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The Effect of Urbanicity and Region on Trends in Adolescent Suicide From 2007-2018.

Abstract

Background: In the United States, suicide is the second leading cause of death for adolescents ages 10-19, and adolescent suicide rates have been rising since 2007. Suicide rates in adolescents are higher in areas of lower urbanicity, but urbanicity is not evenly distributed across the U.S. Regional suicide differences have been found across the country, but no study has examined regional differences and the interaction with urbanicity. Objective: To compare the change in crude rates of suicide between populations of 10-19-year-old adolescents in three different levels of urbanicity with stratification by national region. Methods: Suicide rates were queried from the CDC WONDER database from 2007-2018 for 10-19-year-olds and stratified by collapsed urbanicity level based on the 2013 NCHS Urban-Rural Scheme for Counties. Linear regression analysis tested the impact of the interaction of region and urbanicity over time on suicide rates and trends. Results: Overall, 26,933 adolescents committed suicide from 2007-2018. Suicide rates were highest in nonmetro areas, followed by medium/small metro and large metro areas respectively, and rates of rise were highest in nonmetro areas. Regional differences in suicide rates were found in each stratum of urbanicity, but trends in suicide rates did not significantly differ by region, though they did differ by urbanicity overall. Conclusion: A regional differences in suicide rates between metro levels and increasing suicide trends between metro areas suggests that more support is needed in nonmetro areas, especially in the West, to prevent further increase in suicide in adolescents.

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