Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks
Department of Emergency Medicine
Emergency Medicine | Health Services Administration | Health Services Research | Psychiatry | Psychiatry and Psychology | Race and Ethnicity
PURPOSE: In a sample of patients presenting to the emergency department (ED), the current study was conducted with two aims: (1) to investigate the protective effects of educational attainment (i.e., completing college) on subsequent risk of suicide attempt/death among patients presenting to the ED and (2) to compare this effect between non-Hispanic Black and non-Hispanic White ED patients.
METHODS: The current study analyzed data from the Emergency Department Safety Assessment and Follow-Up Evaluation (ED-SAFE) study, a quasi-experimental, eight-center study of universal suicide screening and follow-up of ED patients presenting for suicidal ideation and behavior. Our sample included 937 non-Hispanic White and 211 non-Hispanic Blacks. The dependent variable was suicide attempt/death during the 52-week follow-up. The independent variable was completing college. Age, gender, lesbian/gay/bisexual status, psychiatric history, and previous suicide attempts at baseline were covariates. Race/ethnicity was the focal effect modifier. Logistic regression models were used to test the protective effects of educational attainment on suicide risk in the overall sample and by race/ethnicity.
RESULTS: In the overall sample, educational attainment was not associated with suicide risk over the follow-up period. A significant interaction was found between race/ethnicity and educational attainment on suicide risk, suggesting a larger protective effect for non-Hispanic Whites compared with non-Hispanic Blacks. In race/ethnicity-specific models, completing college was associated with decreased future suicide risk for non-Hispanic Whites but not Blacks.
CONCLUSIONS: Consistent with the Minorities' Diminished Return theory, educational attainment better protected non-Hispanic White than non-Hispanic Blacks against future suicide attempt/death. While Whites who have not completed college may be at an increased risk of suicide, risk of suicide seems to be independent of educational attainment for non-Hispanic Blacks.
Socioeconomic status, Ethnic health disparities, Race, Ethnicity, Blacks, Suicide
DOI of Published Version
J Racial Ethn Health Disparities. 2019 Oct;6(5):1001-1010. doi: 10.1007/s40615-019-00601-z. Epub 2019 Jul 5. Link to article on publisher's site
Journal of racial and ethnic health disparities
Assari S, Schatten HT, Arias SA, Miller IW, Camargo CA, Boudreaux ED. (2019). Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks. Emergency Medicine Publications. https://doi.org/10.1007/s40615-019-00601-z. Retrieved from https://escholarship.umassmed.edu/emed_pp/191