile Research at the University of Illinois at Chicago, noting that most suicide rates are calculated per 100,000 people, but this study was per 1 million people.
“I'm sorry, but there is no appreciative difference in that rate even though the number has almost tripled,” Bell said. “It's not even close to a trend—it's not even a speed bump of an atom.”
He said the only reason to look at the numbers further is that blacks typically have the lowest suicide rate among U.S. ethnic groups and this goes against that tradition.
Jeffrey Bridge, the study's lead author, disagreed with Bell's assessment of the report and its use of a per-million rate.
“We elected to report the suicide rate per 1 million persons not to make it look as if the numbers were being inflated, but rather to make the numbers more easily interpretable since suicide rates in children aged 5 to 11 years are rare,” said Bridge, the principal investigator of the Center for Innovation in Pediatric Practice at Nationwide Children's Hospital in Columbus, Ohio. “The trends in black and white children, however, are statistically significant and would be whether we reported them per 100,000 or per 1 million persons. It is also important to note that suicide ranked 14th as a leading cause of death in black children in 1993-1997 but rose to ninth in 2008-2012.”
