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State-level social capital and suicide mortality in the 50 U.S. states

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Abstract

This study investigated whether state levels of social capital are associated with rates of completed suicides in the fifty U.S. states. To do this we regressed state-level suicide rates on an index of social capital, along with other variables known to influence suicide rates such as gun ownership, income inequality, alcohol abuse and dependence, drug abuse and dependence, serious mental illness, unemployment, percent of population living in urban areas, poverty, population instability, and living in a "suicide belt" state. Suicide rates were aggregated from 1999 to 2002, and examined separately by sex and different race/ethnic groups. The results showed that White men and women in states with higher levels of social capital had significantly lower rates of suicide when controlling for the other influential variables. When we examined sub-dimensions of social capital, we found that community organizations (for White women) and group membership (for White men) were particularly strongly associated with lower suicide risk.

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... violence prevention is that the frequency and distribution of risk and protective factors at the individual and relationship level (e.g., substance use, poor parent-child relationships), and the capacity of a jurisdiction to implement prevention strategies, are products of the underlying social characteristics and community/societal level risk and protective factors of that jurisdiction. Thus the differences in social and structural factors between states or countries has a bearing on the extent to which these states and countries manifest different rates of death from injury and violence (Galea & Vaughan, 2018;Smith & Kawachi, 2014). ...
... We measured residential instability using census data from each country as the percentage of the population not currently living in the same residence that they were five years prior. Community and social support and connectedness, or the lack thereof, have been linked to multiple forms of violence including child abuse and neglect (Coulton, Crampton, Irwin, Spilsbury, & Korbin, 2007;Freisthler, Merritt, & LaScala, 2006), intimate partner violence (Capaldi, Knoble, Shortt, & Kim, 2012;Pinchevsky & Wright, 2012), sexual violence (DeGue et al., 2013), youth violence (Sampson, Morenoff, & Gannon-Rowley, 2002), suicide (Arango, Opperman, Gipson, & King, 2016;Desai, Dausey, & Rosenheck, 2005;Smith & Kawachi, 2014), and elder abuse and neglect (Johannesen & LoGiudice, 2013). Lack of community connectedness and cohesion has been measured in a number of studies using societallevel census data on residential stability/instability which include the indicator used in this study (Drake, Jonson-Reid, & Sapokaite, 2006) as well as others such as percentage of vacant housing units (Abrams & Freisthler, 2010), and percentage of rental housing units (Ahern et al., 2013). ...
... Income inequality has been found to correlate with child abuse and neglect (Eckenrode et al., 2014), intimate partner violence (Asal & Brown, 2010), youth violence (Fajnzylber et al., 2002;Kennedy, Kawachi, Prothrow-Stith, Lochner, & Gupta, 1998;Nivette, 2011), and bullying (Elgar, Craig, Boyce, Morgan, & Vella-Zarb, 2009). Consistent with other studies that have measured income inequality (Phillips, 2002;Singh, Kogan, & van Dyck, 2008;Smith & Kawachi, 2014), we measured income inequality using Gini coefficients from census data. ...
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In this ecological study, we attempt to quantify the extent to which differences in homicide and suicide death rates between three countries, and among states/provinces within those countries, may be explained by differences in their social, economic, and structural characteristics. We examine the relationship between state/province level measures of societal risk factors and state/province level rates of violent death (homicide and suicide) across Australia, Canada, and the United States. Census and mortality data from each of these three countries were used. Rates of societal level characteristics were assessed and included residential instability, self-employment, income inequality, gender economic inequity, economic stress, alcohol outlet density, and employment opportunities). Residential instability, self-employment, and income inequality were associated with rates of both homicide and suicide and gender economic inequity was associated with rates of suicide only. This study opens lines of inquiry around what contributes to the overall burden of violence-related injuries in societies and provides preliminary findings on potential societal characteristics that are associated with differences in injury and violence rates across populations.
... Social capital, referring to the acquisition of resources embedded in social connectedness, [4] has been recognized to influence suicide [5,6] as well as a variety of other health outcomes such as mortality and mental health. [7,8] In the absence of other forms of capital [9][10][11] such as cultural and economic capital, social capital is recognized to have more pronounced protective effects on the health of the poor than the non-poor. However, some studies where social capital was mainly specified at the individual level showed that the protective effects of social capital on general health [12] and suicide prevention [6] may not be equal among subgroups, or even increase the risk of spreading undesirable consequences [13] as adverse social interaction may bring negative impact on health. ...
... Social capital or social relations in the broad sense, is a multidimensional concept (eg, social support, network, trust, reciprocity, and participation), and the use of various measures contributes to the inconsistent demonstration of the effects of social capital. Some previous studies using a composite score such as the state social capital index, [8] the summative social capital score, [16] the social fragmented index, [17] or the social embeddedness scale [18] monitored the overall status of social capital, but this masked substantial variations across different items. Other studies focusing on selected dimensions of social capital such as trust [19] or social support [3] were limited to represent comprehensive dimensions of social capital. ...
