Impacts of Social Determinants of Health and COVID-19 Pandemic Factors on Suicide Risk among Youth

项目摘要 自杀是年轻人中的一个重大公共卫生问题。数据显示自杀行为在增加 甚至在新冠肺炎大流行开始之前，年轻人中的艾滋病人就已经增加了，而且自疫情爆发以来，这一比例可能增加得更多。 这项R16建议的研究旨在解决紧迫的精神健康危机，并回应最近 来自美国卫生局局长的建议，强调需要更好地了解 在年轻人中流行。我们会通过以下具体目标达到这一目标：(1)确定 大流行期间年轻人自杀风险的轨迹，并测试是否存在差异 基于人口统计学的变化；(2)确定健康的社会决定因素如何与自杀风险相关 以及(3)描述健康的社会决定因素在青年中的调节和调解作用 新冠肺炎负担与青年自杀风险的相关性研究本研究在以下几个方面具有创新性 方式。首先，它将应用健康的社会决定因素框架，从而扩大对 自杀行为危险因素超越个人层面的因素，包括相关的社会、经济、教育、 有形基础设施和医疗保健风险因素，这些因素在新冠肺炎精神中经常被忽视 与年轻人一起进行健康研究。其次，它将使用实时危机应对数据来确定自杀风险如何 在大流行期间发生了变化，这是一项重要的资产，因为报告时间滞后涉及其他 数据源。第三，它将链接来自大型国家数据库(SDOH、危机文本行、USAFact)的数据 每一项都提供了重要和独特的优势(例如，全国性、实时、探索性取向和种族 身份)，以评估健康和新冠肺炎的社会决定因素的直接、间接和交互影响 年轻人自杀行为的负担。我们的研究团队特别准备承担这一任务 调查。私家侦探在自杀研究、二级数据分析和辅导方面有丰富的经验 学生和联合调查员有使用几个建议的数据源和类似数据源的经验 所建议的数据分析方法。此外，阿巴拉契亚州立大学是一所理想的学校 这个奖项因为佩尔助学金资助了28%的本科生，所以它授予生物医学学位 在过去的两年里，他只获得了一次NIH的拨款。

Project Summary Suicide is a significant public health problem among youth. Data indicate suicidal behaviors were increasing among youth even before the COVID-19 pandemic began and have likely increased even more since its onset. This R16 proposed research seeks to address the urgent mental health crisis and respond to the recent advisories from the US Surgeon General that highlight the need for a better understanding of the impact of the pandemic on youth. We will meet this objective by pursuing the following specific aims: (1) Identifying the trajectory of suicide risk among youth across the pandemic period and testing if there have been differential changes based on demographics; (2) Determining how social determinants of health are related to suicide risk among youth; and (3) Characterizing the moderating and mediating roles of social determinants of health in the association between COVID-19 burden and suicide risk among youth. This research is innovative in several ways. First, it will apply a Social Determinants of Health framework and thus will widen the investigation of suicidal behavior risk factors beyond individual-level factors to include relevant social, economic, education, physical infrastructure, and healthcare risk factors, which have often been overlooked in COVID-19 mental health research with youth. Second, it will use real-time crisis response data to determine how suicide risk has changed over the course of the pandemic, an important asset given the reporting time lag involved with other data sources. Third, it will link data from large national databases (SDOH, Crisis Text Line, USAFacts) that each provides important and unique strengths (e.g., national, real-time, explores sexual orientation and race identity) to assess the direct, indirect, and interactive effects of social determinants of health and COVID-19 burden on suicidal behavior among youth. Our research team is particularly poised to undertake this investigation. The PI has extensive experience in suicide research, secondary data analysis, and mentoring students, and the Co-Investigators have experience using several of the proposed data sources and similar data analytic approaches as proposed. Further, Appalachian State University is an ideal institution to receive this award because Pell grants support 28% of its undergraduate students, it awards degrees in biomedical sciences, and has received only one NIH grant in the past two years.