In a retrospective, cross-sectional study, between January 2007 and December 2016, researchers examined suicides among 20,982 US youths between the ages of 5 and 19 using International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes from the Centers for Disease Control and Prevention’s Compressed Mortality File. They then examined county poverty concentration and the percentage of the population living below the poverty line, and partitioned the counties into five categories: 0% to 4.9%, 5.0% to 9.9%, 10.0% to 14.9%, 15.0% to 19.9%, and 20.0% or more of the population living below the federal poverty level.
The researchers analyzed the data using multivariable binomial regression models and assessed the correlation between pediatric suicide rates and county poverty levels using adjusted incidence rate ratios (aIRRs) with 95% CIs. They also controlled for year and demographic characters of children who died (e.g., race, sex, age). They performed a data analysis from February 2019 to September 10, 2019.
The results showed that the annual suicide rate was 3.35 per 100 000 youths aged 5 to 19 years. In the multivariable model, compared with counties with the lowest poverty concentration (0%-4.9%), children living in very poor areas (concentrations of 10% or greater) had higher suicide rates in a stepwise manner (10.0%-14.9%: aIRR, 1.25 [95% CI, 1.06 to 1.47]; 15.0%-19.9%: aIRR, 1.30 [95% CI, 1.10 to 1.54]; and 20.0% or more: aIRR, 1.37 [95% CI, 1.15 to 1.64]). When stratified by method, they observed that firearm suicides had the strongest association with county poverty concentration (aIRR, 1.87; 95% CI, 1.41-2.49) in counties with 20% or higher poverty concentration juxtaposed to counties with 0% to 4.9% poverty concentration.
— JAMA Pediatrics (@JAMAPediatrics) January 27, 2020
“The findings suggest that higher county-level poverty concentration is associated with increased suicide rates among youths aged 5 to 19 years,” the research authors wrote in summation.
They added that their findings “may guide research into upstream risk factors associated with pediatric suicide to inform suicide prevention efforts.”
"When stratified by method, firearm suicides had the strongest association with county poverty concentration"… Association of Pediatric Suicide With County-Level Poverty in the United States, 2007-2016 https://t.co/CZ6t4mClZv @MichiganYVPC @UMInjuryCenter
— Alison Miller (@AlisonMillerPhD) January 27, 2020