To determine if racial and ethnic subgroups of adolescents are at high risk for engagement
in suicidal behaviors. Using the nationally representative school-based Youth Risk
Behavior Survey from the years 1991 to 2017, we conducted logistic regression analyses
to examine trends by different racial and ethnic groups, with each suicide indicator
serving as a dichotomous outcome. Participants included 198 540 high school students.
Across all sex and race and ethnic groups, there were significant linear decreases
in self-reported suicidal ideation and suicide plans from 1991 to 2017. Female adolescents
(odds ratio [OR], 0.98; P < .001) had significant decreases in attempts over time.
Black adolescents had positive linear trends for suicide attempts among both boys
(OR, 1.04; P < .001) and girls (OR, 1.02; P = .003). Black adolescent boys (OR,
1.04; P = .048) had a significant linear increase in injury by attempt. The results
suggest that, over time, black youth have experienced an increase in suicide attempts,
which is troubling because attempts are the most prominent risk factor associated
with suicide death. For black boys, a significant increase in injury by attempt occurred,
which suggests that black boys may be engaging in increasingly lethal means when attempting
suicide. Examining trends of suicidal thoughts and behaviors over time by sex and
race and ethnicity allow us to determine where to focus prevention and intervention
efforts. Future research should examine the underlying reasons for these changes observed
in US high school students.