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Coupled with the lowest level of social connectedness, South Korea has the highest suicide rate among the Organization for Economic Co-operation and Development countries. A possible link between community and suicide is social capital imprinted in social connectedness. This study explores whether social capital is protective against suicide ideation in relation to the poverty level of communities, and whether the associations are specific to certain elements of social capital.A total of 908 participants were included to assess cross-sectional association of social capital at individual level with suicide ideation by comparing between poor (government-leased apartments) and non-poor communities (nongovernment-leased apartments). Logistic regression analyses were performed to examine various social capital dimensions in relation to suicide ideation.Suicide ideation was far higher among those living in the poor communities (poor communities 12%; non poor communities 6.3%) and the level of social capital was lower in the poor communities. Nevertheless, the protective effect of social capital, in particular, the cognitive dimension against suicide ideation was demonstrated only in the poor communities (eg, odds ratio = 0.27, 95% confidence interval: 0.12-0.58 for trust in the poor communities). Low income was significantly associated with suicide ideation only in the poor communities, but depression and resilience were associated with suicide ideation both in the poor and non-poor communities.To increase the reliability of the results, established measures based on relevant literature were utilized, but measures on bridging social capital and social network might have relatively low reliability.As to protection against suicide ideation, the extent of reliance on social capital was higher in poor communities than in non-poor communities, in particular, the cognitive dimension was likely to activate in this regard.
... Indeed, the review contains no methods at all. The consequences are evident, as numerous relevant studies are excluded, nearly all of which find a significant association between firearm availability and suicide (Anestis & Houtsma, 2018;Briggs & Tabarrok, 2014;Crowder & Kemmelmeier, 2014;Duggan, 1999;Hamilton & Kposowa, 2015;Hemenway & Miller, 2002;Killias, 1993;Kposowa, 2013;Miller, Barber, White, & Azrael, 2013;Opoliner, Azrael, Barber, Fitzmaurice, & Miller, 2014;Phillips, 2013;Reisch, Steffen, Habenstein, & Tschacher, 2013;Smith & Kawachi, 2014). ...
... There was a significant positive association between firearms and non-firearm suicide within the Native American demographic group. However, these associations are unreliable as a consequence of large amounts of suppressed data due to low counts, a recurring problem for this group (Smith & Kawachi, 2014). Total suicides were suppressed in 10 states and DC (20%), firearm suicides in 24 states and DC (47%), and non-firearm suicides in 23 states and DC (45%). ...
Article
Objective: Using data from n = 194 nation-states, Kleck found that firearm availability was only associated with firearm suicide rates, but not total or non-firearm suicides. He thus concluded that while firearm availability influences how people commit suicide, it does not affect total numbers. However, the study contains numerous logical and methodological issues and is at odds with the evidence base. Therefore, I attempt to reproduce the original results. Method: I reproduce the original study's methods: ordinary least squares regression, weighted by the square root of the population, with log-transformed suicide rates and three separate firearm availability measures: global estimates from the Small Arms Survey, proportion of suicides committed with firearms, and a European Union survey of firearm ownership. I also test several methodological variations and include U.S. suicide data. Results: In contrast to Kleck, global analyses with Small Arms Survey data found a significant and positive association between firearm availability and total suicides, as did U.S. analyses. Analyses with other firearm availability measures comported with the original study, finding no association. Conclusion: The main result in Kleck failed to reproduce, finding instead a significant association between firearm availability and suicide rates, as did U.S. analyses. While reproductions of Kleck's other analyses continued to show no association, they were based on unreliable methods. I therefore reject Kleck's conclusion that that firearm availability does not influence suicide rates. HighlightsUsing data global data, I find firearm availability is positively associated with suicide rates.I identify serious flaws in the logic and methods of Kleck and an earlier review.For transparency, data and code have been archived on a public repository.
... Social capital can facilitate access to informational, instrumental and emotional support from people in the society to improve quality of life (Requena, 2003;Rogers, Halstead, Gardner, & Carlson, 2011). In addition, social capital can strengthen social cohesion and trust in the community by growing connections among community members (Smith & Kawachi, 2014). Adequate community social capital is required for collective efficacy-an informal social control of social undesirable behaviors, including sexual risk behaviors (Skrabski, Kopp, & Kawachi, 2004). ...
... The positive impact of social capital has long been reported, and high social capital promotes health protective behaviors, inhibit health risk behaviors, and enhance mental health and wellbeing (Almedom, 2005;Lundborg, 2005;Smith & Kawachi, 2014). People with higher social capital are less likely to suffer from mental health problems (Harpham, Grant, & Rodriguez, 2004). ...
Article
Background: Few studies have examined the complex relationship of migration stress and depression with sexual risk behaviors among migrants. The relationship between migration stress and sexual risk behaviors may be mediated by depression, and the mediation process may be modified by social capital. The study aims to investigate this moderated mediation mechanism among rural-to-urban migrants. Methods: Data were collected from rural-to-urban migrants in China. Migration stress, depression, and social capital were measured with validated scales and used as predictor, mediator and moderator, respectively, to predict the likelihood of having sex with risk partners. Mediation and moderated mediation models were used to analyze the data. Results: Depression significantly mediated the migration stress–sex with risk partner relationship for males (the indirect effect [95%CI] = 0.36 [0.08, 0.66]); the mediation effect was not significant for females (0.31 [−0.82, 0.16]). Among males, social capital significantly moderated the depression-sex with risk partner relation with moderation effect −0.12 [−0.21, −0.04], −0.21 [−0.41, −0.01] and −0.17 [−0.30, −0.05] for total, bonding and bridging capital respectively. Conclusion: Social capital may weaken the association between migration stress and sexual risk behavior by buffering the depression-sexual risk behaviors association for males. Additional research is needed to examine this issue among females.
