School environment, physical activity, and sleep as predictors of suicidal ideation in adolescents: Evidence from a national survey

Abstract

INTRODUCTION: Suicide is the second leading cause of death among individuals between 10 and 34 years of age and suicidal ideation substantially increases during adolescence. The purpose of this study was to examine the associations among physical activity, sleep, and factors relating to the school environment with adolescent self-reported rates of suicidal ideation on the 2017 National Risk Behavior Survey (YRBS). METHODS: A multi-stage cluster sampling procedure was employed to yield a representative sample of US adolescents recruited from the 9th through 12th grade. The number of sampled adolescents was 18,324 with 10,125 students submitting questionnaires with useable data for this study. Weighted logistic regression models were employed to examine the predictive utility of physical activity, sleep, and factors related to the school environment with suicidal ideation, adjusting for age, sex, and BMI percentile. RESULTS: Meeting physical activity guidelines every day of the week (OR 0.62, 95% CI: 0.51-0.76), hours of sleep (OR 5.46, 95% CI: 4.21-7.09), and factors relating to the school environment including bringing weapons to school (OR 2.06, 95% CI: 1.24-3.41), perceived school safety (OR 1.59, 95% CI: 1.27-2.00), and being bullied (OR 3.23, 95% CI: 2.71-3.87) and buying illegal drugs at school (OR 1.92, 95% CI: 1.63-2.27) all significantly independently predicted suicidal ideation. CONCLUSIONS: Physical activity, sleep, and the school environment significantly predict suicidal ideation among this national sample of adolescents. These factors should be considered when designing interventions or programs to reduce the risk of suicidal ideation among adolescents.