A public health nurse is applying for a grant related to suicide prevention. When describing social groups at highest risk, which of the following should the nurse include?

A. Native Americans have the highest suicide rates among racial and ethnic groups in the United States. Contributing factors include historical trauma, high rates of poverty, limited access to mental health care, substance use, and social marginalization. Public health initiatives targeting suicide prevention in this population are critical. B. Japanese Americans generally have lower suicide rates compared with Native Americans and other high-risk groups in the U.S. Cultural factors may influence mental health, but they are not among the highest-risk groups in this context. C. African Americans historically have lower suicide rates than Native Americans, although certain subgroups, such as young African American males, may have increased risk. Overall, the population-level risk is lower than that for Native Americans. D. South Americans refers to a regional group rather than a U.S. racial/ethnic population. While suicide rates vary across countries in South America, in the context of U.S.-based public health, this is not considered a high-risk group.