... Hence, this explains the importance of this paper, demonstrating the dramatic therapeutic impact of DMQ on suicidal ideation and associated impulsivity in our patients. [34,37] PBA must be distinguished from other disorders of affect and from mood and personality disorders. Depression is probably the most commonly applied misdiagnosis in patients with PBA. ...
... In regards to severity of TBI, impact location, linear and rotational acceleration and whether the person is aware of the impending blow are the major factors. [34] TBI is followed by a complex cascade of ionic, metabolic and physiologic events. Immediately after a TBI, there is a disruption of neuronal membranes, axonal stretching, and a release of excitatory transmitters such as glutamate with an efflux of potassium resulting in a brief period of hyperglycolysis. ...
... For example, a study with data from 50 countries in the past 2 decades found that lack of social capital and trust were the risk factor for increased rate of suicide at the national level (Helliwell 2007). A similar finding was reported in a study conducted in 11 European countries with social trust as a measure of social capital (Kelly et al. 2009).The negative association between social capital and suicide has been replicated in many other studies in which social capital was measured either by aggregating data at the individual level (Okamoto et al. 2013;Smith and Kawachi 2014), or direct analyzing the data at individual-level (Fitzpatrick et al. 2007;Lindström and Rosvall 2015). ...
... First of all, findings of the study confirmed the conclusion from reported studies that social capital is a modifiable and protective factor in reducing the risk of suicidal behaviors considering the influence of migration duration (Fitzpatrick et al. 2007;Helliwell 2007;Kelly et al. 2009;Kunst et al. 2013;Lindström and Rosvall 2015;Okamoto et al. 2013;Smith and Kawachi 2014). Rural migrants who acquired more social capital were less likely to engage in suicidal behaviors. ...
Article
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Suicide for rural-to-urban migrants in China presents a challenge. Social capital as a modifiable factor is associated with suicidal behaviors at different levels for different populations. This study focuses on the social capital–suicidal behavior relationship among rural migrants with detailed social capital measures and their interaction with migration duration. Data were collected from a rural migrant sample in Wuhan, China. Outcome variable was reported suicidal ideation and attempts in the past 12 months. Social capital was measured using the Personal Social Capital Scale. Year of migration was measured as the number of years a subject migrated to the city. Multivariate logistic regression (coefficients [95%CIs]) was used for data analysis. Time of crossover for interaction was estimated as the year when the effect of social capital on a suicidal behavior revered from negative to positive. Study findings show a negative association between social capital and suicidal ideation (− 1.48 [− 2.86, − 0.10]), but the association was not significant for suicidal attempts (− 1.30 [− 2.68, 0.08]) after considering the positive interaction between social capital and year of migration (0.11 [0.03, 0.19] for ideation and 0.11 [0.02, 0.19] for attempts). Similar effects were found for detailed social capital measures. The estimated time of crossover ranged from 7.0 to 14.8 years for different social capital measures. The findings of this study confirm the protective relationship between social capital and suicidal behaviors in the early years of migration among rural migrants. Following these findings, suicide prevention among rural migrants should consider social capital during the first 7 to 15 years of migration.
... According to recent studies (5,6) increases in suicide rates are linked to rising unemployment rates. Moreover, there exists evidence for an inverse relationship between social cohesion and suicide (7)(8)(9). Adding to these findings, the aim of this study is to provide empirical evidence on potential associations of individual level indicators of socioeconomic status (SES) and social isolation (SI) with district suicide rates. While suicide itself is a complex phenomenon determined by genetic, cultural and behavioral factors (10,11), such associations help to identify populations at risk. ...
Article
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Suicide represents a major challenge to public mental health. In order to provide empirical evidence for prevention strategies, we hypothesized current levels of low socioeconomic status (SES) and high social isolation (SI) to be linked to increased suicide rates in N = 390 administrative districts since SES and SI are associated with mental illness. Effects of SES on suicide rates were further expected to be especially pronounced in districts with individuals showing high SI levels as SI reduces the reception of social support and moderates the impact of low SES on poor mental health. We linked German Microcensus data to register data on all 149,033 German suicides between 1997 and 2010 and estimated Prentice and Sheppard’s model for aggregate data to test the hypotheses, accounting for spatial effect correlations. The findings reveal increases in district suicide rates by 1.20% (p < 0.035) for 1% increases of district unemployment, suicide rate decreases of −0.39% (p < 0.028) for 1% increases in incomes, increases of 1.65% (p < 0.033) in suicides for 1% increases in one-person-households and increases in suicide rates of 0.54% (p < 0.036) for 1% decreases in single persons’ incomes as well as suicide rate increases of 3.52% (p < 0.000) for 1% increases in CASMIN scores of individuals who moved throughout the year preceding suicide. The results represent appropriate starting points for the development of suicide prevention strategies. For the definition of more precise measures, future work should focus on the causal mechanisms resulting in suicidality incorporating individual level data.
