Study: Black Women, Aged 18–65 Years, Have Highest Suicide Risk Among Women

Suicide is the second leading cause of death in the U.S. among individuals aged 10-34 years of age and the fourth leading cause of death for individuals aged 35-44 years. Suicide attempts (non-fatal, self-directed potentially injurious behavior with any intent to die) and self-inflicted injuries represent a major risk factor for completed suicides. In 2020, more than 1.2 million people over the age of 18 reported a suicide attempt in the U.S. and hundreds of thousands more presented to hospitals with self-harm injuries. Although there is data on gender disparity in suicide/self-inflicted injury rates in the U.S., few studies have examined the factors associated with suicide/self-inflicted injury in females.

In a new study, looking only at women, researchers from Boston University Chobanian & Avedisian School of Medicine and Howard University have identified Black women aged 18–65 years, to have the highest risk for suicide irrespective of their socioeconomic status.

The study found that Black women in the highest income strata had a 20% increase in the odds of suicide/self-inflicted injury compared to white women in the lowest socioeconomic strata.

“Our findings were surprising because most studies usually show that the rate of suicide was higher in white women in the U.S. However, when we begin to look at the intersection of race and income, a different picture begins to emerge,” explained corresponding author Temitope Ogundare, MD, MPH, clinical instructor of psychiatry at the School.

To determine the factors associated with suicide/self-inflicted injuries, the researchers reviewed the National Inpatient Sample database, the largest all-patient database in the U.S., from 2003-2015. They identified and collected demographic data (insurance type, smoking status, exposure to domestic violence, etc.) on women age 18-65 years who were hospitalized with a diagnosis of self-inflicted injury or attempted suicide. They then used a computer model  to test how race and socioeconomic status interacted to determine the risk of suicide.

The study concluded that interventions and policies that reduce smoking, prevent intimate partner violence, address racial discrimination and bias, and provide universal health coverage are needed to prevent excess mortality from suicide deaths.

According to the researchers, these findings are important because it allows identification of which population has the greatest risk of suicide. “In public health, we want to target interventions for the most vulnerable population. In addition, results from this model  continue to highlight racial disparities in health outcomes and the need to approach public health interventions through a racial justice lens,” said Ogundare, who also is a psychiatric resident at Boston Medical Center.

Ogundare believes interventions targeted at helping women who have experienced domestic violence, lack of universal health coverage as well as addressing racial discrimination must become part of a comprehensive suicide prevention strategy.

Howard University’s Oluwasegun Akinyemi, MBCHB, MS, is a co-first author on the paper.

These findings appear online in the journal PLOS One.