Differential trends in US suicide rates, 1999-2020: Emerging racial and ethnic disparities

Suicide is an important cause of mortality in the United States. This study aimed to examine US suicide trends by race and ethnicity from 1999 to 2020. Publicly available de-identified data were extracted from the CDC's Wide-ranging Online Data for Epidemiologic Research. The International Classification of Diseases Codes, 10th Revision- X60-X84, U03, and Y87.0 were used to identify suicide decedents aged 10 years and above from 1999 to 2020. A Joinpoint regression model was fitted to estimate the annual percentage change (APC) and average annual percentage change in suicide rate over the study period. From 1999 to 2020, a total of 838,560 persons died by suicide in the US. Recent mortality trends have declined by 3.8% per year (95% CI: -7.1, -0.5) among Non-Hispanic Whites from 2018 to 2020, but have increased among Non-Hispanic Blacks (APC = 6.1; 95% CI: 5.0, 7.3), Asians/Pacific Islanders (APC = 1.5; 95% CI: 1.2, 1.9), American Indians/Alaska Natives (APC = 3.3; 95% CI: 3.0, 3.6), and Hispanics (APC = 3.8; 95% CI: 2.7, 5.0). Based on suicide mechanism, recent trends have increased by firearm (APC = 1.7; 95% CI: 1.5, 2.0) and suffocation (APC = 3.8; 95% CI: 3.5, 4.1), decreased by drug poisoning (APC = -2.9; 95% CI: -3.9, -1.9), and stabilized by non-drug poisoning (APC = 0.6; 95% CI: -2.4, 3.7). Racial and ethnic disparities exist in suicide trends in the United States. Further research to identify individual and contextual factors for the differences may guide effective public health intervention efforts.