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Understanding the Rising Suicide Risk Among Black Youth

Understanding the Rising Suicide Risk Among Black Youth 1024 576 Alaina Doklovic

A new large-scale Medicaid study sheds light on complex factors driving risk and the protective factors that may help save lives.

Suicide rates among Black youth (children, adolescents and young adults) have risen sharply in recent years, surpassing those of other racial and ethnic groups. In 2023, it was the third leading cause of death for Black youth aged 10-24 years. However, research examining factors contributing to suicide in this population remains limited.

A new study, led by Cynthia Fontanella, PhD, principal investigator for the Center for Suicide Prevention and Research at Nationwide Children’s Hospital, is the first large-scale study to examine multi-level risk and protective factors for suicide among Medicaid-enrolled Black youth with a lifetime mental health diagnosis.

“We focused on a Medicaid population because Black youth are disproportionately covered by Medicaid compared to other child populations,” says Dr. Fontanella. “They often face social and economic challenges that impact both health and health care navigation. This study allowed us to gain a deeper understanding of intragroup patterns with the hope of more targeted suicide prevention strategies.”

The study included 875 Black youth aged 9-24 years who died by suicide between January 1, 2010, and December 31, 2019. Each suicide case was matched with 10 living controls (8,750 individuals) on age, sex and state. The study included a total of 9,625 individuals with 6,950 of them being male. All cases and controls were Medicaid-enrolled and had a documented lifetime mental health diagnosis.

The study found factors associated with increased odds of suicide included:

  • Depression and schizophrenia/psychosis diagnoses
  • Prior deliberate self-harm
  • Prior psychiatric acute care
  • Brain injury
  • Exposure to violence
  • Family relational problems
  • Foster care and disability status
  • Living in an urban community or in a county with a moderate to high socially vulnerable index – these counties face significant challenges due to poverty, low education, high unemployment, inadequate transportation or crowded housing

The highest risk for suicide for Black youth was prior deliberate self-harm (56.4%). According to Dr. Fontanella, timely assessment and continuous follow-up after deliberate self-harm is crucial in decreasing risk of suicide.

“We know from research literature that one of the highest risk periods for suicide in all youth is after hospitalization for psychiatric care,” says Dr. Fontanella. “We need to target these critical periods. In a previous research study, we found that kids that received a timely follow up after hospitalization were significantly less likely to die by suicide. However, there are huge disparities in race. Black youth were less likely to receive follow up, putting them at a greater risk.”

This study found that suicide risk among Black youth is not one dimensional. It is driven by a complex interplay of individual, familial and contextual factors.

Protective factors associated with decreased odds of suicide included diagnoses of anxiety and developmental disorders and living in a county with moderate to high rates of religious institutions.

“Community involvement and religiosity were found to be important protective factors for Black youth,” says Dr. Fontanella. “This was a big finding. There is very little research looking at the direct impact of religion in these communities, so this is a definite area for further research. Learning what interventions are effective in this population, including culturally tailored interventions and psychosocial interventions are crucial.”

The study highlights the importance of culturally responsive, community rooted and equity focused prevention strategies to reduce the risk of suicide. Further research is needed to clarify why faith-based and community organizations offer protection. Effectively integrating these strengths into suicide prevention strategies for Black youth could make all the difference.

Reference:

Fontanella CA, Xia X, Llamocca EN, Steelsmith DL, Brock GN, Xiao Y, Bridge JA, Young A, Campo JV, Ruch D. Suicide Risk and Protective Factors Among Medicaid-Enrolled Black Youth With a Mental Health Diagnosis. JAMA Network Open. 2026;9(2):e2559657.

Image credit: Adobe Stock

About the author

Alaina Doklovic is a Marketing Specialist for Research Communications at Nationwide Children’s Hospital. She received her BS in medical anthropology and English from The Ohio State University. Her passions for science and health, combined with her desire to help others, motivated her to pursue a career in which she could actively help improve patient outcomes and scientific research through writing.

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