Suicide rates among Black women increased from 1999 to 2020, especially among teens and young adults, according to an analysis of national data.
Among Black women ages 15 to 84, suicide rates rose from 2.1 per 100,000 in 1999 to 3.4 per 100,000 in 2020, according to Victoria Joseph, MPH, of the Columbia University Mailman School of Public Health in New York, and colleagues.
Notably, those increases were concentrated among Black women and girls ages 15 to 24, rising from 1.9 to 4.9 per 100,000 during that time period, the researchers reported in the American Journal of Psychiatry.
“Our findings are in line with evidence that suicidal behaviors are increasing among minoritized youth,” the authors wrote. “Importantly, interventions targeting certain stressors may be particularly salient for young Black females, with evidence indicating that cyberbullying and online racial attacks toward Black female youth are on the rise.”
Structural racism may also play a role in this trend, the authors said, as access to care during a suicidal crisis “is a critical component of suicide prevention efforts.” Structural racism “can reduce access to care of Black youth due to experiences of stigma and mistrust of support systems,” they wrote.
The authors also noted that intimate partner violence, neighborhood violence, and poverty contribute to poor mental health outcomes and limited treatment access, and are “overrepresented risk factors among Black girls and women in some areas.”
For their study, Joseph and colleagues analyzed data from the National Center for Health Statistics’ Multiple Cause of Death 1999–2020 database, which included year of death, race, sex, age, and U.S. census region. They focused on suicide deaths among Black or African-American women ages 15 to 84 using ICD-10 codes.
In total, they found 9,271 suicide deaths, which ranged from 289 in 1999 to 652 in 2020.
They evaluated suicide rates by age, period, and cohort to provide data about suicide risk for specific birth cohorts, across recent time periods, and at specific ages to enable “more precise identification of populations in which interventions are particularly urgent.”
The authors said their results indicated the presence of all three effects — a “clear age effect” with higher rates among younger women; a period effect “with rates generally increasing across time for most ages”; and a cohort effect “with suicide rates highest among females born after 2002 and a clustering of increased suicide rates among the youngest cohorts.”
When analyzed by region, Joseph and colleagues found suicide rates among Black women were highest in the West, peaking at 4.8 per 100,000 among those ages 25 to 34. They also noted that deaths were concentrated in the South due in part to the larger Black population in that region.
The study was limited by potential administrative misclassification of suicide mortality, and by limited information on death certificates.
In an accompanying editorial, Ruth Shim, MD, MPH, of the University of California Davis, and Carolyn Rodriguez, MD, PhD, of Stanford University in Palo Alto, California, said the work is the first to examine the epidemiology of suicide among Black women in the U.S. by geographical region. It’s also “consistent with data that suicidal behaviors are increasing among minoritized youth.”
They offered strategies to mitigate higher suicide rates among Black women, including increasing capacity to build culturally inclusive mental health access, increasing mental health workforce leadership opportunities for Black women, enhancing data-driven accountability, and targeting future opportunities for research.
The study “helps to dispel longstanding myths about which populations are at risk for suicide,” the editorialists wrote. “It also represents a vital step in collecting more granular data to shape substantial and enduring transformational change to achieve improved mental health outcomes for Black women.”
The study was supported by a grant from the NIH.
Neither the authors nor the editorialists reported any financial conflicts of interest.
American Journal of Psychiatry
Source Reference: Joseph VA, et al “Trends in suicide among Black women in the United States, 1999–2020” Am J Psychiatry 2023; DOI: 10.1176/appi.ajp.20230254.
American Journal of Psychiatry
Source Reference: Shim RS, Rodriquez CI “A mental health crisis and call to action: increasing trends in suicide among Black women in the United States” Am J Psychiatry 2023; DOI: 10.1176/appi.ajp.20230819.