Examining the Impact of Minimum Handgun Purchase Age and Background Check Legislation on Young Adult Suicide in the United States, 1991-2020.

Objectives. To examine the independent and joint effects of state legislation on minimum age for purchasing handguns and background checks on the suicide of young adults aged 18 to 20 years. Methods. We used negative binomial regressions with fixed effects for year and generalized estimating equations for state to estimate the effects of state legislation on annual counts of firearm, nonfirearm, and total young adult suicides in all 50 US states from 1991 to 2020. Results. Minimum age laws decreased the incidence rate of firearm suicide among young adults, an effect that was amplified in states with permit to purchase laws; there was no effect on the nonfirearm or total suicide rate. Permit to purchase laws significantly decreased the young adult firearm suicide incidence rate by 39% (incidence rate ratio [IRR] = 0.61; 95% confidence interval [CI] = 0.51, 0.74) and the overall suicide incidence rate by 14% (IRR = 0.86; 95% CI = 0.75, 0.99), with no effect on the nonfirearm suicide rate. Conclusions. Permit to purchase laws are a more promising avenue for reducing young adult suicides than are age-based restrictions. (Am J Public Health. 2024;114(8):805-813. https://doi.org/10.2105/AJPH.2024.307689).

Contextualizing school discipline: Examining the role of general peer and teacher discrimination at the individual- and school-level on individual suspension.

Past research has linked peer and teacher discrimination to risk factors for school discipline, but few studies have examined whether peer and teacher discrimination have a direct impact on school discipline. This study examines the effects of general peer and teacher discrimination at the individual- and school-level on school suspension using nationally representative, secondary data on almost 12,000 youth across 131 schools. Hierarchical logistic regression models indicated that general teacher discrimination at the individual- and school-level-but not general peer discrimination-increased the odds of receiving school suspension. Findings suggest that general discrimination by direct learning instructors and teachers representing the broader school culture can shape student conduct. Reducing school discipline thus falls on teachers, staff, principals, and learners.

The impact of anticipated, vicarious, and experienced racial and ethnic discrimination on depression and suicidal behavior among Chicago youth.

There is a growing body of research linking racial and ethnic discrimination to adverse youth outcomes. Beyond experienced racial and ethnic discrimination, this study considers the relevance of anticipated and vicarious racial and ethnic discrimination for depression and suicidal behavior. Hierarchical regression models on a diverse sample of 1147 youth (50.31 % female) within 79 neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated that experienced, anticipated, and vicarious racial and ethnic discrimination were associated with an increased risk of depression and suicidal behavior. Additionally, African American and Hispanic youth were disproportionately exposed to-but not differentially impacted by-racial and ethnic discrimination. Findings suggest that developmental research should account for experienced, anticipated, and vicarious racial and ethnic discrimination.

Examining the Contemporaneous, Short-Term, and Long-Term Effects of Secondary Exposure to Violence on Adolescent Substance Use.

The relationship between secondary exposure to violence-defined as witnessing violence in the home, community, or school-and adolescent substance use is well-documented. Yet, multi-wave empirical studies examining this relationship are sparse. In addition, studies have only begun to examine whether this relationship varies by the situational components of the violent event. Using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), this study examines the contemporaneous, short-term, and long-term effects of secondary exposure to violence on substance use, and whether witnessing violence in which a weapon is present has a different impact on adolescent substance use than does witnessing violence without a weapon. Hierarchical logistic regression models on a racially and ethnically diverse sample of 1670 youth (51.5% female) residing in 79 neighborhoods indicated that: (1) the effects of secondary exposure to violence on alcohol and marijuana use were enduring, albeit attenuated, over time; (2) the effect of secondary exposure to violence on illicit drug use was suppressed in the short-term but significant in the long-term; (3) witnessing violence without a weapon was salient for alcohol and marijuana use at all time points; and (4) witnessing violence with a weapon impacted illicit drug use in the long-term. The results suggest that addressing the consequences of secondary exposure to violence requires prolonged intervention efforts and that the study of secondary exposure to violence requires a more nuanced approach that accounts for situational aspects of the violent event.

Parents, Peers, Perceived Risk of Harm, and the Neighborhood: Contextualizing Key Influences on Adolescent Substance Use.

