Do associations of suicide ideation and suicide attempts with health risk behaviors vary by race/ethnicity among 9th-12th grade female students?

Suicidal behavior is a leading cause of morbidity and mortality among adolescents. The prevalence of suicidal ideation and behavior (SIB) varies by race/ethnicity, particularly among females. Of particular concern is the disproportionately high prevalence of SIB among Hispanic females. The reasons for this disparity are not well-understood. The purpose of this study was to examine whether associations of SIB with health risk behaviors vary by race/ethnicity among female students. Results are based on data from the 2005 Youth Risk Behavior Survey, a cross-sectional survey of health risk behaviors among a representative sample of U.S. students in grades 9-12. Measures of SIB included seriously considering suicide and attempting suicide. Other health risk behaviors included behaviors related to unintentional injury and violence; substance use; sexual behaviors; physical activity; and dietary behaviors. All analyses were conducted among female students (n=6,858) using weighted data. The prevalence of suicide ideation was significantly higher among Hispanic (24.2%) and non-Hispanic (NH) white (21.5%) than NH black (17.1%) female students. The prevalence of suicide attempts was higher among Hispanic (14.9%) than NH white (9.3%) and NH black (9.8%) female students. Statistically significant racial/ethnic differences in associations of suicide ideation and suicide attempts with health risk behaviors were observed for only 2 of 20 behaviors examined (physical fighting and marijuana use). These findings suggest that racial/ethnic disparities in SIB cannot be understood solely based on their association with other health risk behaviors. Other factors, such as family characteristics, acculturation, and the socio-cultural environment, should be examined in future research.