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The Role of Racial Disaggregation in Understanding AI/AN Adolescent Suicidal Behavior: Assessment of the Youth Risk
Abstract:
This study compared rates of suicidal ideation and suicide attempts among adolescents categorized as American Indian/Alaska Native (AI/AN) using the computed raceeth variable in the Youth Risk Behavior Surveillance System (YRBSS) to those identified through self-reported ethnoracial identity. We conducted a cross-sectional analysis of the 2021 YRBSS, examining rates of suicidal ideation and attempts using both the raceeth variable and self-reported ethnoracial combinations. Population-weighted percentages were calculated using survey design and sampling weights. Adolescents categorized as AI/AN (non-Hispanic) using the raceeth variable had population-weighted suicidal ideation and attempt rates of 27.3% and 21.85%, respectively. However, those self-reporting as AI/AN with multiple ethnoracial identities had significantly higher rates. Suicidal ideation was highest among AI/AN + White (Hispanic) at 42.3%, AI/AN + Black (non-Hispanic) at 33.3%, and AI/AN + Black + White (non-Hispanic) at 41.05%. Suicide attempts were highest for AI/AN + Black + White (non-Hispanic) at 43.6% and AI/AN + White (Hispanic) at 32.43%. The raceeth variable may exclude key AI/AN subgroups at elevated risk. Addressing disparities among multiracial AI/AN adolescents requires healthcare awareness and inclusive public health research methods.
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