Recent research has affirmed the need to examine contextual influences on adolescent substance use in a multilevel framework. This study examined the role of neighborhood opportunities for substance use in promoting adolescent substance use. Data came from two components of the Project on Human Development in Chicago Neighborhoods: the Longitudinal Cohort Study, consisting of interviews with youth and their primary caregivers across three waves of data with an average span of 4.5 years; and a Community Survey of neighborhood residents. Analysis used an Item-Response Theory-based statistical approach on 6556 substance use item responses from 1639 youth (49.0 % female) within 80 neighborhoods to assess the extent to which neighborhood opportunities for substance use had direct and indirect effects on adolescent substance use. Neither direct nor mediated effects of neighborhood opportunities for substance use on adolescent substance use were detected. But, analyses revealed moderating effects such that higher levels of neighborhood opportunities for substance use: (1) amplified the detrimental effects of parental substance use and peer substance use on youth substance use; and (2) attenuated the protective effect of adolescents' perceived harm of substance use on adolescent substance use. The results suggest that the ways in which neighborhood characteristics impact adolescent behavior are nuanced. Rather than impact individual-level outcomes directly, neighborhood context may be particularly relevant by conditioning the effects of salient individual-level risk and protective factors for substance use.

Risk Factors for and Behavioral Consequences of Direct Versus Indirect Exposure to Violence.

Research suggests that direct exposure (personal victimization) and indirect exposure (witnessing or hearing about the victimization of a family member, friend, or neighbor) to violence are correlated. However, questions remain about the co-occurrence of these phenomena within individuals. We used data on 1915 youths (with an average age of 12 years at baseline) from the Project on Human Development in Chicago Neighborhoods to examine this issue. Results indicated that youths who tended to be personally victimized were also likely to witness violence; conversely, youths who disproportionately witnessed violence were relatively unlikely to experience personal victimization. In addition, direct and indirect exposures to violence were associated with subsequent adverse outcomes in similar ways. The key distinguishing factor was, rather, the cumulative level of violence (both direct and indirect) to which youths were exposed.

Contextual Determinants of Adolescent Perceived Early Fatality.

Adolescents overestimate their risk for early or premature death. In turn, perceived early fatality is associated with a host of adverse developmental outcomes. Research on the correlates of perceived early fatality is nascent, and an examination of the contextual determinants of perceived early fatality is largely absent from the literature. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study examines whether friendship networks and the school climate impact youth's perceptions of premature death. Analysis using hierarchical linear models on 9617 youth (52.0 % female) within 113 middle and high schools across the U.S. assess the extent to which peer and school future orientation climate and friendship network characteristics (network size, density, popularity, and centrality) impact respondents' life expectancy. Consistent with hypotheses: (1) higher levels of life expectancy in respondents' friendship networks and schools are associated with more optimistic expectations about the future among sample respondents; and (2) youth embedded in larger and denser friendship networks report higher levels of life expectancy. The results are consistent with the literature on peer effects, studies documenting the insulating effects of extensive and closely knit peer networks, and research on the contextual effects of the school environment. More generally, the results suggest that adolescent friendship networks and the school climate are key contexts in which youth develop expectations for the future.

Examining Change in Adolescent Street Efficacy and Its Association With Violent Outcomes.

Research suggests that street efficacy-the perceived ability to avoid dangerous situations in one's neighborhood-is related to violent outcomes. We investigated change in street efficacy using data from the Project on Human Development in Chicago Neighborhoods. Measures of street efficacy and violence (offending, victimization, secondary exposure) were constructed at Waves 2 (1997-2000) and 3 (2000-2002) from youth interviews and parent reports. Results from hierarchical overdispersed Poisson models indicated that street efficacy was a malleable construct with stronger contemporaneous than enduring effects. Furthermore, rates of all three violent outcomes were reduced as individuals increased their levels of street efficacy. Findings support (a) teaching youths to safely navigate violent neighborhood situations and (b) continuously reinforcing youths' perceived ability to navigate danger.

The covariates of parent and youth reporting differences on youth secondary exposure to community violence.

