In the United States, suicide has become the second leading cause of premature death among people ages 10 to 24; It is the leading cause of death among adolescents ages 13 to 14.
Researchers at Florida Atlantic University’s Schmidt College of Medicine and collaborators conducted a study exploring trends in suicide rates among 13- and 14-year-olds in the U.S. from 1999 to 2018. They also explored possible changes by sex , race, level of urbanization, census region, month of the year and day of the week.
The results, published online ahead of print in the journal Annals of Pediatrics and Child Health , showed that among children ages 13 to 14, suicide rates more than doubled between 2008 and 2018, following an increase in social networks and despite significant decreases in suicide mortality in this age group previously from 1999 to 2007.
These trends were similar in urban and rural areas, but were more common in children in rural areas where firearms are more common.
These statistically significant increasing trends were similar by sex, race, urbanization, and census regions. In rural areas, firearms were used in 46.7 percent of child suicides and in 34.7 percent of metropolitan areas. Suicides occurred significantly more often between September and May and were highest on Mondays followed by all other days of the week, suggesting that school stress contributes.
“Although more analytical studies are needed, there are certainly important clinical and public health implications based on the findings of our study,” said Sarah K. Wood, MD, senior author, professor of pediatrics, vice dean for medical education, and interim president of the Department of Women’s and Children’s Health, FAU Schmidt College of Medicine. “Specifically, these descriptive data have temporal correlates with social media, school stress, and firearms, which require further investigation. In the meantime, there are clinical and public health initiatives for those most at risk.”
From 2007 to 2018, in suicides among American youth ages 13 to 14 in metropolitan areas (large central, large strip, medium and small), 56.7 percent were due to hanging, strangulation or suffocation , while in the 34.7 percent firearms were used . In medium and small cities 38.9 percent of suicides were due to hanging, strangulation or suffocation, 38.9 percent were due to firearms. In rural areas (micropolitan and non-central, non-metropolitan), 46.9 percent of suicides were due to hanging, strangulation or suffocation, while 46.7 percent were due to firearms.
“During the years immediately preceding the onset of increases in suicide rates among 13- and 14-year-olds, several prominent social media platforms used by teens were launched, including Reddit, YouTube, Twitter, Facebook, Myspace, and Tumblr. . Collectively, all of these sites have grown to billions of users, but as big as they are, in 2018, Instagram and Snapchat surpassed everyone but YouTube in terms of teen usage,” said Charles H. Hennekens, MD, DrPH, co-author, first Sir Richard Doll Professor of Medicine, senior academic advisor to the dean and interim chair of the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine, and associate professor of family medicine and community, at Baylor University of Medicine.
Among the four US Census regions, there were remarkably similar and statistically significant increases in all areas, namely the Northeast, Midwest, South, and West.
“Our data shows that non-metropolitan areas have higher rates of teen suicide, regardless of method, and rural areas have higher rates due to firearms,” Hennekens said.
For the study, researchers used publicly available data from the U.S. Centers for Disease Control and Prevention’s "Multiple Causes of Death" fields.
Co-authors of the study are Robert S. Levine, MD, first author and professor of Family and Community Medicine at Baylor College of Medicine, and affiliate professor at FAU’s Schmidt College of Medicine; Elliott M. Levine, undergraduate student at the University of Minnesota; Alexandra Rubenstein, a medical student entering Tufts University School of Medicine; Vishnu Muppala, MD, resident emergency department physician at Maimonides Hospital and graduate of FAU Schmidt College of Medicine; Maria C. Mejia, MD, MPH, associate professor; Sandra González, Ph.D., assistant professor; and Roger J. Zoorob, MD, MPH, professor and chair, all in the Department of Family and Community Medicine at Baylor College of Medicine.
