Suicide Ideation, Attempt Highest in Hispanic and Black Bisexual Women

Lauren Forrest, PhD

Credit: Penn State

A groundbreaking cross-sectional study revealed the intersectional disparities when it comes to suicidality among diverse social groups. Data specifically demonstrated Hispanic and non-Hispanic Black bisexual women to have the highest estimated prevalence of suicide ideation, plan, and attempt.¹

These suicidal behaviors have become a critical public health concern, with certain social groups facing disproportionate burdens. While previous studies have examined inequities within individual identities, this study addressed the intersection of gender, sexual orientation, race and ethnicity, and rurality to assess disparities in suicide ideation, plan, and attempt.

Lauren Forrest, PhD, Department of Psychiatry and Behavioral Health, College of Medicine, Pennsylvania State University, and a team of investigators explored whether there are variations across different combinations of these identities and their relation to structural discrimination as contributing factors.

The investigation analyzed data from the 2015 - 2019 National Survey on Drug Use and Health (NSDUH), encompassing a population-based sample of 189,800 noninstitutionalized US civilians. investigators employed intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) models, nesting participants within social strata representing all possible combinations of gender, sexual orientation, race and ethnicity, and rurality.

Results exhibited a complex social patterning of suicidal thoughts and behavior prevalence that varied significantly across different social strata, highlighting a disproportionate burden of suicidal thoughts and behaviors among individuals experiencing multiple forms of marginalization. Specifically, the study identified Hispanic and non-Hispanic Black bisexual women living in nonmetropolitan counties as the group with the highest estimated prevalence of suicide ideation, plan, and attempt.

• Suicide Ideation: Among Hispanic bisexual women living in nonmetropolitan counties, the estimated prevalence of suicide ideation was 18.1% (95% CrI: 13.5% - 24.3%).
• Suicide Plan: For non-Hispanic Black bisexual women in nonmetropolitan counties, the estimated prevalence of suicide planning was 7.9% (95% CrI: 4.5% - 12.1%).
• Suicide Attempt: The estimated prevalence of suicide attempts for non-Hispanic Black bisexual women in nonmetropolitan counties was 3.3% (95% CrI: 1.4% - 6.2%).

According to the study, these findings underscore the significance of considering intersectional identities and structural-level processes when examining suicidal thoughts and behavior disparities. The prevalence of suicide ideation, plan, and attempt was notably elevated among Hispanic and non-Hispanic Black bisexual women residing in nonmetropolitan areas, indicating potential compounding effects of structural discrimination they may face.

Investigators noted that structural discrimination, such as sexism and racism, can exacerbate mental health challenges, leading to higher suicidal thoughts and behavior rates among multiple marginalized individuals.

The study stated by shedding light on the higher prevalence of suicidal thoughts and behaviors among Hispanic and non-Hispanic Black bisexual women in nonmetropolitan counties, the research emphasized the need for targeted suicide prevention efforts and equity initiatives.

“Shifting investigations of suicidal thoughts and behavior inequities from single-axis to intersectional paradigms may lead to more nuanced knowledge of the structural processes of power, privilege, and disadvantage that contribute to suicidal thoughts and behavior inequities for structurally oppressed groups,” the team wrote. “Moreover, suicidal thoughts and behaviors prevention and intervention approaches should expand to include both individual-level and structural-level processes contributing to suicidal thoughts and behaviors.”

References:

1. Forrest LN, Beccia AL, Exten C, Gehman S, Ansell EB. Intersectional Prevalence of Suicide Ideation, Plan, and Attempt Based on Gender, Sexual Orientation, Race and Ethnicity, and Rurality. JAMA Psychiatry. Published online July 19, 2023. doi:10.1001/jamapsychiatry.2023.2295