Survey data for studying youth's secondary exposure to community violence (i.e., witnessing or hearing violence in the community) come from both parents and their children. There are benefits of considering multiple informants in psychosocial assessments, but parents and youths often disagree about comparable information. These reporting differences present challenges for both researchers and clinicians. To shed new light on the individual, family, and neighborhood factors that contribute to parent and youth reporting differences regarding youth's secondary exposure to community violence, this study analyzed hierarchical item response models on a sample of youth respondents from the Project on Human Development in Chicago Neighborhoods. Participants were aged approximately 9, 12, and 15 years (trimodal distribution; mean age = 12.0 years) at baseline (N = 2,344; 49.6% female). Descriptive analyses indicated that parents significantly underestimated their children's exposure to community violence. Logistic hierarchical item response models indicated that absolute discrepancies between parent and youth reports were a function of youth demographic characteristics (male, Hispanic or African American as compared to white, age, 3rd as compared to 1st generation immigrant), individual difference factors (lower levels of self-control, higher levels of violent peer exposure), and family factors (lower household socioeconomic status). Parental under-reporting of youth's exposure to violence was associated with youth demographic characteristics (male, age, 2nd as compared to 3rd generation immigrant), family factors (lower levels of parental supervision), and neighborhood characteristics (higher levels of violence, less access to youth services). The results suggest that a constellation of individual and contextual factors may contribute to the understanding of parent and youth reporting differences. The findings speak to the utility of examining parent and youth reporting differences from a hierarchical lens.

Examining the Etiology of Asian American Suicide in the United States.

Research highlights racial and ethnic disparities in suicide, but Asian American suicide receives very little attention in the literature. This is the first comprehensive, large-scale, nationally representative study of completed suicide among Asian Americans in the United States. Descriptive and multilevel regression techniques compared the risk factors for completed suicide across 227,786 Asian American, White, African American, Hispanic, and American Indian suicide decedents from 2003 to 2019. Results indicated that Asian American suicide decedents were significantly less likely than their counterparts to have several risk factors for suicide. Asian Americans were less likely to be male, uneducated, and unmarried. Asian Americans were less likely to use alcohol and drugs, to have mental health problems, and to die by firearm, relative to other suicide methods. Asian Americans were less likely to have a history of prior suicide attempts, to have intimate partner problems, and to have criminal legal problems. Conversely, Asian Americans were more likely to reside in places with higher levels of concentrated disadvantage, residential instability, racial and ethnic heterogeneity, and population density. The results underscore the need for race-specific suicide prevention strategies that, for Asian Americans in particular, take into account cultural values and barriers to help-seeking behavior.

Disproportionate burden of violence: Explaining racial and ethnic disparities in potential years of life lost among homicide victims, suicide decedents, and homicide-suicide perpetrators.

Research indicates that the burden of violent death in the United States is disproportionate across racial and ethnic groups. Yet documented disparities in rates of violent death do not capture the full extent of this inequity. Recent studies examining race-specific rates of potential years of life lost-a summary measure of premature mortality-indicate that persons of color may die at younger ages than their counterparts, leading to increased trauma among surviving family members, friends, and communities. This study examines racial and ethnic disparities in potential years of life lost among people who died by homicide and suicide. We calculated potential years of life lost using life expectancy values specific to each racial and ethnic group, thereby isolating racial differences in potential years of life lost due to violence. Findings indicated that persons of color were disproportionately impacted by violence. Non-Hispanic African American homicide victims, suicide decedents, and homicide-suicide perpetrators died eleven or more years earlier than their non-Hispanic White counterparts. Similar disparities were observed for non-Hispanic Asian or Pacific Islander decedents. Less pronounced differences were observed for Hispanic and non-Hispanic American Indian or Alaska Native decedents. These racial and ethnic disparities were partly accounted for by a broad array of individual differences, incident characteristics, and contextual factors. The results suggest that homicide and suicide exact a high societal cost, and the burden of that cost is disproportionately high among persons of color.

Individual, family background, and contextual explanations of racial and ethnic disparities in youths' exposure to violence.

We used data from the Project on Human Development in Chicago Neighborhoods to examine the extent to which individual, family, and contextual factors account for the differential exposure to violence associated with race/ethnicity among youths. Logistic hierarchical item response models on 2344 individuals nested within 80 neighborhoods revealed that the odds of being exposed to violence were 74% and 112% higher for Hispanics and Blacks, respectively, than for Whites. Appreciable portions of the Hispanic-White gap (33%) and the Black-White gap (53%) were accounted for by family background factors, individual differences, and neighborhood factors. The findings imply that programs aimed at addressing the risk factors for exposure to violence and alleviating the effects of exposure to violence may decrease racial/ethnic disparities in exposure to violence and its consequences.

Gender differences in the effects of parental underestimation of youths' secondary exposure to community violence.

