Children to young adult suicide rates by sex, race/ethnicity and method 2017–2021—essential data for a community response in the United States

Background: Coronavirus disease 2019 (COVID-19) pandemic lockdown’s impact on youth death by suicide is unknown. We assessed suicide trends for those aged 10–24 years for 2017–2021. Methods: Retrospectively, suicide mortality data from National Vital Statistics System were obtained by ICD-10 codes (intentional self-harm). Temporal trends by joinpoint regression were reported as annual percent change (APC). Results: Between 2017 and 2021, 33,911 youth (10–24 years) suicides occurred with an overall stable trend [APC =0.93%, 95% confidence interval (CI): −2.16% to 3.97%]. However, following a stable trend (2017–2019 APC =−2.36%, 95% CI: −5.29% to 0.63%), joinpoint regression detected a significant increasing rate and trend post-2019, rising from (per 100,000) 10.19% [2019] to 11.18% [2021], APC =+4.26% (95% CI: 1.21% to 7.47%). This increase was observed across all age groups, driven by youth aged 20–24 years [2017–2019: APC =−0.19%, 95% CI: −2.89% to 2.55% vs. 2017–2021: APC =5.08%, 95% CI: 2.35% to 7.92%]. The suicide trend among females (APC =5.25%, 95% CI: 1.26% to 9.47%) increased faster than males (APC =4.02%, 95% CI: 1.17% to 6.99%), although male rates consistently exceeded female rates (per 100,000) throughout the study period (15.75% vs. 4.36% in 2019 and 17.19% vs. 4.89% in 2021). Across racial groups, the highest increase was observed among Black youth (APC =12.99%, 95% CI: 10.08% to 16.06%), with the highest rates (per 100,000) observed in American Indian and Alaska Native youth (36.97%), followed by White (12.63%), Black (11.52%), Asian (9.60%), and Hispanic (7.85%) youth in 2021. Firearms were the most common suicide method (48.8%) then suffocation (35.7%). Conclusions: Deaths by suicide increased during COVID-19 lockdown driven by Black youth. Firearm use increased significantly. Age and culturally appropriate suicide interventions are needed.