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Racial Disparities in Spatial and Temporal Youth Suicide Clusters
Journal article   Open access   Peer reviewed

Racial Disparities in Spatial and Temporal Youth Suicide Clusters

Jonathan M Platt, John R Pamplin II, Catherine Gimbrone, Caroline Rutherford, Sasikiran Kandula, Mark Olfson, Madelyn S Gould, Gonzalo Martínez-Alés, Jeffrey Shaman and Katherine Keyes
Journal of the American Academy of Child & Adolescent Psychiatry, Vol.61(9), pp.1131-1140.e5
09/2022
DOI: 10.1016/j.jaac.2021.12.012
PMCID: PMC9271532
PMID: 35031449
url
https://doi.org/10.1016/j.jaac.2021.12.012View
Published (Version of record) Open Access

Abstract

Deaths by suicide correlate both spatially and temporally, leading to suicide clusters. This study aimed to estimate racial patterns in suicide clusters since 2000. Data from the US National Vital Statistics System included all 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, ages 5-34. 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. 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 race 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, and hot clusters were concentrated in Southeastern and mid-Atlantic counties. Suicide rates and clusters in youth and young adults have increased in the past two 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.
spatiotemporal analysis suicide clusters racial health disparities age-period-cohort analysis child and adolescent health

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