Suicide
Poorest people are at Highest risk of Suicide
By British Journal of Psychiatry
Jul 5, 2005 - 10:23:00 PM

The more socio-economic disadvantages a person suffers, the higher the risk of suicide, according to a new European comparative study.

Published in the July issue of the British Journal of Psychiatry, this is the first European overview of socio-economic inequalities in suicide mortality in men and women, co-ordinated by the Erasmus MC in Rotterdam.

The researchers used a prospective follow-up of population censuses linked to mortality registries throughout an average follow-up period of four years in ten European countries or cities: Norway, Finland, England and Wales, Denmark, Belgium, Switzerland, Austria, Turin, Barcelona and Madrid.

In eight out of ten countries it was found that, for men, the suicide risk was significantly higher in those with a low level of education compared with the highly educated group.

Suicide inequalities were smaller and less consistent in women. For example, a lower level of educational attainment was a significant, positive but weak risk factor for suicide only in Belgium and Finland. A lower educational level, by contrast, proved to be a protective risk factor for women in Norway, Denmark and Switzerland.

In most countries, the greater the socio-economic disadvantage, the higher the risk of suicide. The intermediate socio-economic groups (high level of education and tenant; low level of education and house owner) were at less risk of suicide than the lowest group.

In Turin, socio-economic status was associated only slightly with suicide risk.

The authors of the study comment that, in line with previous studies, housing tenure seems to be a more important risk factor than education, and shows more consistent results in both men and women.

Overall, the findings of this study are similar to those of a previous worldwide meta-analysis of socio-economic risk factors for mental disorders, a main risk factor for suicide.

Why is there no suicide inequality in Turin, whilst the largest inequalities were found in Madrid? The authors speculate that the outstanding mental health care system in Italy may play a part.

The large educational inequalities found in Madrid (and in some analyses also in Barcelona) may be due to the higher prevalence of drug misuse in these Spanish cities compared with other countries in the European Union. Suicide is a frequent cause of death among drug users in southern Europe.

The strong association between socio-economic status and suicide calls for an improvement in access to psychiatric care for lower socio-economic groups, say the authors of the study.

People of lower socio-economic status are more likely to receive such care in countries (such as Italy and The Netherlands) that have succeeded in integrating mental health within the primary and community care sectors.

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