Risk factors for suicide in blacks and whites: an analysis of data from the 1993 National Mortality Followback Survey.
OBJECTIVE
Data on risk factors for suicide in blacks in the United States are needed, given the dramatic increase in the black suicide rate from 1980 to 1997. The 1993 National Mortality Followback Survey represented an unprecedented opportunity to identify risk factors for suicide in blacks and to determine whether race differences (black versus white) in risk factors exist.


METHODS
Multiple logistic regression analyses were used to compare cases of suicide (150 suicides in blacks and 1,279 suicides in whites) with cases of accidental deaths (737 cases in blacks and 3,458 cases in whites). Predictors of interest were 18 items tapping four domains: antisocial behavior, substance use/abuse, depressive symptoms, and psychotic symptoms.


RESULTS
Four items distinguished suicides from accidental deaths in both black and whites: death ideation, suicidal ideation, bizarre behavior, and making violent threats. Items in two of the four domains discriminated risk for suicide in whites more strongly than in blacks: reports of community complaints and problem drinking. No variable conferred greater risk for suicide in blacks than in whites.


CONCLUSIONS
The current study underscores the need for examination of race differences in risk factors for suicide. It is also essential to examine variables that were unavailable in the National Mortality Followback Survey data set, particularly racism, perceived discrimination, and feelings of alienation from the dominant culture.
Department of Psychiatry, Division of Psychology, University of Rochester Medical Center, NY 14642, USA. kathryn_castle@urmc.rochester.edu
Kathryn
K
Castle
Paul R
PR
Duberstein
Sean
S
Meldrum
Kenneth R
KR
Conner
Yeates
Y
Conwell
D000059:Accidents / Q000401:mortality / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000987:Antisocial Personality Disorder / Q000208:ethnology / Q000401:mortality / Q000523:psychology; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data*; D002423:Cause of Death; D015897:Comorbidity; D003866:Depressive Disorder / Q000208:ethnology / Q000401:mortality / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000401:mortality* / Q000523:psychology; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D010552:Personality Assessment; D011287:Prejudice; D011618:Psychotic Disorders / Q000208:ethnology / Q000401:mortality / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D012918:Social Alienation / Q000523:psychology; D019966:Substance-Related Disorders / Q000208:ethnology / Q000401:mortality / Q000523:psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*; D001741:Black or African American