Date of Award

1-6-2017

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Shanta Rishi Dube, PhD

Second Advisor

Daniel Whitaker, PhD

Third Advisor

J. Michael Bryan, MPH

Abstract

INTRODUCTION: Adolescence is a period known for risk taking behaviors. Both weapon carrying and suicidality among U.S. youth are growing public health concerns. The goal of this study is to examine the patterns between weapon carrying and suicidality among U.S. high school students using 2015 national Youth Risk Behavior Survey (YRBS).

METHODS: Analyses were performed using data from the 2015 YRBS (N=15,624). The sample consisted of students in grades 9-12 (48.7% female and 51.3% as male) Of those surveyed, 54.5% identified as White, 13.6% as African American, 22.3% as Hispanic, and 9.7% as another race/ethnicity. The main exposure variable weapon carrying (carried a weapon in the past 30 days) was analyzed against three outcome variables: suicide ideation (seriously considered suicide in the past 12 months), suicide planning (made a plan to commit suicide in the past 12 months), and suicide attempt (attempted suicide at least once in the past 12 months). Bivariate analysis was used to determine prevalence across the exposure and outcome variables, as well as determine potential covariates. Multivariate logistic regression tables were built to examine the relationship between weapon carrying and the three suicide outcomes, controlling for sex, race/ethnicity, interpersonal violence exposures, alcohol use, drug use, and sad/hopeless feelings. Additionally, adjusted odds ratios were calculated after stratifying by sex.

RESULTS: Among 15,624 high school students, 16.2% reported carrying a weapon (knife, club, gun or other) in the past 30 days. Additionally, 5.3% of students reported having carried a gun in the past 30 days, the large majority of which identified as male (85.4%). It was found that 17.7% of the students reported having seriously considered suicide, 14.6% reported having made a plan to commit suicide, and 8.6% had actually attempted suicide; the majority of those who reported suicidality were female. The multivariate logistic regression model found that students who reported weapon carrying were 1.6 times more likely to report serious consideration of suicide than those students who did not report weapon carrying (OR adj =1.61, 95% CI [1.16, 2.24]), 1.77 times more likely to report having made a plan to commit suicide than those students who did not report weapon carrying (OR adj= 1.77, 95% CI [1.23, 2.55]); and 1.5 times more likely to have reported a suicide attempt than those students who did not report weapon carrying (OR adj=1.51, 95% CI [1.08, 2.10]). After stratification, females who carried weapons were 1.8 times as likely to report suicide ideation (OR adj=1.80, 95% CI [1.37, 2.67]), 2.3 times as likely to report suicide planning (OR adj=2.28, 95% CI [1.40,3.73]), and 2.7 times as likely to report suicide attempt (OR adj=2.71, 95% CI [1.52, 3.41]) than those who did not carry weapons. Males who carried weapons were 1.6 times as likely to report suicide ideation than those who did not carry weapons (OR adj=1.55, 95% CI [1.11, 2.18]), and there was not a statistically significant difference between males who carried weapons and those who did not in the suicide planning or attempt models.

DISCUSSION: Given the correlation found between weapon carrying and suicidality, future youth suicide prevention programs should consider weapon carrying to be an important factor for youth suicidality and should target adolescents at high risk for weapon carrying. Furthermore, as 5.3% of students reported having carried a gun in the past 30 days, weapon carrying prevention should pay special attention to youth’s access to firearms. Firearms are the most lethal mode of suicide and considering the high prevalence of students already at risk for suicidality, measures should be taken to reduce youth access to firearms.

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