Suicide Risk and Protective Factors Among Asian American Adults and Older Adults in the California Health Interview...

Suicide is an increasing public health crisis, especially impacting older adults and racial/ethnic minority groups. The aim of this study was to investigate risk and protective factors for suicidal ideation among Asian American adults by age, as well as differences in suicidal ideation and health care needs across age and subethnic groups.

This cross-sectional study used data from the 2021-2022 California Health Interview Survey and included adults aged 18 and older who self-identified as Asian. Measured variables included age, sex, subethnicity (Chinese, Korean, Japanese, Vietnamese, Filipino, South Asian, Southeast Asian, Other Asian), suicide risk factors, mental health care barriers, and protective social environment indicators. Suicidal ideation and behavioral healthcare needs (i.e., for mental illness or substance use) were the outcomes of interest.

Of 7240 participants, the largest subgroups were Chinese and Filipino respondents. Older adults reported lower levels of suicide ideation and behavioral healthcare needs compared to the younger age group. Among Asian subethnic groups, Other Asian and Korean Americans reported the highest levels of suicidal ideation (23.1% and 20.7%) and behavioral healthcare needs (20.5% and 18.4%). Healthcare discrimination was uniquely associated with suicidal ideation among older Asian adults (PR 4.19, p < .001). Other risk factors included a history of intimate partner violence, household mental health history, psychological distress, chronic pain, and healthcare costs.

Findings identified significant age and subethnic differences in suicidal ideation. Despite having a lower overall risk, older Asian adults remain susceptible to healthcare discrimination and ongoing mental distress that elevates their risk for suicidality.