Suicide in US Preteens Aged 8 to 12 Years, 2001 to 2022 (2024)

Youth suicide is a significant public health concern. In 2021, the National Institute of Mental Health convened a research roundtable series to address the rising rates of suicide in preteens, defined as youths aged 8 to 12 years.¹ Participants emphasized the need for an improved understanding of suicide risk in preteen subpopulations, particularly those who historically experience health disparities or have been underrepresented in suicide research.¹ Little is known about the epidemiology of preteen suicide, limiting our ability to inform targeted prevention strategies. We investigated characteristics and trends in suicide rates among US preteens using national mortality data from 2001 to 2022.

Data for this cross-sectional study were obtained from the Web-based Statistics Query and Reporting System (WISQARS) where suicide was listed as the underlying cause of death for US preteens from January 1, 2001, to December 31, 2022.² The number of suicide deaths were extracted overall and by sex, race and ethnicity (eMethods in Supplement 1), suicide method, metropolitan or nonmetropolitan area, and region. Trends in were assessed using Joinpoint Regression, version 5.0.2. Negative binomial regression models estimated incidence rate ratios (IRRs) and corresponding 95% CIs to compare period trends using Stata/IC, version 16.0. Confidence intervals that did not include 1.00 were considered statistically significant.

This study was not considered human participant research by the Nationwide Children’s Hospital Institutional Review Board and was therefore deemed exempt from the need for approval or informed consent. We followed the STROBE reporting guideline.

A total of 2241 preteens died by suicide from 2001 to 2022 (714 [31.9%] female and 1527 [68.1%] male; 162 [7.2%] American Indian or Alaska Native, Asian, or Pacific Islander; 549 [24.5%] Black; 422 [18.8%] Hispanic; and 1530 [68.3%] White). Following a downward trend until 2007, suicide rates significantly increased 8.2% annually from 2008 to 2022, corresponding to a significant increase in the overall rates between 2001 to 2007 and 2008 to 2022 (3.34 to 5.71 per 1 million; IRR, 1.71) (Figure and Table). Analyses revealed significant increases among all subgroups, with the greatest increase in girls (IRR, 3.32), American Indian or Alaska Native, and Asian or Pacific Islander preteens (IRR, 1.99), Hispanic preteens (IRR, 2.06), and firearm suicides (IRR, 2.29).

Study findings revealed a significant increase in the suicide rate among US preteens between the 2001-2007 and 2008-2022 periods. Results showing a disproportionate increase in female suicide rates relative to male expand on existing evidence depicting a narrowing of the historically large gap in youth suicide rates between sexes.³ Suicide was the 11th leading cause of death in female preteens between 2001 and 2007 and the 5th leading cause of death between 2008 and 2022, while suicide in male preteens ranked consistently as the 5th leading cause of death.⁴

Consistent with previous research,⁵ Black preteens had the highest rates of suicide for both periods, whereas Hispanic preteens had the highest percentage increase. These findings highlight a need to better understand suicide risk among racial and ethnic subgroups, including multiracial individuals who comprise the fastest-growing racial group in the US.⁶ While hanging or suffocation was the predominant method of suicide for the entire period, the largest increase in preteen suicides was by firearm.

This study was limited by potential misclassification of suicides as other causes of death. This misclassification, coupled with a lack of more specific racial and ethnic categorizations, also limits the accuracy of suicide statistics and our knowledge of suicide trends. Additionally, we were unable to examine suicide data through an intersectionality lens, such as racial and ethnic differences by sex, due to small cell counts in WISQARS.²

This study provides a foundation for future research to explore unique factors associated with preteen suicide. The findings also support the need for culturally informed and developmentally appropriate prevention efforts that emphasize robust risk screening and lethal means restriction.

Accepted for Publication: May 30, 2024.

Published: July 30, 2024. doi:10.1001/jamanetworkopen.2024.24664

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2024 Ruch DA et al. JAMA Network Open.

Corresponding Author: Donna A. Ruch, PhD, Center for Suicide Prevention and Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, 444 Butterfly Gardens Dr, Columbus, OH 43205 (donna.ruch@nationwidechildrens.org).

Author Contributions: Dr Ruch had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Ruch, Hughes, Luby, Fontanella, Bridge.

Acquisition, analysis, or interpretation of data: Ruch, Horowitz, Sarkisian, Bridge.

Drafting of the manuscript: Ruch, Bridge.

Critical review of the manuscript for important intellectual content: All authors.

Statistical analysis: Ruch, Bridge.

Administrative, technical, or material support: Sarkisian, Bridge.

Supervision: Ruch, Fontanella, Bridge.

Conflict of Interest Disclosures: Dr Hughes reported receiving grant funding from the American Foundation for Suicide Prevention and the National Institute of Mental Health (NIMH); royalties from Guilford Press; additional funding from the Society for Clinical Child and Adolescent Psychology; travel funds from the American Psychological Association and Karolinska Institutet; and personal fees from the Jed Foundation, The Child Center of New York, Intermountain Health, Family Connections, and Baylor College of Medicine outside the submitted work. Dr Bridge reported receiving grant funding from the Patient-Centered Outcomes Research Institute and Centers for Disease Control and Prevention during the conduct of the study and serving as a member of the Scientific Advisory Board of Clarigent Health outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported by grant K01MH127417 from the NIMH, National Institutes of Health (NIH) (Dr Ruch); annual report number ZIAMH002922 from the Intramural Research Program of the NIMH (Dr Horowitz); grant P50-MH127476 from the NIMH, NIH (Drs Fontanella and Bridge); grant R01-HS028413 from the Agency for Healthcare Research and Quality (Dr Fontanella); and grant R01-DA058303 the National Institute of Drug Abuse, NIH (Dr Fontanella).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2.