Intentional Self-Harm Mortality Among 15-24 Year Olds in Asian American Subgroups, 2011-2020 

Ellen Chang*, Lester Andrew Uy*, Sanya Desai*, Miguel Esteban Villarreal, George A. Hung, Nicholas Kikuta, Armaan Jamal, Adrian M. Bacong, Robert J. Huang, Gloria S. Kim, Latha P. Palaniappan, Malathi Srinivasan, Steven Sust

Stanford Medicine, Center for Asian Health Research and Education

(*Author Order TBD) 

Kindly note that this manuscript is a work in progress. Results and interpretation are subject to change.

Objective

Intentional self-harm (suicide) was the primary cause of death among Asian American (AA) youth aged 15-24 between 2011 and 2020. However, the lack of data disaggregation between AA subgroups hinders a comprehensive understanding of this statistic.

Methods

This cross-sectional study extracted U.S. death certificate data from the National Vital Statistics System for 15-24-year-olds from 2011-2020. 39,861 suicides were extracted, retaining sex, age group, nativity status, location of death, and race, encompassing six Asian American subgroups and non-Hispanic White. Using the 2010 U.S. standard population, age-standardized mortality rates (ASMR) were calculated, adjusting for age, sex, and disaggregated Asian subgroups. Proportional Mortality (PM), Proportional Mortality Ratios (PMR), and Joinpoint regression analyses were calculated for each AA subgroup using RStudio.

Results

Analysis of PM reveals similar trends between aggregated Asian American and NHW youth suicide rates, increasing from 2011-2018 and slightly declining from 2018-2020. Disaggregated, Korean PM exceeds NHW PM in 2018 and 2019, and Japanese PM exceeds NHW PM in 2020. Filipino, Japanese, Vietnamese and White native-born youths were more likely to complete suicides than foreign born counterparts. Joinpoint regression analyses show a steady rise in Filipino suicide deaths from 2011-2020 a decline in Asian Indian and Chinese suicide deaths from 2015-2020, and a dramatic increase in Japanese suicide deaths from 2018-2020.

Conclusions

This study found that suicide rates for AA youth vary greatly when disaggregated by Asian subgroup. Notably, Japanese American suicide deaths have increased nearly five-fold from 2018-2020. Our results call for targeted suicide prevention among the vulnerable population.

Keywords: Intentional self-harm, Suicide, Asian American, Youth, Mental Health, Mortality, Ethnicity