Perinatal & Pediatric
Nationwide Regional Trends in Proportion of Adolescent Suicides During the COVID-19 Pandemic Marie-Laure Charpignon* Marie-Laure Charpignon Johnattan Ontiveros Oliver Nizet Kenneth Mandl Maimuna Majumder
In October 2021, the American Academy of Pediatrics declared a state of emergency regarding child and adolescent mental health. We investigate the relative proportion of adolescent suicides across geographic regions of the United States (US). Using the CDC WONDER platform, we analyzed yearly mortality (2010-2021) among 528,805 all-age US decedents with suicide as the underlying cause of death. We compared pre-pandemic (2010-2019) and pandemic-period (2020-2021) suicides for adolescents aged 10–19 inclusive and the overall population. To examine how suicides shifted among age groups, we computed the yearly proportion of overall suicides among adolescents.
Since adolescent suicide is a rare event, we selected LOESS (locally estimated scatterplot smoothing), a flexible nonparametric approach, to model our primary outcome. Data were disaggregated by the ten Health and Human Services regions. Baseline models were fitted using historical data over ten-year windows (2010–2019 for 2020 and 2011–2020 for 2021 projections, respectively).
Relative to 2010-2019, the proportion of nationwide suicides among adolescents increased in 2020 (6.1% observed versus 5.2% [95% CI: 4.5–5.9%] projected), i.e., 401 [77–724] excess deaths. This shift was not geographically uniform. From 2020-2021, the nationwide adolescent suicide proportion remained stable at 6.1%; however, the reported suicide count in 2021 (2941) exceeded the expected value (2484 [2046–2922]).
Such trends may owe in part to pandemic-period caregiver loss, among many stressors affecting adolescent psychosocial outcomes. Alone, the three regions most affected by changes in the age distribution of suicides in 2020 account for 40% of US adolescents; the two regions newly affected in 2021 raise the total percentage to 53%. Further examination of regional trends in the burden of adolescent suicide and its multiple drivers, including racial-ethnic disparities, is imperative to address this ongoing public health crisis.