... Edwin Shneidman, the founder of the American Association of Suicidology, considered the common purpose of suicide as an ending of human consciousness (2) and seeking a solution for their chronic psychological pains (3). Sociologists mostly refer to the outward social causes such as social capital (4)(5)(6)(7), economic crisis (8)(9)(10)(11)(12), and education level (13,14), while psychologists talk about its correlation with depression (15,16), hopelessness (17,18), religious beliefs (19), and cognitive distortions (20). Although scientists have studied the causality of suicide in different views, because of their methodologies, they looked at the problem with a horizontal view and had not gone deep into the subject to find the underlying roots. ...
... Focusing on a location in the Intermountain West is also important. Several western states are considered the "suicide belt" given their consistently high rates of suicide (Case & Deaton, 2017;Smith & Kawachi, 2014;Steljes, Fullerton-Gleason, Kuhls, Shires, & Fildes, 2005): Arizona, Colorado, Idaho, Montana, New Mexico, Nevada, Utah, and Wyoming. However, research specific to this region is scarce. ...
... Edwin Shneidman, the founder of the American Association of Suicidology, considered the common purpose of suicide as an ending of human consciousness (2) and seeking a solution for their chronic psychological pains (3). Sociologists mostly refer to the outward social causes such as social capital (4)(5)(6)(7), economic crisis (8)(9)(10)(11)(12), and education level (13,14), while psychologists talk about its correlation with depression (15,16), hopelessness (17,18), religious beliefs (19), and cognitive distortions (20). Although scientists have studied the causality of suicide in different views, because of their methodologies, they looked at the problem with a horizontal view and had not gone deep into the subject to find the underlying roots. ...
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Background: Despite many studies on suicide, the causation remains ambiguous, and there is a necessity for new all-inclusive methodology. Causal layer analysis (CLA) is a relatively new technique to deeply explore the etiologies of suicide in Iran. Methods: Causal layered analysis (CLA) combines empirical, interpretative, critical, and action research methods in comprehensive hierarchical layers of causality, like an iceberg. Layers begin from the first observable layer called litany to the deeper underneath layers, including systemic, worldview, and metaphor. In the litany layer, the general appearance of suicide in Iran was extracted through published evidence. In the systemic layer, observed quantitative results of litany was interpreted based on the short-term historical facts by conducting 30 semi-structured interviews with experts. In the worldview layer, 40 deep interviews with suicide attempt cases, 10 focus-groups among adolescents, and 20 semi-structured interviews with nurses and experts were conducted. In the myth and metaphor layer, the Persian poetry of the last century was studied and suicide notes and stories were reviewed. Results: Three causal models of CLA 1 (self-burning of women as an objection to the closed society), CLA 2 (duality of parent's addiction- divorce), CLA 3 (suicide as a reaction to the identity crisis) were extracted. Conclusion: Macrohistorical changes such as war, urbanization, and modernity have confronted the new the new generation with distinctive and unexpected realities in life, which are not similar to their dreams and old stories. Suicide is a reaction to this silent inner battle between old metaphors and new realities.
... The highest rates of death from suicide are concentrated among states in the Mountain division, although North Dakota, South Dakota, and Alaska, in the West North Central and Pacific divisions, respectively, also had high rates of death from suicide. This pattern mirrors the "suicide belt" researchers have documented for adults (Smith and Kawachi 2014). Despite the high rates of death from suicide in the Mountain division states, and lack of a clear geographic patterning in rates of death from drug poisoning, the data presented in Table 3 and Figure 3 shows a substantial disparity in all-cause mortality among adolescent and young adult males in most states concentrated in the East South Central and West South Central divisions. ...
Article
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Background: Recent studies of US adult mortality demonstrate a growing disadvantage among southern states. Few studies have examined long-term trends and geographic patterns in US early life (ages 1 to 24) mortality, ages at which key risk factors and causes of death are quite different than among adults. Objective: This article examines trends and variations in early life mortality rates across US states and census divisions. We assess whether those variations have changed over a 50-year time period and which causes of death contribute to contemporary geographic disparities. Methods: We calculate all-cause and cause-specific death rates using death certificate data from the Multiple Cause of Death files, combining public-use files from 1965-2004 and restricted data with state geographic identifiers from 2005-2014. State population (denominator) data come from US decennial censuses or intercensal estimates. Results: Results demonstrate a persistent mortality disadvantage for young people (ages 1 to 24) living in southern states over the last 50 years, particularly those located in the East South Central and West South Central divisions. Motor vehicle accidents and homicide by firearm account for most of the contemporary southern disadvantage in US early life mortality. Contribution: Our results illustrate that US children and youth living in the southern United States have long suffered from higher levels of mortality than children and youth living in other parts of the country. Our findings also suggest the contemporary southern disadvantage in US early life mortality could potentially be reduced with state-level policies designed to prevent deaths involving motor vehicles and firearms.
