Adolescent firearm suicide risk patterns: A latent class analysis using U.S. National Violent Death Reporting System surveillance data, 2007–2017

2021 
Abstract Objectives Suicide is the second leading cause of death among adolescents in the United States, and a substantial proportion are committed with a firearm. This study identifies risk patterns among adolescent firearm suicides and examines how demographic factors relate to these patterns. Methods A latent class analysis was conducted using US National Violent Death Reporting System data, years 2007–2017. Adolescent firearm suicide decedents ages 10–17 years were included in the primary analyses (n = 2139). Factors used to identify risk patterns fell under the categories of mental health, relationship or other social problems, and substance use. Demographic factors examined in relation to risk patterns were age, race/ethnicity, and sex. Results Three risk patterns emerged: low problems (i.e., a low probability of all risk factors included in the model; n = 1075; 50.26%); high mental health problems and history of suicidal behavior, ideation, and suicide attempts (n = 742, 34.69%); and high problems at school (n = 322, 15.05%). Compared to White adolescents, Black adolescents had decreased odds of being in the “high mental health and suicidal behavior” class, compared to being in the “low problems” class (AOR, 0.53, 95% CI: 0.36, 0.79). A post hoc analysis identified four risk patterns for non-firearm suicides (n = 3319), with mental health problems featuring more prominently compared to firearm suicide patterns. Conclusions Findings indicate that half of adolescent firearm suicides are characterized by a low probability of having common risk factors for suicide. This emphasizes the importance of universal safe storage practices among firearm-owning parents. Results also indicate a need for more research on the risk factors unique to Black adolescents.
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