Suicide among Arab-Americans

Abdulrahman M El-Sayed,Sandro Galea,Peter Scarborough,Melissa Tracy,Jeremy Miles

doi:10.1371/journal.pone.0014704

Abdulrahman M El-Sayed, Sandro Galea + Show 3 more

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https://doi.org/10.1371/journal.pone.0014704

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Abstract

BackgroundArab-American (AA) populations in the US are exposed to discrimination and acculturative stress—two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.Methodology/Principal FindingsICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%).Conclusions/SignificanceSuicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

Highlights

Little is known about the health of Arab-Americans (AAs) in the United States
In a study of all suicide deaths among AAs and non-ethnic whites in Michigan between 1990 and 2007 we found that suicide rates among AAs were lower than among non-ethnic whites across gender
We found that while residence in Wayne County, MI was associated with higher rates of suicide among non-ethnic whites, it was associated with lower rate of suicide among AAs compared to residence in the rest of the state

Summary

Introduction

Little is known about the health of Arab-Americans (AAs) in the United States. A recent review of research into the health of AAs found only 34 studies in the peer-reviewed literature that empirically assessed health metrics among this group [1]. AA populations may be exposed to higher levels of discrimination and acculturative stress, which have both been shown to influence health outcomes among this group [1]. Several studies that have explored the mental health of AAs in the US have shown that discrimination may be an important determinant of adverse mental health. A recent study by Padela and Heisler [6] considered the relation between discrimination and mental health among a representative sample of AAs in metropolitan Detroit and found that selfreported experiences of discrimination were associated with higher levels of psychological distress [6]. Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress—two factors that have been associated with higher suicide risk. We explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US

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