Introduction
In the U.S., youth enrolled in Medicaid experience more risk factors for suicide,
such as mental illness, than youth not enrolled in Medicaid. To inform a national
suicide prevention strategy, this study presents suicide rates in a sample of youth
enrolled in Medicaid and compares them with rates in the non-Medicaid population.
Methods
Data sources were death certificate data matched with Medicaid data from 16 states,
and the Web-based Injury Statistics Query and Reporting System. Deaths by suicide
that occurred between 2009 and 2013 by youth aged 10 to 18 years were identified for
Medicaid and non-Medicaid groups. Age-, gender-, and cause-specific mortality rates
were calculated separately for both groups. Standardized mortality ratios were calculated
to compare rates, and standardized mortality ratio 95% CIs were estimated with Poisson
regressions. The data were analyzed in 2018.
Results
A substantial proportion (39%) of the total number of deaths by suicide (N=4,045)
in youth occurred among those enrolled in Medicaid. The overall suicide rate did not
significantly differ between groups (standardized mortality ratio=0.96, 95% CI=0.90,
1.03). However, compared with the non-Medicaid group, the suicide rate in the Medicaid
group was significantly higher among youth aged 10 to 14 years (standardized mortality
ratio=1.28, 95% CI=1.11, 1.47), females (regardless of age; standardized mortality
ratio=1.14, 95% CI=1.01, 1.29), and those who died by hanging (standardized mortality
ratio=1.26, 95% CI=1.16, 1.38).
Conclusions
The population-based profile of suicide among youth enrolled in Medicaid differs from
the profile of youth not enrolled in Medicaid, confirming the importance of Medicaid
as a “boundaried” suicide prevention setting.
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Article Info
Publication History
Published online: January 17, 2019
Identification
Copyright
© 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
