Counties with higher concentrations of poverty also had higher rates of pediatric suicide, according to a study published online in JAMA Pediatrics.
The retrospective study categorized suicides by 20,982 children and adolescents—ages 5 to 19 years—by poverty concentration in the youth’s county of residence. Researchers divided counties into 5 categories based on how much of its population lived below the federal poverty level: 0% to 4.9%, 5% to 9.9%, 10% to 14.9%, 15% to 19.9%, and 20% or more.
“The results were consistent in a step-wise fashion,” said researcher Lois Lee, MD, MPH, of the department of emergency medicine at Boston Children’s Hospital, Massachusetts. “As poverty increased, so did the rate of suicide.”
Compared with counties with the lowest poverty concentration (0%-4.9%), those with poverty concentrations of 10% or more had higher suicide rates, the study found. Adjusted incidence rate ratios were 1.25 for counties with a 10% to 14.9% poverty concentration, 1.30 for counties with a 15% to 19.9% poverty concentration, and 1.37 for counties with a 20% or more poverty concentration.
The rate of suicide by firearm was higher in counties with the most poverty, compared with those with the least, the study also found. The two other most prevalent methods of suicide—suffocation and poisoning—did not appear to be associated with county poverty concentration, however.
A better understanding about risk factors associated with pediatric suicide can inform interventions aimed at prevention, researchers noted.
“This study is more evidence that to provide the best healthcare for all children and youth, we need to try to improve some of the socio-economic areas or conditions where these children live,” Dr. Lee said. “At a minimum, that means actions like improving parental employment, increasing the minimum wage, and ensuring that everyone has health insurance.”
Hoffmann JA, Farrell CA, Monuteaux MC, Fleegler EW, Lee LK. Association of pediatric suicide with county-level poverty in the United States, 2007-2016. JAMA Pediatrics. 2020 January 27;[Epub ahead of print].