Youth Gang Suicidality Disparities: Intersectional Implications for Research and Practice

Background and Purpose: Suicide is the second leading cause of death among adolescents in the U.S. (CDC, 2019), and emerging evidence suggests gang-involved youth may be at elevated risk (Whaling & Sharkey, 2019). Given that suicide disparities are routinely documented for marginalized youth, one explanation for this elevated risk may be the multiple marginalized identities often held by gang-involved youth. Little is known about differences in suicidality prevalence between gang and non-gang youth, and how disparities emerge across social identities. Guided by an intersectional framework (Robards et al., 2020), this study aimed to 1) document gang and non-gang differences in suicidality prevalence; 2) examine subgroup differences across social identities (ethnoracial, socioeconomic, gender, sexual orientation); and 3) test whether having multiple marginalized identities influences the gang-suicidality link. Implications include building awareness of disparities and informing targeted prevention efforts.

Methods: Data come from a statewide survey of students in 8^th, 10^th, and 12^th grades (N=81,080). The sample was ethnoracially diverse, 51% female, 18% lesbian/gay, bisexual, or questioning (LGBQ), and 15 years old on average. Approximately 6% self-identified as gang involved. Suicidality was measured via three dichotomous indicators of any reports of suicidal ideation, planning, or attempts in the past 12 months. We hypothesized that gang-involved youth, and particularly those with marginalized identities, would have higher suicidality prevalence. Building on prior theorizing regarding potential health promoting effects of gang membership for multiply marginalized youth (Harper et al., 2008),we hypothesized that membership would reduce the likelihood of suicidality for those holding a greater number of marginalized identities. Chi-square tests, t-tests, and logistic regression models were used to test study hypotheses.

Results: Approximately 20% of the sample reported suicidal ideation, 17% reported making plans, and 9% reported at least one attempt. Gang-involved youth had significantly higher prevalence across all three outcomes compared to non-gang youth. We also observed within- and between-group disparities. Notably, gang youth who were also poor, youth of color, or a gender or sexual minority had significantly higher suicidality prevalence compared to non-gang youth with these same identities; effects were strongest for gender and sexual minorities. Yet, moderation analyses found that having a greater number of marginalized identities decreased the likelihood of suicidality for gang youth comparatively.

Conclusions and Implications: Findings highlight the complex and intersectional nature of youth gang membership and suicidality. While gang membership may increase suicide risk for certain singular identities (e.g., females), we also found evidence of moderation where membership may offer protective effects for those experiencing greater marginalization. Traditional approaches to research and practice with gang-involved youth center delinquency and legal system intervention with limited attention to health and well-being. Addressing suicidality disparities will require alternative approaches. Social work researchers and practitioners are uniquely positioned for this work given the profession’s commitment to addressing inequities that give rise to complex disparities. The consideration and application of intersectionality in suicide prevention, combined with research and policy efforts to reduce marginalization and reshape how we think about gang membership in the context of mental health, will be discussed.