Suicide Rates Among Black Women and Girls Have Climbed for Two Decades

Suicide rates among Black women increased from 1999 to 2020, especially among Black teens and young adults, according to new research by scientists at Columbia University Mailman School of Public Health. The study is the first to examine the epidemiology of suicide among Black females in the U.S. by geographical region. The results are published in the American Journal of Psychiatry.

Among Black women ages 15 to 84, suicide rates rose from 2 deaths per 100,000 in 1999 to 3.4 per 100,000 in 2020. Increases considerably spiked among Black women and girls ages 15 to 24, rising from 1.9 to 4.9 per 100,000 during that same period.

“Suicides are rapidly increasing among young, Black females in the U.S.,” said Victoria Joseph, MPH, an analyst in the Department of Epidemiology at Columbia Mailman School, and first author. “High rates among those aged 25–27 years, suggest that this age may be a developmental period for Black women with particular need of additional support.”

“These findings are in line with evidence that suicidal behaviors are increasing among minoritized youth. While the reasons why remain under investigation, it could be that cyberbullying and online racial attacks toward Black female youth may be on the rise, in particular, and therefore interventions targeting certain stressors are particularly critical for young Black women. noted Katherine Keyes, PhD, professor of Epidemiology at Columbia Mailman School, and senior author.

While structural racism from stigma and a mistrust of support systems can reduce access to care of Black youth, it may also play a role in suicidal behavior, according to Joseph and colleagues, as access to help during a suicidal crisis is a critical component of suicide prevention efforts.

Using the National Center for Health Statistics' Multiple Cause of Death 1999-2020 database which covers year of death, race, sex, age, and U.S. census region, the researchers focused on suicide deaths among Black or African-American individuals classified as female ages 15 to 84. This included in total 9,271 suicide deaths, ranging from 289 in 1999 to 652 in 2020. “We selected 2010 as our reference period as it was an inflection point for subsequent increases in suicide deaths,” observed Joseph.

Evaluating suicide rates by age, period, and cohort provided data about suicide risk for specific birth cohorts, and across recent time periods, “enabling more precise identification of populations in which interventions are particularly urgent,” according to the authors.

Results indicated the presence of a “clear age effect” with higher rates among younger women; a period effect “with rates generally increasing across time for most ages”; and a cohort effect “with suicide rates highest among females born after 2002 as well as a grouping in suicide rates among those youngest affected by suicide.”

With regard to region of the country, suicide rates among Black women were highest in the West, rising to nearly 5 suicide deaths per 100,000 among those ages 25 to 34. Also notable: deaths were concentrated in the South due in part to the larger Black population in that region.

“Intimate partner violence, neighborhood violence, and lack of investment into federal and state support systems  also contribute to poor mental health outcomes and limited treatment access,” said Joseph, and “are overrepresented risk factors among Black girls and women in some areas.”

“We encourage future research to fine-tune deeper delineations that take into account and consider state-level trends and analyses among various ethnicities and gender identities,” said Keyes.

Co-authors are Gonzalo Martínez-Alés, Hospital La Paz Institute for Health Research, Madrid, Spain;  Mark Olfson and Madelyn Gould, Columbia Department of Psychiatry; Jeffrey Shaman, Columbia Mailman School of Public Health and Columbia Climate School; and Catherine Gimbrone, Columbia Mailman School.

The study was supported by the National Institutes of Health, grant MH121410.