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Does State-Level Structural Racism Impact Risk for Suicide Ideation and Attempts Among US Adolescents Across Race and
Lillian Polanco-Roman1, Sharifa Z Williams2, Ana Ortin-Peralta3
1The New School, New York, New York.
Journal of the American Academy of Child and Adolescent Psychiatry
|December 26, 2024
Summary
Adolescents in states with higher structural racism had lower rates of suicide ideation and attempts. This suggests racism impacts youth suicide risk differently across racial and ethnic groups.
Area of Science:
- Public Health
- Sociology
- Psychiatry
Background:
- Structural racism, defined by racial inequities across institutions, is a significant public health concern.
- Understanding the differential impact of structural racism on adolescent mental health is crucial for targeted interventions.
Purpose of the Study:
- To examine the association between state-level structural racism and past-year suicide ideation (SI) and suicide attempts (SA) among non-Hispanic Black, Hispanic, and non-Hispanic White adolescents.
- To investigate how race and ethnicity moderate the relationship between structural racism and adolescent suicide-related behaviors.
Main Methods:
- Secondary analysis of linked data from Youth Risk Behavior Surveys (2011-2019), American Community Survey (2019), and the Structural Racism Index (SRI) (2019).
- Generalized estimating equations were used to assess associations between SRI and SI/SA, adjusting for covariates.
- Race/ethnicity was included as a moderator in the analyses.
Main Results:
- Higher state-level Structural Racism Index (SRI) was negatively associated with SI and SA for both Black-White and Hispanic-White inequities.
- These associations were significantly modified by race and ethnicity, with Black and Hispanic adolescents in higher SRI states showing lower SI and SA rates compared to White adolescents.
- Exploratory analyses indicated negative associations between residential segregation and SI/SA among Black and Hispanic adolescents, and a positive association between Black-White incarceration rates and SA among Black adolescents.
Conclusions:
- Adolescents residing in states with higher structural racism exhibited lower risks for suicide ideation and attempts.
- Racial inequities within institutions differentially influence suicide-related risk among adolescents.
- Addressing institutional markers of racism is essential for developing culturally responsive youth suicide prevention strategies.
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