Temporal Trends in Correlates for Suicidal Thoughts and Behaviors Among Black High School Students in the United States, 1991-2021.

Introduction: Suicide among Black youth has become a public health concern. To better understand the rapid increase in Black youth suicide, we aimed to determine whether there had been changes in the risk correlates and their impacts on suicidality among Black youth over the past three decades.

Methods: We analyzed four suicide-related outcomes-ideation, planning, attempts, and attempt-related injuries-using Black youth's responses from the 1991-2021 Youth Risk Behavior Survey (survey-adjusted n = 31667.12). Potential correlates considered were demographics, sexuality, injury, violence, bullying, diet, physical activity, mental health, substance use, school connectedness, and exposure to community violence. Correlate-by-year interactions were included to allow for time-varying effects of factors. Missing data were imputed five times, and logistic LASSO regressions were used to select important factors.

Results: Rates of suicidal ideation decreased from 22% (1991) to 12% (2005), then increased to 22% (2021). Suicide planning and attempts had similar trends, whereas rates of injuries remained stable (ranging from 2% to 4%). Correlates identified for all four outcomes were similar and consistent over time, including violent behaviors, substance use, body image concerns, and sex. All correlates' effects remained unchanged over time.

Conclusion: Although trends of suicidality in Black youth changed over time, correlates associated with them remained stable.