Secondary exposure to community violence is particularly detrimental for male youths, who disproportionately report witnessing community violence and suffering associated trauma-related symptoms. Yet, few studies have investigated whether parents perceive and report similar gender disparities among youths. In addition, few studies have examined the potentially negative effects of parent-child discord as to the youth's level of exposure to violence, or whether these effects vary across gender. Therefore, this study investigated whether differences between parents' and youths' reports of youths' exposure to violence, and the consequences of such reporting discord, varied across the gender of the youth informant. Participants were adolescents aged approximately 12 and 15 years at baseline (N = 1,517; 51 % female). Descriptive analyses indicated that male youths reported significantly higher levels of exposure to violence than female youths, but parents similarly under-reported their male and female children's experiences with violence. Hierarchical analyses indicated that parental underestimation of youths' exposure to violence had negative consequences. Moreover, significant interaction effects demonstrated that only females responded to reporting discord with internalizing problems. Conversely, both male and female youths responded to reporting discord with externalizing problems and offending. The results suggest that while parent-child discord is associated with negative outcomes for both male and female youths, discord may be disproportionately associated with negative outcomes among young females. The findings speak to the utility of examining the correlates and consequences of exposure to violence from a "gendered" perspective.

Examining the Factors that Impact Suicide Following Heterosexual Intimate Partner Homicide: Social Context, Gender Dynamics, and Firearms.

Despite a wealth of research on intimate partner homicide, research on intimate partner homicide followed by suicide of the perpetrator is sparse. Existing studies on intimate partner homicide-suicide: tend to be descriptive, not keeping pace with quantitative advances in the epidemiological and social sciences; have yet to examine how context impacts intimate partner homicide-suicide; and are typically limited to male perpetrators, given small localized samples of female-perpetrated intimate partner (homicide and) homicide-suicide. This study uses data on 7584 heterosexual intimate partner homicide and homicide-suicide cases distributed across 2465 places and 42 U.S. states from the National Violent Death Reporting System (2003-2018) to examine the victim and perpetrator characteristics, relationship dynamics, situational factors, and contextual features that influence the likelihood of committing suicide following intimate partner homicide. Hierarchical logistic regression models indicate that victim characteristics that increase the vulnerability to victimization (alcohol and drug use, mental health problems, less than some college education) decrease the odds of committing suicide following intimate partner homicide. Similarly, situational (victim weapon usage, additional perpetrators) and contextual (concentrated disadvantage, residential instability) risk factors decrease the odds of committing suicide following intimate partner homicide. Conversely, impairment of the perpetrator (alcohol use, mental health problems) and a more intimate victim-perpetrator relationship (spousal relationship, caregiver) increases the odds of homicide-suicide. Additionally, results indicate that firearms play an integral part in homicide-suicide as well as in decreasing the gender gap in homicide-suicide. The findings suggest that the internalization of guilt by perpetrators of intimate partner homicide may play a key role in subsequent suicide. Practically, limiting firearm exposure will not only reduce the lethality of intimate partner violence, but will decrease the odds of perpetrator suicide following intimate partner homicide. This is particularly true for female-perpetrated homicide-suicide, which is unlikely to occur without a firearm.

The salience of social context, opioid antagonist use, and prior opioid exposure as determinants of fatal and non-fatal opioid overdoses.

This study examines the salience of social context for opioid overdoses in Boston from 2014 to 2019. Longitudinal negative binomial models with random effects indicated that higher levels of concentrated disadvantage, residential instability, and illicit drug activity increased annual block group counts of opioid overdoses. Logistic hierarchical and cross-classified random effects models indicated that the use of Narcan and greater exposure to drugs through previous opioid overdose and contextual lillicit drug crime activity reduced the odds of fatal opioid overdose relative to non-fatal opioid overdose. The findings suggest that the accurate tracking of both fatal and non-fatal overdoses, and a consideration of the broader social context, can facilitate effective public health resource allocation to reduce opioid overdoses.

Discrimination in Context: Examining Neighborhood-Level Variation in the Incidence and Adverse Effects of Perceived Racial and Ethnic Discrimination Among Chicago Youth.

A growing body of research links interpersonal racial and ethnic discrimination to adverse youth outcomes. Yet, studies examining the relevance of neighborhood context for discrimination are sparse. This study examines neighborhood-level variation in the incidence and impact of perceived racial and ethnic discrimination on depressive symptoms, suicidal behavior, violent behavior, and substance use. Hierarchical regression models on a sample of 1333 African American and Hispanic youth (52.44% female; x̄ = 13.03 years, SD = 3.25 at wave 1) residing in 238 Chicago neighborhoods from the Project on Human Development in Chicago Neighborhoods indicated little to no neighborhood-level variation in the incidence and impact of discrimination. Findings suggest that the experience of discrimination among youth of color is ubiquitous.

