Funding: NIAAA R21MH128817
Principal Investigator: Camillia K. Lui
As suicide is the leading cause of death among Asian American and Pacific Islander (AAPI) adolescents, research into the mechanisms that elevate suicide risks for different AAPI subgroups is a critical area for public health. By disaggregating AAPIs into eight subgroups, this study systematically investigates modifiable, individual-level factors influencing suicide risk, including school-related stressors, alcohol use, and insufficient sleep, and the school and community contexts that moderate these factors. Study results will inform public health intervention priorities for universal strategies that reduce suicide risks for AAPI adolescents as an aggregate population and selective strategies for specific high-risk AAPI adolescent subgroups.
As one of the most diverse U.S. racial/ethnic minority groups, AAPI adolescents are often overlooked because as an aggregate they appear to have lower rates than other racial/ethnic groups. When disaggregated, some AAPI groups show significantly higher suicide rates than non-Hispanic white adolescents. Continuing to aggregate AAPI adolescents will only perpetuate the hidden problems of adolescent suicide and mask AAPI people’s different ethnic group histories, settlement experiences, socioeconomic positions, and health behaviors, which may contribute to higher suicide risk.
Recognizing the heterogeneity in AAPI people and their diverse sociocultural contexts, this study aims to examine individual- and contextual-level risk and protective factors that may influence and help explain variations in adolescent suicide risk in eight AAPI groups of people: Asian Indians, Chinese, Filipinos, Japanese, Koreans, Pacific Islanders, Southeast Asians (i.e., Hmong, Cambodians, Laotians), and Vietnamese.
Applying the Social Ecological Model and informed by minority and stress process theories, our study investigates salient school- related stressors of academic performance and race-relevant bullying. We will examine the roles of alcohol use, marijuana use and insufficient sleep – the latter two rising in prevalence – as potentially modifiable responses to these stressors, that also vary in prevalence across AAPI subgroups and gender.
Capitalizing on survey data from the largest U.S. school system and with the largest AAPI student population, this study will entail secondary data analysis of adolescent surveys linked with school administrator surveys of teacher/staff perceptions of school climate, school administrative data of student composition and academic performance, and community data of AAPI demographic and socioeconomic conditions.
For each AAPI subgroup-by-gender, this study will address three aims: (1) examine the relationships between school-related stressors (i.e., poor grades, bullying) and suicide risk, and assess how these relationships vary by school and community contexts (i.e., school climate, co-ethnic density, disadvantage), (2) assess the extent to which alcohol use, marijuana use and sleep individually modify and mediate these associations with suicide risk, and (3) illuminate intervention levers by estimating the reduction in suicide risk at the population level associated with changes in stressors and risk behaviors, and the added reduction associated with enhanced protective contexts.
This research addresses novel questions about race-relevant stressors and risk behaviors on suicide risk, and how these mechanisms vary across the eight AAPI adolescent groups and gender.