# The Relationship Between Gender Identity, Economic Stressors, Social Support, Concurrent Substance Use and Suicidal Ideation

## TL;DR

This study finds that middle-aged adults who are gender minorities or use substances are at higher risk for suicidal thoughts, highlighting the need for targeted interventions.

## Contribution

The study identifies concurrent substance use, gender minority status, and economic stressors as key predictors of suicidal ideation in middle-aged adults.

## Key findings

- 10.4% of middle-aged adults reported suicidal ideation in the past year.
- Concurrent substance use and financial stressors significantly increase the odds of suicidal ideation.
- Higher social support reduces the likelihood of repeated suicidal ideation.

## Abstract

To examine a comprehensive list of demographic, substance use, economic, and social factors associated with suicidal ideation (SI) among middle-aged adults.

Cross-sectional data were obtained from a national sample of middle-aged adults between February and November 2022. The study’s final sample include 1,337 respondents who represented the adult population of persons aged 40–60 years in the United States. Bivariate and multivariate statistics were employed to identify significant factors associated with past year SI, in particular single vs. multiple instances of SI.

Of the sample, 140 (10.4%) reported SI in the past year. Among those, more than half (60.0%, n = 84) reported SI multiple times in the past year. Multivariable logistic regression indicated that those who were a gender minority, engaged in concurrent substance use, or had financial stressors had significantly higher odds of past SI. Multinomial regression found that concurrent substance use (adjusted odds ratio [aOR] 3.17; 95% confidence interval [CI] 1.76–5.70) and having a lower standard of living than their parents/caregivers (aOR 2.99; 95% CI 1.39–6.41) predicted repeated past year SI whereas higher social support was protective against multiple SI experiences (aOR 0.65; 95% CI 0.55–0.78).

Gender minorities and those reporting concurrent substance use had the highest odds of past year SI. Findings underscore the need to develop public health and clinical interventions tailored to these highest-risk middle-aged adults in order to prevent suicide.