Substance use and suicide in pacific islander, American Indian, and multiracial youth
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Introduction National estimates of U.S. Native Hawaiian and other Pacific Islander (NHPI), American Indian/Alaskan Native (AIAN), and multiracial adolescent substance use and suicidality are scarce because of their small population sizes. The aim was to estimate the national prevalence of, and disparities in, substance use and suicidality among these understudied adolescents.Methods Analyses conducted in 2017 of U.S. adolescents (grades ninth to 12th) from the 1991-2015 Combined National Youth Behavioral Risk Surveys estimated (1) prevalence of lifetime and current (past 30-day) substance use, past 12-month depressed mood, and suicidality by racial group; and (2) AORs for depressed mood and suicidality regressed on current alcohol, cigarette, and marijuana use.Results Among 184,494 U.S. adolescents, alcohol, cigarettes, and marijuana were commonly used with lifetime prevalence of 75.32%, 58.11%, and 40.55%, respectively, and current prevalence of 44.51%, 24.58%, and 22.01%, respectively. Past 12-month prevalence of suicidal thoughts, suicide planning, and attempted suicide were 18.87%, 14.75%, and 7.98%, respectively. Relative to non-Hispanic whites, NHPI, AIAN, and multiracial adolescents had higher prevalence of using many illicit substances (e.g., marijuana, heroin), depressed mood, and suicidal thoughts, planning, and attempts (p<0.05). Except for NHPIs and current alcohol use, current alcohol and cigarette use were independently associated with 2.0-2.3 times greater AORs (p<0.05) for attempted suicide among the target adolescents.Conclusions U.S. NHPI, AIAN, and multiracial adolescents are disproportionately burdened by illicit substance use, depressed mood, and suicidality. Current alcohol and cigarette use may predispose these adolescents toward suicidality, offering potential pathways to alleviate suicide risk.
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Cultural trauma is linked to numerous health disparities, as in American Indians, whose traumatic displacement and ensuing cultural loss instigated multiple health disparities that persist to this day (e.g., heart disease, suicidality, alcohol use disorders).
“Consequently, to be considered a fundamental cause, cultural trauma must be linked to numerous health disparities as in the case of American Indians, whose traumatic displacement and ensuing cultural loss instigated multiple health disparities that persist to this day (e.g., heart disease, suicidality, alcohol use disorders) (Brave Heart et al., 2011; Gone et al., 2019; Subica and Wu, 2018).”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Subica and Wu, 2018
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Experimental — accuracy not yet measuredCultural wounds may be felt collectively across generations, impacting offspring through exposure to daily reminders of the cultural trauma including discrimination and loss of traditional languages, family systems, and spiritual/healing practices.
“These wounds may be felt collectively across generations, impacting offspring through exposure to daily reminders of the cultural trauma including discrimination and loss of traditional languages, family systems, and spiritual/healing practices”
From Cultural trauma as a fundamental cause of health disparities (2022) · cites this paper as Subica and Wu, 2018
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References 41 · Cited by 110
Research works printed but not linked: 2
- [20]Indian Health Service. Trends in Indian Health 2014 edition. Rockville, MD: U.S DHHS; 2015.
- [28]Wood E, Kerr T, Spittal PM, Tyndall MW, O’Shaughnessy MV, Schechter MT. The health care and fiscal costs of the illicit drug use epidemic: the impact of conventional drug control strategies, and the potential of a comprehensive approach. B C Med J. 2003; 45(3): 128– 134.
- Authors
- Subica, A. M., & Wu, L.-T.
- Affiliations
- University of California, Riverside (US)
- Duke University (US)
- Corresponding author
- Subica, Andrew M.
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 54
- Issue
- 6
- Pages
- 795-805
- ISSN
- 0749-3797 (ISSN-L)
- PMC
- PMC6706273
- OpenAlex
- W2801365252
- Cited by
- 110
- References
- 41
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 13 · 2023: 18 · 2022: 24 · 2021: 15 · 2020: 8 · 2019: 9 · 2018: 1
- FWCI
- 9.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R21MH110814)
- National Institute on Drug Abuse (R01DA019623, UG1DA040317)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Keywords
- adolescent substance use, suicidality, multiracial adolescents, alcohol consumption, cigarette smoking, cannabis use, depressive mood, suicide attempts, suicide planning, racial disparities
- MeSH terms
- Cigarette Smoking, Adolescent, Alcohol Drinking, Cross-Sectional Studies, Ethnicity, Female, Humans, Male, Marijuana Smoking, Surveys and Questionnaires, Risk-Taking, Illicit Drugs, Suicide, United States, Prevalence, American Indian or Alaska Native, Native Hawaiian or Pacific Islander
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