... The positive and direct effect of decision making on MDD shows that this executive function is very influential in this disorder. Most studies confirm that depression leads to making the decision to get a divorce (Smith, Daniel & Ichiro, 2014), to commit suicide (Steptoe, Angus & Arthur, 2015), to quit a job and to avoid friends and family members (Philips, 2013). Therefore, it is apparent that the impact of decision making on depression is quite considerable and significant. ...
Article
This study aimed to investigate the mediator roles of meta-cognition, decision making and working memory between coping with stress styles and major depressive disorder (MDD). The sample size was 250 participants that filled in five scales to assess MDD, coping with stress styles and executive functions. The model representing the mediation role of meta-cognition, decision making and working memory between coping with stress styles and MDD is fit. The effect of problem focused coping (PFC) on meta-cognition as well as the effect of emotion focused coping (EFC) on working memory was strongly significant. Decision making was an executive function that independently influenced on MDD. Our overall results represented that the main executive functions that strongly influenced the correlation between coping with stress styles and MDD were meta-cognition, working memory and decision making respectively.
... 16 In a study by Smith et al. in 2014, it was again found that higher incomes are associated with fewer suicide rates. 17 However, in a study by Saurina et al. in 2013, no clear association between suicide rates and income could be established. 18 According to previous studies, burns is a highly lethal means of attempt. ...
Article
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Background: Suicide is one of the top ten leading causes of death in the world as well as India. Poisoning is one of the most common modes of attempting suicide. Self-immolation is a devastating form of suicide attempt. Impulsivity has been demonstrated as an important risk factor for suicide. Lethality and intent were found to be interrelated in previous studies. But a comparative study of impulsivity, lethality and intent between self-immolation and poisoning was not found in a literature search. Objectives: To compare socio-demographic characteristics, impulsivity, intent and lethality in those who attempt suicide by self-immolation and poisoning. To find the intercorrelations between intent, impulsivity and lethality. Methods: A cross-sectional comparative study was done among persons attempting suicide by self-immolation (n=40) and poisoning (n=50). Barratt's impulsivity scale, Smith's LSARS (lethality of suicide attempt rating scale) and Beck's suicide intent scale were used to assess impulsivity, lethality and intent, respectively. Percentages, mean, median and range were used to describe the data. Chi-square test, t-test and Pearson correlation were used for statistical analysis. Results and discussion: There were significant associations between occupation, family income and socioeconomic status and mode of suicide attempt. Lethality was higher in self-immolation. Lethality and intent were significantly intercorrelated in both groups. Impulsivity and lethality were negatively correlated in the self-immolation group. Conclusion: Self-immolation is a highly lethal method of attempting suicide. Highly lethal suicide attempts have high intent. Greater the impulsivity, less lethal the attempt is likely to be.
... This variable measured the opportunity for people to engage with various organizations and community programs. Consistent with prior research, 37,38 these findings indicate that greater opportunities for social engagement and connection within a county are associated with lower suicide rates. Programs establishing connectedness and social support within a community are a potential strategy for reducing suicide. ...
Article
Importance Understanding geographic and community-level factors associated with suicide can inform targeted suicide prevention efforts. Objectives To estimate suicide rates and trajectories, assess associated county-level contextual factors, and explore variation across the rural-urban continuum. Design, Setting, and Participants This cross-sectional study included all individuals aged 25 to 64 years who died by suicide from January 1, 1999, to December 31, 2016, in the United States. Spatial analysis was used to map excess risk of suicide, and longitudinal random-effects models using negative binomial regression tested associations of contextual variables with suicide rates as well as interactions among county-level contextual variables. Data analyses were conducted between January 2019 and July 2019. Exposure County of residence. Main Outcomes and Measures Three-year county suicide rates during an 18-year period stratified by rural-urban location. Results Between 1999 and 2016, 453 577 individuals aged 25 to 64 years died by suicide in the United States. Decedents were primarily male (349 082 [77.0%]) with 101 312 (22.3%) aged 25 to 34 years, 120 157 (26.5%) aged 35 to 44 years, 136 377 (30.1%) aged 45 to 54 years, and 95 771 (21.1%) aged 55 to 64 years. Suicide rates were higher and increased more rapidly in rural than in large metropolitan counties. The highest deprivation quartile was associated with higher suicide rates compared with the lowest deprivation quartile, especially in rural areas, although this association declined during the period studied (rural, 1999-2001: incidence rate ratio [IRR], 1.438; 95% CI, 1.319-1.568; P < .001; large metropolitan, 1999-2001: 1.208; 95% CI, 1.149-1.270; P < .001; rural, 2014-2016: IRR, 1.121; 95% CI, 1.032-1.219; P = .01; large metropolitan, 2014-2016: IRR, 0.942; 95% CI, 0.887-1.001; P = .06). The presence of more gun shops was associated with an increase in county-level suicide rates in all county types except the most rural (rural: IRR, 1.001; 95% CI, 0.999-1.004; P = .40; micropolitan: IRR, 1.005; 95% CI, 1.002-1.007; P < .001; small metropolitan: IRR, 1.010; 95% CI, 1.006-1.014; P < .001; large metropolitan: IRR, 1.012; 95% CI, 1.006-1.018; P < .001). High social capital was associated with lower suicide rates than low social capital (IRR, 0.917; 95% CI, 0.891-0.943; P < .001). High social fragmentation, an increasing percentage of the population without health insurance, and an increasing percentage of veterans in a county were associated with higher suicide rates (high social fragmentation: IRR, 1.077; 95% CI, 1.050-1.103; P < .001; percentage of population without health insurance: IRR, 1.005; 95% CI, 1.004-1.006; P < .001; percentage of veterans: IRR, 1.025; 95% CI, 1.021-1.028; P < .001). Conclusions and Relevance This study found that suicide rates have increased across the nation and most rapidly in rural counties, which may be more sensitive to the impact of social deprivation than more metropolitan counties. Improving social connectedness, civic opportunities, and health insurance coverage as well as limiting access to lethal means have the potential to reduce suicide rates across the rural-urban continuum.
