Social Support and Its Effects on Attempted Suicide Among American Indian/Alaska Native Youth in New Mexico

Abstract

Objective: How social support (SS) affects the odds of suicide attempt among American Indian/Alaska Native (AI/AN) youth in New Mexico and is modified by school location and metropolitan status. Methods: Multiple logistic regression for complex design was used to produce the adjusted odds of suicide attempt by SS using the New Mexico Youth Risk and Resiliency Survey (NM-YRRS) for 2011 (n = 2,730), 2013 (n = 3,171), and 2015 (n = 2,604) while adjusting for age, grade, gender, and maternal education level. Primary outcome: $\text{at least}$one self-reported suicide attempt in the past 12 months. Primary exposure: social support, categorized as low, moderate, and high support. Additional analysis on the 2015 NM-YRRS to understand how SS and the odds of suicide attempt were modified by (a) school location and (b) metropolitan status while adjusting for age, grade, gender, maternal education level, urbanicity, reservation status, unstable housing, forced sexual intercourse, and teen dating violence (n = 1,373). Results: The adjusted odds of suicide attempt among AI/AN students with low support compared to those with high support has declined from 2011 to 2015 (AOR= 5.5, 95% CI 3.3–9.6, in 2011; AOR= 2.2, 95% CI 1.3–3.7, in 2015). Low SS is a significant risk factor for rural/on reservation students. In contrast, low SS was not a risk factor for AI/AN students who attended schools in urban counties. Conclusion: Results address a gap in current research regarding differences in urban/rural AI/AN youth. In addition to SS, this study indicates there are unknown risk factors that drive suicide attempt for AI/AN youth in off reservation/urban schools.

Keywords:

• social support
• suicide attempt
• youth
• American Indian/Alaska Native
• urban/rural

ACKNOWLEDGMENTS

The authors thank Kristine Tollestrup PhD, MPH, and Lily Ann Dow Velarde, PhD, MHP, for support editing the final manuscript. They also thank Dan Green, MPH, New Mexico Department of Health, for providing the NM-YRRS data.