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24 August 2021

U.S. Youth Suicide, Homicide, And Drug Overdose Death Trendlines By Gender And Race

U.S. Youth Suicide And Homicide Rates By Gender, Race And Ethnicity
Suicide rates for black kids are way up. The Journal of the American Medical Association notes that for both male and female youth aged 15 to 24 years, suicide rates were higher among:

* American Indian or Alaskan Native youth (eg, 2019 rate among female youth: 23.0 per 100 000 individuals)

* White youth (6.1 per 100 000 individuals)

* Asian or Pacific Islander youth (5.1 per 100 000 individuals)

* Hispanic youth (4.4 per 100 000 individuals) for all years

* Black youth (4.3 per 100 000 individuals)

* The suicide rate increased for Black male youth in this age group by 47%, from 12.2 per 100 000 individuals in 2013 to 17.9 per 100 000 individuals in 2019.

* The suicide rate increased for Asian or Pacific Islander male youth in this age group by 40%, from 12.0 per 100 000 individuals in 2013 to 16.8 per 100 000 individuals in 2019.

At some point not so long ago, suicide rates for black youths are still on the low side, relatively speaking, despite growing significantly. But relatively low rates of death from suicide are offset by very high rates of homicide deaths for black youths. 

Not broken down by race, the trends for homicide, suicide and firearm related teen deaths are as follows:


From here

Overall youth homicide rates hit a record low in 2014 and rose 32% over the next four years. Overall youth suicide rates hit a low in about 2007 and have increased 76% since then.

Broken down by race and gender the numbers for homicide and suicide deaths per 100,000 teens from 1994 to 2017 (from the same source) are as follows:


Combined suicide and homicide teen deaths are down for all races and ethnicities except non-Hispanic whites and American Indian teen boys. 

In the case of American Indian teens, the total numbers going into the rate calculations are too small to be statistically meaningful (i.e. they are basically statistical flukes). The 61% decline in homicides, 11% decline in suicides, and 32% decline in combined suicides and homicides, from 1994 to 2017 resulting from pooling the statistics from American Indian teen boys and girls to get a more statistically meaningful sample sizes is a more meaningful number for the rate of change over time.

But, the numbers for non-Hispanic white suicides are not a fluke. 

Hispanic teens are now comparable to Non-Hispanic white teens in combined suicides plus homicides, with fewer suicides compensating for more homicides. This probably reflects greater assimilation following an extended period of time of stalled Hispanic immigration to the U.S.



Even today, homicide deaths greatly disproportionately impact black teens relative to other teens, whose suicide rates, while surging, are still lower than average. But, the overall death rate from trauma and other preventable causes of death for black youths is down. 

Are Drug Overdose Deaths Related?

My intuition is that there is strong geographic population structure hiding in the non-Hispanic white homicide and suicide numbers, that mirrors trends in drug overdoes deaths. The number of drug overdose deaths for the U.S. as a whole has surged in the last twenty years, especially in the time period that has been marked by the sharpest increases in suicide rates:
It would be interesting to compare accidental drug overdose deaths in these time periods for the same age groups by race and ethnicity. The surging drug overdose death problem in the U.S. is certainly not limited to adults. The data over time by gender and race and ethnicity for children in the U.S. is as follows:


These disparities mirror those in suicide rates by race and gender, which makes sense because the classification of a drug overdoes death as accidental or as a suicide by poisoning is often as much a question of the mood affiliation of the person classifying the cause of death as it is something that can be determined scientifically.

By race and ethnicity without controlling for age over the last twenty years the data are as follows (from top to bottom on the right hand side the line are non-Hispanic white, black, Hispanic, and other): 


Total drug overdose death rates by state are as follows (from the same source):
Non-Hispanic whites in Appalachia have particularly high drug overdose death rates.

The map for overdose death rates for non-Hispanic whites by state is as follows (data not available from the District of Columbia due to sample size issues):

Within these states, rural and suburban non-Hispanic whites are disproportionately affected.

Drug overdose rates for non-Hispanic blacks by state:

Non-Hispanic blacks in the Rust Belt are much more at risk of deaths from drug overdoses than those in the South.

Drug overdose death rates for Hispanics by state:

Is There A Homicide-Suicide Substitution Effect?

There is a superficially plausible argument that across the board, some significant portion of homicide deaths, are really "suicide by murderer" cases of people who would otherwise have killed themselves seeing taking high risks as an easier way out. Similarly, it is plausible that a significant share of accidental drug overdoses are basically "statistical suicides".

But, the trouble with a substitution "suicide by murderer" hypothesis is that homicide rates and suicide rates have tended to move in the same general direction. The rise in suicide rates now parallels a rise in homicide rates after hitting an all time low a few years ago.

Does Access To Firearms Explain The Racial Disparity In Suicide Rates?

Another plausible explanation for racial disparity in suicide rates could be differing rates of household gun ownership, which a 2017 Pew study documents:


Data from 2019 in the U.S. regarding the means by which teenagers commit suicide show that firearms are the leading methods of suicide among U.S. teens, especially teenage boys, which much more likely to commit suicide than teenage girls.

The fact that racial disparities in suicide rates are lower for teen girls, who are less likely to use firearms to commit suicide, and greater for teen boys, who are more likely to do so, again, suggests that firearms access may be an important driver of the racial disparities.

Studies looking at the impact of "means reduction", through new gun control laws, on suicide rates also supports the conclusion that access to firearms in a household may be an important factor in differences in teen suicide rates. 

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