... In residential or geographical areas, social capital has attracted attention for its protective effects against suicide. A growing number of studies have investigated the relationship between social capital and suicide-related factors [14][15][16][17][18][19][20][21][22][23]. These studies demonstrated empirical support for a positive association between high social capital and a low suicide rate, less suicidal behavior, and decreased suicidal ideation. ...
Article
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Background: A growing body of evidence has demonstrated the associations between social capital and health. In residential or geographical areas, social capital has attracted attention for its protective effects against suicide. However, to this date, the relationship between social capital and suicidal ideation is not fully elaborated in the occupational setting. Therefore, the aim of the present study was to examine the association between workplace social capital and suicidal ideation in the past year among employees in Japan. Methods: A cross-sectional, web-based survey was conducted in February/March 2017 via an anonymous self-administered questionnaire distributed to workers in Tsukuba Science City, Japan. Binomial logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation in the past year, controlling for age group, marital status, educational attainment, and annual household income. The results were shown stratified by sex and occupation. Results: In total, 7255 of 19,481 workers responded, out of which we could analyze 6325 responses (4030 men, 2295 women). The prevalence of suicidal ideation in the past year was 5.9% for men and 7.8% for women. Low workplace social capital was statistically significantly associated with suicidal ideation both for men (OR = 2.57, 95% CI = 1.72-3.83) and for women (OR = 1.75, 95% CI = 1.15-2.66), compared with high workplace social capital after controlling for socioeconomic factors. Conclusion: Higher workplace social capital was associated with a reduced risk of suicidal ideation in the past year. Promoting workplace social capital could contribute to preventing suicide among employees in Japan.
... We included covariates known to be associated with both religious exposures and the psychiatric outcomes at either the individual-or contextual-level (Borch et al., 2010a;Chatters et al., 1992;Hayward & Krause, 2014;Pan et al., 2013;Smith & Kawachi, 2014;Vilhjálmsson et al., 1998). Individual-level covariates were age; race/ ethnicity (non-Hispanic black, non-Hispanic white, Hispanic, other); sex (men, women); marital status (married/cohabitating, widowed, separated or divorced, and never married); nativity (U.S.-born, foreign-born); educational attainment (less than high school, completed high school, college graduate, and graduate education and higher); personal income ($0-$19,999, $20,000-$34,999, $35,000-$69,999, $70,000 and greater); residence in one of the four census regions (Northeast, Midwest, South, West); and residence in a Metropolitan Statistical Area (MSA) (that is a central city, in an MSA that is not a central city, not in an MSA). ...
Article
Background Suicide and alcohol use disorders (AUD) have high public health and economic costs. We investigate the relationship between religious features that are external to the individual (hereafter, contextual religiosity) and individuals’ risk of AUD and suicidal thoughts. Methods Data are from Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions (analytic N = 34,326). Regression analysis assessed whether contextual (i.e., Geographic state) religiosity and membership rates of Catholics and the three major Protestant traditions, are associated with DSM-IV AUD risk in the past 12 months and suicidal thoughts since last interview, controlling for individual and state-level covariates. In a secondary analysis, we test for interactions between individual race/ethnicity and contextual religiosity on the outcomes since prior work suggested differences by race and individual religiosity. Results Some contextual religious variables were significantly associated with AUD risk but not suicidal thoughts. Individuals living in a state with higher membership rates of Evangelical Protestant had higher AUD risk (Adjusted Relative Risk [ARR]=1.27, 95%CI=1.08—1.49). Individuals living in states with higher membership rates of Historically Black Protestant had a lower risk of AUD (ARR=0.83, 95% CI=0.72—0.96). The interaction between individual race and contextual-level religious variables on the outcomes were not significant. Limitations NESARC is an observational cross-sectional so causality between religiosity and the outcomes cannot be established. Conclusions The risk of AUD among individuals varies depending on the religious membership rates among Protestant groups within their geographic state of residence. Contextual religiosity may impact AUD risk above and beyond one's individual religiosity.
