Although global suicide mortality rates decreased by almost a third between 1990 and 2016 (1), suicide mortality in the United States has increased rapidly (2). Particularly high suicide mortality has been identified among American Indian or Alaska Native (AIAN) people (2), whose life expectancy is also 7 years shorter than that of the White population in the United States (3). Understanding trends and patterns in suicide mortality in AIAN populations may offer insights into strategies to reduce health inequality in this highly vulnerable population.