Racism As a Social Determinant of Suicidal Thoughts and Behaviors Among Pre-Adolescents in the United States: An Investigation Using the Adolescent Brain Cognitive Development Study

Background and Purpose

Suicide among adolescents has been identified as a major public health concern. Racism has also been recognized as a significant social determinant of health and has been found to increase the risk of adverse mental health outcomes, including depression, anxiety, psychological distress, and suicidal thoughts and behaviors (STBs). For adolescents of color, experiencing racism is a critical stressor to consider given the recent increase of suicide rates among minoritized racial/ethnic adolescents (Baiden et al., 2022; Bridge et al., 2018). While cross-sectional studies have investigated the effects of perceived racial discrimination on STBs among adolescents, few studies have used longitudinal data to examine these effects, particularly among pre-adolescents. This study investigates the association between the risk of racism and STBs among pre-adolescents.

Methods

This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) study (2017-2020). The sample consisted of 10,301 pre-adolescents aged 11-12, with the risk of racism at Wave 1 as the main explanatory variable and STBs at Wave 2 as the outcome variable. Binary logistic regression was employed for the main analysis.

Results

Of the 10,301 pre-adolescents examined, 13.01% reported experiencing STBs. In terms of the risk of racism, 54.58% were classified as low risk, 42.54% as moderate risk, and 2.88% as high risk. Controlling for demographic characteristics, and risk and protective factors, pre-adolescents at high risk of racism had 3.76 times the odds of experiencing STBs [AOR=3.76, CI=2.18-6.49], and those at moderate risk had 2.36 times the odds [AOR=2.36, CI=1.52-3.66], compared to their low-risk counterparts. Accounting for the risk of racism, Black [AOR=0.44, CI=0.28, 0.70] and Latine [AOR=0.45, 95% CI=0.28, 0.71] adolescents had lower odds of STBs compared to their White counterparts. Parental acceptance and monitoring emerged as protective factors against the detrimental effects of racism on STBs.

Conclusions and Implications

The findings highlight the significant impact of racism on STBs among pre-adolescents, emphasizing the importance of addressing racial discrimination as a social work and public health issue. Given the unique findings of this study, social work researchers should directly measure experiences of racism rather than relying on race/ethnicity as proxies for racism. Furthermore, the protective role of parental acceptance and monitoring demonstrates the need for social practitioners to incorporate protective factors in mental health prevention and intervention. Finally, there is the need for targeted anti-racist policies to combat racism and promote protective familial relationships to mitigate pre-adolescent suicidality.

Sources

Baiden, P., LaBrenz, C. A., Onyeaka, H. K., Muoghalu, C., Nicholas, J. K., Spoor, S. P., Bock, E., & Taliaferro, L. A. (2022). Perceived racial discrimination and suicidal behaviors among racial and ethnic minority adolescents in the United States: Findings from the 2021 Adolescent Behaviors and Experiences Survey. Psychiatry Research, 317, 114877.

Bridge, J. A., Horowitz, L. M., Fontanella, C. A., Sheftall, A. H., Greenhouse, J., Kelleher, K. J., & Campo, J. V. (2018). Age-related racial disparity in suicide rates among US youths from 2001 through 2015. JAMA Pediatrics, 172(7), 697–699.