... Related to location-specific characteristics, a growing number of studies have focused on the relationship between community social capital and suicide (Congdon, 2012;Fujiwara & Kawachi, 2008;Kelly, Davoren, Mhaoláin, Breen, & Casey, 2009;Kim et al., 2011;Okamoto, Kawakami, Kido, & Sakurai, 2013;Szreter & Woolcock, 2004). Smith and Kawachi (2014) conducted a notable state-level study on social capital and suicide rates in the US that identified a link between social capital and suicide mortality. Recker and Moore (2016) conducted a similar meso-level study and determined that social capital had a significant impact on the suicide rates of US counties. ...
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This study investigates social and economic factors influencing suicide rates in 231 South Korean cities, counties, and districts from 2010 to 2015. The results of a panel data analysis indicate that the number of social organizations did not have a significant effect on suicide rates; however, among six types of social organizations, social/recreational organizations showed a strong negative impact on suicide rates, suggesting that not all social organizations equally created social capital that addresses community health problems. Moreover, poverty and income are two strong predictors of municipal-level suicide rates, but municipal governments’ welfare spending was only effective in rural areas. © 2019
... Previous studies have highlighted a strong association between higher levels of contextual-level trust and improvements in objective measures of health such as mortality, life expectancy, cancer, and depression, and as well as subjective assessments of health including self-reported health and health-related quality of life. 6,[14][15][16] Four main explanations regarding the positive effects of contextual-level trust on health status can be provided. 15 First, societies with higher levels of trust foster more egalitarian policies and higher levels of social protection, thus leading to better health for all citizens. ...
Article
We analyse the effect of contextual-level social capital on health status in a sample of 26 transitional countries of Central and South Europe, Mongolia, and the former Soviet Union for 2006-2010 (N = 51 911). Contextual-level social capital is conceptualized as country-level social trust, while health status is conceptualized as self-rated health. We use ordinary least squares and instrumental variable regressions to address endogeneity and especially to rule out reverse causality. Both instrumental variable and ordinary least squares regressions suggest a strong positive effect of country-level trust on health. This finding is consistent for the whole sample as well as separate regional estimations.
... Though lack of mental wellbeing is an issue in developed and developing countries alike, with suicide being globally the 15th leading cause of death in 2012 and the second leading cause among the 15 to 29 year olds ("WHO | Suicide Data" 2016), there is some evidence that rates of mental illness increase with population density, and disruption social capital was suggested as one of the underlying cause of this relationship (Mckenzie 2008). Indeed greater social capital was found in several studies in developed countries to be associated with lower suicide rates, higher self-reported health, and better mental health (Smith and Kawachi 2014;Kunst et al. 2013;Okamoto et al. 2012;Congdon 2011;Langille et al. 2011;Poortinga 2012). Place attachment (that is, attachment to the living environment, rather than to people) is also disrupted by urbanization, especially through rural to urban migration (Nauman, VanLandingham, and Anglewicz 2016), and also suggested to be important for mental wellbeing (Jack 2010). ...
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The rapidly increasing urbanization of the world creates important environmental and social problems. By bringing the cultivation of food closer to where people live, urban agriculture could contribute to alleviating some of these, especially when involving the participation of the residents. Here the potential socio-environmental impacts of public urban orchards was studied, using as a case-study a public urban orchard planted in 2010 in Sainte-Anne-de-Bellevue on the island of Montreal (Quebec, Canada) by the city administration. The socio-environmental constructs evaluated were: place attachment, social capital, food and food system knowledge, and environmental knowledge. Observations of the users of the site were performed, and semi-directed interviews were conducted with eleven users of the bike path and two members of the city administration who have developed the project. The interviews with the users were analyzed using a mixed inductive and deductive qualitative approach. Evidence of positive impacts was found for place attachment, social capital, and food knowledge, while no evidence of impacts was found for food system and environmental knowledge. Impacts on social capital were seen for most of the social capital components studied, but not for bridging social capital. Impacts on place attachment appeared to take place in large part through an increased appreciation of the city administration, thereby also possibly increasing the trust in the administration (social capital). However, this effect appeared to be dependent on a level of maintenance of and communication about the orchard project perceived as adequate by the residents. Finally, the interviewees manifested a high level of interest in participating in maintenance or harvesting activities around the orchard, mainly for interaction with their community. Based on the results I suggest that implementing participatory activities and providing more information about the orchard, the food system and the environment could increase the impacts on the four constructs studied, and I propose other potential means through which urban agriculture could impact socio-environmental sustainability, namely through improving quality of life and reducing urban sprawl. Though further research is needed to evaluate the extent to which the results are transferable to other contexts, this study should be of interest to city administrations seeking cost efficient means of positively contributing to socio-environmental sustainability and to the individual wellbeing of their residents, as well as to researchers interested in the relationship between urban planning and socio-environmental sustainability.
... 16 In a study by Smith et al. in 2014, it was again found that higher incomes are associated with fewer suicide rates. 17 However, in a study by Saurina et al. in 2013, no clear association between suicide rates and income could be established. 18 According to previous studies, burns is a highly lethal means of attempt. ...
