title: Suicidal ideation in a community-based sample of elementary school children: A multilevel and spatial analysis.
abstract: To examine whether bullying victimization, psychological status, parental and peer relationships and other risk factors are associated with suicidal ideation and to identify high-risk neighbourhoods for suicidal ideation among the elementary school children in Saskatoon Health Region.
  
  
  
  A sample of school students (n = 5340, grades 5-8; ages 9-14 years) from 109 elementary schools in Saskatoon Health Region, Saskatchewan completed the Student Health Survey in 2010-2011. A multilevel logistic regression model was used to investigate the hierarchical data structure at student, grade and school levels. Bayesian spatial analysis was conducted to examine the spatial disparity in the risk of suicidal ideation among residential neighbourhoods.
  
  
  
  Of 5,340 children, 340 (6.4%) indicated they had considered suicide at least once in the previous 12 months. Our findings indicated that school children who were frequently verbally or electronically bullied were more likely to report suicidal thoughts than those who were not bullied. Students who were more depressed or anxious, and those with lower self-esteem and poorer relationships with their parents were also more likely to report suicidal ideation. The Aboriginal elementary school students and those from the west side of the city were at a higher risk of having suicidal ideation.
  
  
  
  Our findings suggest the need for targeted intervention strategies on suicidal ideation among the elementary school children in Saskatoon Health Region, before they reach high school.
authors.affiliation: School of Public Health, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada. cindy.feng@usask.ca.
authors.forename: Cindy Xin
authors.initials: CX
authors.lastname: Feng
authors.affiliation: Large Animal Clinical Sciences and School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Waldner
authors.affiliation: Saskatoon Health Region, Saskatoon, SK, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cushon
authors.affiliation: School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Davy
authors.affiliation: Saskatoon Health Region, Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Cory
authors.initials: C
authors.lastname: Neudorf
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D001499:Bayes Theorem; D058445:Bullying; D002648:Child; D003863:Depression / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data; D004930:Inuit / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D055361:Multilevel Analysis; D010287:Parent-Child Relations; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012525:Saskatchewan; D012574:Schools; D012649:Self Concept; D062206:Spatial Analysis; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D059020:Suicidal Ideation