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In 2004, suicide was the third leading cause of death among youths and young adults aged 10–24 years in the United States, accounting for 4,599 deaths (1,2).

During 1990–2003, the combined suicide rate for persons aged 10–24 years declined 28.5%, from 9.48 to 6.78 per 100,000 persons (2). However, from 2003 to 2004, the rate increased by 8.0%, from 6.78 to 7.32 (2), the largest single-year increase during 1990–2004.

To characterize U.S. trends in suicide among persons aged 10–24 years, CDC analyzed data recorded during 1990–2004, the most recent data available. Results of that analysis indicated that, from 2003 to 2004, suicide rates for three sex-age groups (i.e., females aged 10–14 years and 15–19 years and males aged 15–19 years) departed upward significantly from otherwise declining trends.

The results suggest that increases in suicide and changes in suicidal behavior might have occurred among youths in certain sex-age groups, especially females aged 10–19 years.

Significant upward departures from modeled trends in 2004 were identified in total suicide rates for three of the six sex-age groups: females aged 10–14 years and 15–19 years and males aged 15–19 years (Table). The largest percentage increase in rates from 2003 to 2004 was among females aged 10–14 years (75.9%), followed by females aged 15–19 years (32.3%) and males aged 15–19 years (9.0%). In absolute numbers, from 2003 to 2004, suicides increased from 56 to 94 among females aged 10–14 years, from 265 to 355 among females aged 15–19 years, and from 1,222 to 1,345 among males aged 15–19 years.

The findings in this report indicate that 2004 suicide rates for males aged 15–19 years and females aged 10–14 years and 15–19 years diverged upward significantly from modeled trends during 1990–2004. During 1990–2003, the highest yearly rate for such deaths among females in this age group was 0.35 per 100,000 population in 1998.

The marked increases in suicide rates among females in the two younger age groups suggest possible changes in risk factors for suicide and the methods used, with greater use of methods that are readily accessible (5). Scientific knowledge regarding risk factors for suicide in young females is limited. Research that focuses on suicide mortality has emphasized males, who constitute approximately three fourths of suicide decedents aged 10–19 years (2).

In contrast, research on suicidal behavior among females primarily has examined factors related to suicidal thoughts and nonfatal self-inflicted injuries.

One comparative study, conducted in Singapore, suggested that perceptions of interpersonal relationship problems are more common among young female suicide decedents than among their male counterparts (6).

Family discord, legal/disciplinary problems, school concerns, and mental health conditions such as depression increase the risk for suicide among youths of both sexes (6,7). Drug/alcohol use can exacerbate these problems (7).

Prevention measures should address the underlying reasons for suicide in populations that are vulnerable.
1. National Center for Health Statistics. Multiple cause-of-death public-use data files, 1990 through 2004. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2007.
2. CDC. Web-based Injury Statistics Query and Reporting System (WISQARS™). Atlanta, GA: US Department of Health and Human Services, CDC; 2007. Available at
3. Anderson RN, Minino AM, Fingerhut LA, Warner M, Heinen MA. Deaths: injuries, 2001. Natl Vital Stat Rep 2004;52:1–5.
4. Agresti A. An introduction to categorical data analysis. 2nd ed. Hoboken, NJ: Wiley; 2007.
5. CDC. Methods of suicide among persons aged 10–19 years—United States, 1992–2001. MMWR 2004;53:471–4.
6. Ang RP, Chia BH, Fung DSS. Gender differences in life stressors associated with child and adolescent suicides in Singapore from 1995 to 2003. Int J Soc Psychiatry 2006;52:561–70.
7. Kloos AL, Collins R, Weller RA, Weller EB. Suicide in preadolescents: who is at risk? Curr Psychiatry Rep 2007;9:89–93.
8. Le D, Macnab AJ. Self strangulation by hanging from cloth towel dispensers in Canadian schools. Inj Prev 2001;7:231–3.
9. O’Carroll PW. A consideration of the validity and reliability of suicide mortality data. Suicide Life Threat Behav 1989;19:1–16.
10. Steenkamp M, Frazier L, Lipskiy N, et al. The National Violent Death Reporting System: an exciting new tool for public health surveillance. Inj Prev 2006;12(Suppl 2):ii3–5.

* Includes self-inflicted asphyxiation and ligature strangulation.

† Includes intentional drug overdose and carbon monoxide exposure. [Reported by: KM Lubell, PhD, SR Kegler, PhD, AE Crosby, MD, D Karch, PhD, Div of Violence Prevention, National Center for Injury Prevention and Control, CDC.
[CDC MMWR Weekly, September 7, 2007 / 56(35);905-908]


Suicide: The leading mechanism of suicide among children aged 10–19 years was firearms for whites and blacks (Table 11). However, suffocation, especially by hanging, was the leading mechanism of suicide among AI/ANs, A/PIs, and Hispanics.

Whites aged 10–19 years had the largest percentage of suicides by poisoning (7.6%), and A/PIs had the highest percentage of suicides attributed to falls (8.1%).

Increasing certain protective factors is more effective in reducing suicide attempts than decreasing risk factors.

Protective factors include discussion of problems with relatives and friends, emotional health, and feeling close to relatives (59).
[CDC, MMWR Surveillance Summaries, May 18, 2007 / 56(SS05);1-16, “Fatal Injuries Among Children by Race and Ethnicity — United States, 1999–2002”]