Everyday Discrimination and Suicide Ideation Among African American Men: Examining Depressive Symptoms As a Mediator

Background/Purpose:

While extensive efforts have been made to understand empirical linkages between both: 1) discrimination and depression (Pieterse et al., 2012), and 2) depression and suicide ideation (Oh et al., 2019), few studies have assessed the direct relationship between discrimination and suicide ideation. These pathways are particularly important to consider among African Americans men, who are are four to six times more likely to die by suicide than African American women (Joe et al., 2018). Moreover, suicide has served as the 3^rd leading cause of death for 15-24-year-old African American males since 1995 (CDC, 2016), though empirical investigations remain scant. Thus, the current study purposed to uncover whether discrimination is associated with increased risk for suicide ideation, while also testing whether depressive symptoms mediates the depression-suicide link.

 

Methods:

Data for this study were drawn from the National Survey of American Life (Jackson et al., 2004). Survey responses from a sub-sample of (n=1271) African American men were analyzed. Data were collected from 2001-2003 using in-person and telephone interviews. All participants were between 18 and 96-years-old.

Measures

Everyday discrimination was measured using Williams’ and colleagues (1997) measure of everyday discrimination. Three separate variables were created to examine the influence of differential forms of discrimination. (1) Any discrimination is described as discrimination attributable to any source; (2) Race-based discrimination is described as discrimination attributed to race only; and (3) Other discrimination is described as discrimination attributed to age, weight, etc. 

Depressive symptoms were captured using 12 items from the Center for Epidemiologic Studies Depression Scale (Radloff, 1977). Lifetime suicide ideation was assessed by asking participants to indicate whether they had every considered ending their life.

Data Analysis

Path analysis was used to examine direct and indirect (mediating) effects among key study variables. Three separate mediation models were tested to ascertain which forms of discrimination (any discrimination, race-based discrimination, and other sources of discrimination) were significantly associated with depressive symptoms and suicide ideation. Model fit indices are not reported, as the mediation models were just-identified (Kline, 2016). The WLSMV estimator was used instead of the ML estimator, as the suicide ideation variable is binary and is not normally distributed. All analyses were conducted using Mplus version 8.1 (Muthen & Muthen, 2017).

 

Results:

Study findings revealed that race-based discrimination was the only form of discrimination that was both directly (β= .138, p= .048) and indirectly (β=.027, p= .033; [95% CI= .002 - .052]) associated with suicide ideation. Any discrimination and Other discrimination (e.g. discrimination attributed to age, weight, etc.), however, were not significantly associated with suicide ideation.

 

Conclusions and Implications:

Even after accounting for the role of depressive symptoms, the link between racial discrimination and suicide ideation was still statistically significant (i.e. suggesting that there is evidence for partial mediation). This study offers initial evidence that race-based discrimination is not only associated with depressive symptoms, but also suicide ideation. Thus, culturally-relevant suicide prevention interventions are needed to account for the role of discrimination specifically in the lives of African American men.