Sociodemographic and Precipitating Circumstances Associated With Suicide Among Asian Americans and Pacific Islanders: A Survival Analysis

The purpose of this study is to understand the contributing factors associated with completed suicides among the Asian American and Pacific Islander (AAPI) population, especially culturally specific risk factors. Drawing on previous theoretical and clinical research related to AAPIs, this study included seven life events preceding suicide, including suicide attempt history, alcohol and substance use problem, physical health problem, job problem, interpersonal violence, and family relationship problem, while controlling for the effects of gender among AAPIs. Utilizing the National Violent Death Reporting System (NVDRS), the sample consisted of 1,428 AAPI suicide decedents from 2008 to 2018. The risk and protective factors were analyzed using interval-censored survival analysis. The analyses indicated that substance abuse (Hazard Ratio = 2.000, p < .001) and completion of high school and beyond (Hazard Ratio = 1.517, p < .001) were associated with the highest increases in suicide risk for AAPI. Suicide attempt history was also a significant predictor of completing suicide (Hazard Ratio = 1.211, p =.05) but suicide decedent with a physical health problem was at a lower risk of completing suicide (Hazard Ratio = 0.396, p < .05). The findings highlight how substance abuse, family relationship problems, and educational pressures may be associated with suicide risk. With these factors in mind, we discuss opportunities to help people in the AAPI population to develop coping skills earlier, address shame and guilt, and navigate high-pressure working environments.