Gun Violence Exposure Associated With Suicidal Behavior Among Black Americans

For Black adults, exposure to gun violence — including being threatened with a gun or knowing someone who had been shot — was linked with suicidal outcomes, a cross-sectional study found.

Exposure to one type of gun violence was significantly associated with lifetime suicidal ideation (OR 1.69, 95% CI 1.19-2.39, P=0.003), according to Daniel Semenza, PhD, of Rutgers University in Camden, New Jersey, and co-authors.

This association appeared to have a cumulative effect, with a higher risk for exposure to three or more types of gun violence (OR 2.27, 95% CI 1.48-3.48, P<0.001), they reported in JAMA Network Open.

“There is this vast ripple effect that happens every time a person is shot,” Semenza told MedPage Today.

The findings are especially important given the recent rise in suicide deaths among Black Americans, Semenza said, noting that suicide rates among Black children and adolescents rose by 37% from 2018 to 2021.

For their study, Semenza and colleagues used nationally-representative survey data from 3,015 Black adults in the U.S. from April 12, 2023, to May 4, 2023. The authors used the Self-Injurious Thoughts and Behaviors Interview to assess outcome variables such as suicidal ideation, suicide attempt preparation, and suicide attempt.

Gun violence exposures included ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting.

Respondents had a mean age of 46 and most were female (55%). Overall, the majority (56%) were exposed to at least one type of gun violence, and 12% were exposed to at least three types of gun violence, the researchers found.

Being threatened with a gun or knowing someone who had been shot were both significantly associated with lifetime suicidal ideation (OR 1.44, 95% CI 1.10-2.05, P=0.04 and OR 1.44, 95% CI 1.05-1.97, P=0.02, respectively), they found.

Being shot was significantly associated with ever planning a suicide (OR 3.73, 95% CI 1.10-12.64, P=0.03), and being threatened or knowing someone who had been shot were associated with lifetime suicide attempts (OR 2.41, 95% CI 1.14-5.09, P=0.02 and OR 2.86, 95% CI 1.42-5.74, P=0.003, respectively).

Analysis of data from a subsample of respondents showed that cumulative exposure to three or more types of gun violence was associated with suicide attempt preparation (OR 2.37, 95% CI 1.10-5.63, P=0.05) and attempted suicide (OR 4.01, 95% CI 1.41-11.44, P=0.009), they found.

“The disproportionate burden of gun violence exposure borne by Black communities and exacerbated by numerous structural inequities may represent an even more substantial injustice than previously understood, as it may be influencing suicide rates within those same communities,” the researchers concluded.

The study was limited by its cross-sectional nature, which precluded any conclusions about causality, and by its inability to determine when or how frequently individuals were exposed to gun violence.

Still, Semenza said the findings help “reframe the understanding of gun violence,” and how it can “exacerbate potential disparities in health and well-being across racial and economic lines.”

“This is one piece of the puzzle of understanding how gun violence is not just a problem of public health … but that it actually operates to influence and shape public health in the United States,” Semenza said.

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