Health Disparities
Association between county-level aggregate anti-Black implicit bias and Black youth suicides in the US Parvati Singh* Parvati Singh
Persistent exposure to racism may increase risk factors for suicide among Black populations, and particularly among Black youth. Structural racism shapes societal attitudes and policies, which, in turn, may contribute to the development of implicit biases against minority groups, corresponding with a vicious feedback loop of social priming and bias reinforcement. Aggregate-level implicit anti-Black bias may thus represent one aspect of structural racism that permeates multiple systems and processes, placing Black populations at a continuous disadvantage. Whereas individual-level implicit bias reflects personal attitudes and prejudices, aggregate-level implicit anti-Black bias may offer a more comprehensive measure of structural racism and anti-Black discriminatory attitudes. We examined whether and to what extent, county-level aggregate implicit anti-Black bias scores (exposure) correspond with suicides among Black youth populations (outcome) in the US. We used longitudinal county-level data on aggregate implicit anti-Black bias (retrieved from the Project Implicit database) and suicide deaths among Black youth aged <25 years across all US counties (from CDC’s Restricted Use mortality database) over an 18 year period spanning 2002 to 2019 and examined within-county variations in the patterning of Black youth suicide mortality in relation to aggregate scores of implicit anti-Black bias. County-level two-way fixed effects Poisson regression analyses controlled for several socio-structural factors (e.g. poverty, income, health insurance) that may confound the relation between the exposure and outcome. Analytic results indicate 1.6 additional suicides among Black youth per unit increase in within-county aggregate implicit bias scores (p < 0.001). Our national, ecological study may contribute to current knowledge by providing the first large-scale evaluation of the association between aggregate implicit anti-Black bias scores and suicides among Black youth populations.