NEIGHBORHOOD CONTEXT AND THE GENDER GAP IN ADOLESCENT VIOLENT CRIME.

Although researchers consistently demonstrate that females engage in less criminal behavior than males across the life course, research on the variability of the gender gap across contexts is sparse. To address this issue, we examine the gender gap in self-reported violent crime among adolescents across neighborhoods. Multilevel models using data from the Project of Human Development in Chicago Neighborhoods (PHDCN) indicate that the gender gap in violent crime decreases as levels of neighborhood disadvantage increase. Further, the narrowing of the gender gap is explained by gender differences in peer influence on violent offending. Neighborhood disadvantage increases exposure to peer violence for both sexes, but peer violence has a stronger impact on violent offending for females than for males, producing the reduction in the gender gap at higher levels of disadvantage. We also find that the gender difference in the relationship between peer violence and offending is explained, in part, by (1) the tendency for females to have more intimate friendships than males, and (2) the moderating effect of peer intimacy on the relationship between peer violence and self-reported violent behavior.

Violent Lives: Pathways Linking Exposure to Violence To Suicidal Behavior in a National Sample.

This study explored the extent to which depression, somatic symptoms, and substance use mediated the effects of exposure to violence on suicidal ideation and attempted suicide, and whether these pathways varied across gender, age, and race/ethnicity. Path analysis was conducted on 12,272 adolescents (mean = 15.3 years) from the National Longitudinal Study of Adolescent to Adult Health. The impact of exposure to violence on suicidal ideation was fully mediated, and the impact of exposure to violence on attempted suicide was partially mediated by depression, somatic symptoms, and substance use. Mediating pathways were stronger for females and for younger adolescents. Understanding the impact of exposure to violence on adolescent suicidal behavior requires the consideration of direct, indirect, and conditional indirect effects.

Association of a Crime Prevention Program for Boys With Mortality 72 Years After the Intervention: Follow-up of a Randomized Clinical Trial.

Importance: Mortality is an important outcome in evaluating crime prevention programs, but little is known about the effects on mortality during the full life course. Objective: To determine the long-term outcomes of a crime prevention program on mortality and whether the iatrogenic effects on mortality observed in middle age persist or change in old age. Design: This longitudinal follow-up was conducted in a cohort of boys included in a matched-pair randomized clinical trial (the Cambridge-Somerville Youth Study). Six hundred fifty boys aged 5 to 13 years who lived and attended public and parochial schools in working-class areas of Cambridge and Somerville, Massachusetts, and were identified as at risk for antisocial behavior were matched by age and demographic characteristics. One member of each pair was randomly allocated to the treatment condition. The original trial was performed from June 1, 1939, to December 1945. Follow-up in the present analysis was performed from January 2016 through June 2018. Interventions: Treatment group participants received individual counseling through a range of activities and home visits for an extended duration (mean, 5.5 years). Control group participants received no special services. Main Outcomes and Measures: The 4 outcomes of interest include age at mortality, mortality at latest follow-up, premature mortality (younger than 40 years), and cause of mortality (natural vs unnatural). Results: In the original analysis, 650 participants were matched and randomized to treatment or control conditions, of whom 506 were retained in the analysis (mean [SD] age, 9.8 [1.7] years). Through early 2018, records for 488 participants (96.4%) were located. A total of 446 participants were confirmed dead (88.1%) and 42 alive (8.3%). Matched-pairs analyses showed no significant differences between the treatment and control groups for mortality at latest follow-up (relative risk [RR], 1.05; 95% CI, 0.99-1.11), premature mortality (RR, 1.15; 95% CI, 0.55-2.43), or cause of mortality (RR, 1.19; 95% CI, 0.65-2.18) (P > .05 for all). Cox proportional hazard regression indicated no difference in time to death between groups (hazard ratio, 1.18; 95% CI, 0.98-1.41; P = .09). Conclusions and Relevance: Iatrogenic effects on mortality were not detected in this long-term follow-up. The longitudinal analysis provides information on the utility of life-long assessments of crime prevention programs and draws attention to the need for quality-of-life assessments of participants and their children.