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Structural indicators of suicide: an exploration of state-level risk factors among Black and White people in the United States, 2015–2019

Ryan A. Robertson (Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA)
Corbin J. Standley (Department of Psychology, Michigan State University, East Lansing, Michigan, USA)
John F. Gunn III (Department of Psychology, Gwynedd Mercy University, Gwynedd Valley, Pennsylvania, USA)
Ijeoma Opara (Yale University School of Public Health, New Haven, Connecticut, USA)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 5 January 2022

Issue publication date: 10 February 2022




Death by suicide among Black people in the USA have increased by 35.6% within the past decade. Among youth under the age of 24 years old, death by suicide among Black youth have risen substantially. Researchers have found that structural inequities (e.g. educational attainment) and state-specific variables (e.g. minimum wage, incarceration rates) may increase risk for suicide among Black people compared to White people in the USA. Given the limited understanding of how such factors systematically affect Black and White communities differently, this paper aims to examine these relationships across US states using publicly available data from 2015 to 2019.


Data were aggregated from various national sources including the National Center for Education Statistics, the Department of Labor, the FBI’s Crime in the US Reports and the Census Bureau. Four generalized estimating equations (GEE) models were used to examine the impact of state-level variables on suicide rates: Black adults suicide rate, Black youth (24 years and younger) suicide rate, White adult suicide rate and White youth suicide rate. Each model includes state-level hate group rates, minimum wage, violent crime rates, gross vacancy rates, and race-specific state-level poverty rates, incarceration rates and graduation rates.


Across all GEE models, suicide rates rose between 2015–2019 (ß = 1.11 – 2.78; ß = 0.91 – 1.82; ß = 0.52 – 3.09; ß = 0.16 – 1.53). For the Black adult suicide rate, state rates increased as the proportion of Black incarceration rose (ß = 1.14) but fell as the gross housing vacancy rates increased (ß = −1.52). Among Black youth, state suicide rates rose as Black incarcerations increased (ß = 0.93). For the adult White suicide rate, state rates increased as White incarceration (ß = 1.05) and percent uninsured increased (ß = 1.83), but fell as White graduation rates increased (ß = −2.36). Finally, among White youth, state suicide rates increased as the White incarceration rate rose (ß = 0.55) and as the violent crime rate rose (ß = 0.55) but decreased as state minimum wages (ß = −0.61), White poverty rates (ß = −0.40) and graduation rates increased (ß = −0.97).


This work underscores how structural factors are associated with suicide rates, and how such factors differentially impact White and Black communities.



Dr Ijeoma Opara is supported with funding from the National Institutes of Health, Office of the Director (DP5OD029636) and partially supported by an education grant from the National Institute on Mental Health (R25-MH087217). Points of view, opinions, and conclusions in this paper do not necessarily represent the official position of the U.S. Government.


Robertson, R.A., Standley, C.J., Gunn III, J.F. and Opara, I. (2022), "Structural indicators of suicide: an exploration of state-level risk factors among Black and White people in the United States, 2015–2019", Journal of Public Mental Health, Vol. 21 No. 1, pp. 23-34.



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