The rising incidence of suicide among children and adolescents in the United States (U.S) is a profound public health crisis that demands attention and intervention. Epidemiological data indicate that suicide is the eighth leading cause of death among children and younger adolescents aged 10 – 14 years, and the third leading cause of death among older adolescents and youth aged 15 – 24 years in the U.S [1]. Historically, the prevalence of suicide among adolescents, and especially children and younger adolescents has surged [2], [3], underscoring the complexity of psychosocial challenges faced by adolescents today, including a myriad of factors ranging from psychopathology, early childhood traumas and family, to socio-demographic characteristics [4], [5], [6], [7], [8], [9]. Despite the alarming trends, there remains a significant gap in research focused on suicide among younger children and adolescents (i.e., ages 10–14), with much of the existing literature disproportionately concentrated on older age groups.

Previous research has identified disparities in suicide-related behaviors among adolescents. Overall, prevalence rates of suicidal ideation are notably higher among racial and ethnic minority [9], [10], [11], [12] and sexual minority adolescents [13]. Intersectional factors such as gender and race exacerbate these disparities; black males, for example, demonstrate increasing vulnerability to suicide compared to their peers [8], [9], [11], [14]. These disparities are intensified by comorbid psychopathology and socio-economic vulnerabilities [4], [10]. Adolescents from low-income families and marginalized communities such as poor and rural neighborhoods [15], [16] have elevated odds of suicidal behaviors [4], [16], [17], [18]. due to limited socio-economic resources [16], [17], [18] and reduced access to mental health services [18], [19].

Physical activity, particularly through organized sports participation, has been identified as a protective factor against poor mental health, including suicide ideation and behaviors [20], [21], [22]. Sports participation has numerous physical and mental health benefits such as reduced depressive and anxiety symptoms, lower stress, enhanced general well-being [20], [23], [24], [25], [26], [27], [28], [29], [30], [31], improved self-esteem, and an increased sense of belonging, all of which are critical factors in mitigating suicidal thoughts and behaviors [32], [33]. Team sports provide structured environments that foster vital social support networks and emotional resilience [29]. For example, Taliaferro et al. [34] found that the relationship between sports participation and reduced suicidal ideation was partially mediated by increased self-esteem and perceived social support, highlighting the psychosocial mechanisms that may buffer suicide risk [26]. The level of engagement also matters as participation in multiple team sports has been linked to lower odds of suicidal ideation and behaviors compared to participation in one or no sports [21], [23], [24], [25], [26], [27], [28], [29], [30]. Notably, recent work by Veliz and Mutumba [22] showed that while multiple-sport participation was strongly protective against suicide-related outcomes in pre-pandemic cohorts, this association weakened during the COVID-19 pandemic, suggesting that disruptions to sports engagement or changes in the context of participation may diminish its protective effects [22]. These findings underscore the need to re-examine the stability and direction of the association between sports participation and adolescent mental health over time and across sociocultural contexts.

While previous studies have established an association between sports participation and reduced suicidal behavior [22], [24], [25], [26], it is essential to understand how the relationship between sports participation and suicide-related outcomes may have evolved within the context of recent societal disruptions. Recent research indicates declining levels of sports participation among adolescents [35], a trend exacerbated by the COVID-19 pandemic, alongside increases in mental health issues, including suicidal thoughts and behaviors among adolescents [35], [36]. This evolving context raises critical questions about the stability and strength of sports participation's protective effects post-pandemic. Additionally, the significance of these potential temporal changes across different adolescent age groups has not been systematically explored.

This manuscript aims to address these critical, yet underexplored questions by assessing changes in both sports participation and suicidal ideation and behaviors among middle and high school students between 2007 and 2023. More specifically, this study examines whether and how associations between sports participation and suicidal outcomes vary across pre-pandemic, pandemic, and post-pandemic cohorts (2007–2013, 2015–2019, 2021, and 2023). By focusing specifically on younger adolescents (middle school students, ages 11–14)—a demographic significantly impacted yet less studied in the suicide prevention literature—this study fills an important research gap. It provides empirically grounded recommendations on leveraging sports participation as an accessible, scalable, and sustainable public health strategy for suicide prevention among adolescents in varying contexts.