Suicide is one of the leading causes of mortality in adolescents aged 10-19 years in the US. The prevalence of suicide is higher among youths in impoverished communities, but no significant association between poverty and pediatric suicide has been established. This study aims to examine the association between county-level poverty concentration and suicide rates.

This retrospective, cross-sectional study assessed the total number of suicides that occurred during the ten-year study period. Exposure to county poverty was determined, and the suicides were categorized into 5 poverty concentration categories: 0-49%, 5-9.9%, 10-14.9%, 15-19.9%, and 20% or more. The primary outcome of the study was the incidence of suicide associated with county poverty concentration.

A total of 20,982 youths aged 5-19 years died by suicide, 17,760 (84.6%) of which were aged 15-19 years. A multivariable model that compared with counties with the lowest poverty concentration suggested that the rate of suicide increased in a stepwise manner with poverty concentrations of 10% or higher. Stratification by the method suggested that firearm suicides were most significantly associated with county poverty concentration (adjusted incident rate ratio 1.87).

The research concluded that higher county poverty concentration levels (10% or higher) had a linear association with the rate of suicide in youths in the US.