Risk Profiles for Suicide Attempts, Drug Use, and Violence among Dominican, Mexican, Puerto Rican, and Non-Hispanic White Youth in New York City: Implications for Suicide Prevention Initiatives

By Peña, Juan B.; Kuerbis, Alexis et al. | Centro Journal, Spring 2018 | Go to article overview

Risk Profiles for Suicide Attempts, Drug Use, and Violence among Dominican, Mexican, Puerto Rican, and Non-Hispanic White Youth in New York City: Implications for Suicide Prevention Initiatives


Peña, Juan B., Kuerbis, Alexis, Lee, Rufina, Herman, Daniel, Centro Journal


Introduction

Prevention of suicide attempts among adolescents has been identified as a public health priority in the United States (United States Department of Health and Human Services 2017). The importance of focusing on suicide attempts as an outcome is not only related to the gravity of these acts, but also because they are associated with hospitalization, future attempts, death by suicide, and premature death by causes other than suicide (Ostamo and Lönnqvist 2001; Pfeffer et al. 1993; Suokas et al. 2001). Moreover, the rates of suicide attempts peak during adolescence and young adulthood (Nock et al. 2008), making adolescence a critical time to focus on prevention.

Despite the recognition of the importance of suicide attempt reduction among adolescents, as well as national funding initiatives (Goldston et al. 2010), efforts to prevent suicide attempts among youth has not yet achieved the desired objective set by the U.S. government in its Healthy People 2020 initiative (United States Department of Health and Human Services 2017). For example, the Healthy People Objective MHMD-2 is to reduce suicide attempts requiring medical attention by adolescents from 1.9 per 100 in 2009 to 1.7 per 100 in 2020. However, based on the Youth Risk Behavior Surveillance System (YRBSS), the data source used for this objective, the suicide attempt rates for adolescents requiring medical attention increased from 1.9 in 2009 to 2.7 per 100 in 2013 in the U.S. (Kann et al. 2014).

Compared to their White non-Hispanic counterparts, U.S. Latino high school students are more likely to attempt suicide requiring medical attention (4.1 percent vs. 2.0 percent) (Kann et al. 2014). Latinos are the now the largest ethnic minority group in the U.S. They make up approximately 23.1 percent of the U.S. population that is 17 years old or younger (Passel, Cohn, and Lopez 2011). Therefore, efforts to meet the objective for suicide attempts outlined in the Healthy People 2020 initiative must also consider how to reduce suicidal behaviors among this large and growing population. Moreover, besides the goal of meeting specific benchmarks, the initiative aims to reduce disparities for health outcomes and to address social determinants that may be related to these disparities (United States Department of Health and Human Services 2017).

The reasons for Latinos' elevated risk for suicide attempts compared to their White counterparts are unclear, with few studies exploring which risk factors may account for this disparity (Duarté-Vélez and Bernal 2007; Eaton et al. 2011; Zayas et al. 2005). However, in order to effectively reduce suicide attempts among Latino youth, it is important to understand why Latino youth have elevated suicidal behaviors and what can be done to address these determinants. For example, identifying whether Latino adolescents are more likely to have particular risk profiles for suicidal behaviors based on commonly co-occurring issues may improve prevention strategies and facilitate research on understanding how social determinants may be related to their elevated risk. While there are a variety of correlates that can be used to create risk profiles among teens, we prioritize four broad areas of risk: 1) suicidal behaviors; 2) depressed mood/suicide ideation; 3) substance abuse; and 4) engagement in violent or threatening behaviors. There are three reasons why we believe these areas of risk are of particular importance to understanding risk profiles associated with suicidal behavior among youth.

First, the problems of substance abuse, violence, and depression co-occur in a large proportion of young people who attempt suicide (Pena et al. 2012)violent behavior, and depressive symptoms. To examine the relationship between these subtypes and having had two or more suicide attempts during the past year. To explore race and gender differences across subtypes of suicide attempters. Methods Data were combined from five nationally representative cohorts of the US Youth Risk Behavior Surveillance System (YRBSS). …

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