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Back Ground: Personality disorders especially Emotionally Unstable Personality Disorder (EUPD) may lead to significant marital discord. Though the incidence of separation and divorce are on the rise the problem of underlying personality factors are not given much significance and inadequately studied. Among the personality disorders EUPD is the one that is more likely to be associated with marital discord and separation. Objective To study the marital adjustments of patients with emotionally unstable personality disorder Methodology This cross-sectional study was done in individuals between 18 to 45 years and diagnosed as having EUPD as per ICD 10 DCR criteria, currently staying with their spouse, attending psychiatry department during the study period. Details were collected, Locke Wallace marital adjustment scale was administered, and Chi-square test was used to compare the relevant variables. Results 35 % of the the Sample (n= 34) EUPD subjects reported significant marital dissatisfaction. Co morbid psychiatric disorders were obtained in 23.5% of sample. Association between type of marriage and marital adjustment was found to be significant .41.2% received some kind of psychosocial intervention. 70.6% of the spouses had history of substance use and 23.5 % had history of psychiatric illness. No significant difference in MAT severity was found between EUPD subtypes. Conclusion Study found high level of marital maladjustment among subjects with EUPD.
... ), 以及社会资本在经济发展 (Beugelsdijk et al, 2005; Camps et al, 2014)、 健 康 (Smith et al, 2014; Story, 2014)、移 民 (Kan et al, 2007; Prayitno et al, 2014)等方面的实证研究。国内 冯健, 刘玉. 2007. ...
... Some theoretical models have been proposed to explain how personal control, social support, and positive distraction (or restoration) in neighborhood environments have mediating impacts on mental health (Evans, 2003). While various studies have corroborated the notion that neighborhood factors, such as individual socioeconomic status, feelings of safety, access to facilities and amenities, and social capital are all related to depression (Kim, 2008;Kruger et al., 2007), few studies have examined the correlates of suicide with individual environmental factors, such as social capital (Smith and Kawachi, 2014), natural environment (Helbich et al., 2018), and built environment (Jiang et al., 2021). ...
Article
Background The relationship between neighborhood environments and suicide has not been well studied. In the present study, relations between suicidal ideation and social and physical environments were investigated in Korean adults. Methods This nationwide cross-sectional study was conducted using data from the 2013 Korea Community Health Survey. The final analysis included 221,038 individuals aged ≥ 19 years. A multivariate regression model was used to examine the independent effects of environments on suicidal ideation. Results Approximately 9.4% of participants had experienced suicidal ideation. Stepwise multivariate regression analysis showed that trusting neighbors and all five physical environments were independently associated with suicidal ideation. As regards physical environments, relations with suicidal ideation varied across subgroups: satisfaction with overall safety was to be strongly and consistently related to less suicidal ideation. Limitations Causality and the impact of unmeasured confounders were not addressed. Conclusion Neighborhood environments may reduce suicidal ideation.
... Numerous strategies and resources [5][6][7][8][9][10] have been identified and developed in the past to prevent suicides; however, most of these interventions are for large geographic areas at either the state level or national level. While US state level trends in suicides, contextual factors, and prediction models are well documented [11][12][13][14][15] , these may not necessarily reflect the suicide trends of a particular region or geographic area. Since US counties are the smallest possible geographical classification available in the CDC Wonder Database, county level suicides have been studied in the past [16][17][18][19][20] . ...
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Suicide is a growing public health concern in the United States. A detailed understanding and prediction of suicide patterns can significantly boost targeted suicide control and prevention efforts. In this article we look at the suicide trends and geographical distribution of suicides and then develop a machine learning based US county-level suicide prediction model, using publicly available data for the 10-year period from 2010–2019. Analysis of the trends and geographical distribution of suicides revealed that nearly 25% of the total counties experienced at least a 10% increase in suicides from 2010 to 2019, with about 12% of total counties exhibiting an increase of at least 50%. An eXtreme Gradient Boosting (XGBoost) based machine learning model was used with 17 unique features for each of the 3140 counties in the US to predict suicides with an R2 value of 0.98. Using the SHapley Additive exPlanations (SHAP) values, the importance of all the 17 features used in the prediction model training set were identified. County level features, namely Total Population, % African American Population, % White Population, Median Age and % Female Population were found to be the top 5 important features that significantly affected prediction results. The top five important features based on SHAP values were then used to create a Suicide Vulnerability Index (SVI) for US Counties. This newly developed SVI has the potential to detect US counties vulnerable to high suicide rates and can aid targeted suicide control and prevention efforts, thereby making it a valuable tool in an informed decision-making process.
... While demographic variables yielded 3 expected factors associated with the suicide rate (ie, percentage of population who was male or military veterans, and rural residency status [35][36][37][38], an [25][26][27]30,38 their impact in our findings was subsumed by demographic variables through our use of an analytic method that seeks to eliminate the effects of collinearity. It was notable that pain reliever misuse was associated with suicide, potentially pointing to the role of chronic disease in suicide and a possible overlap with factors associated with drug-related deaths. ...
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Importance: Self-injury mortality (SIM) combines suicides and the preponderance of drug misuse-related overdose fatalities. Identifying social and environmental factors associated with SIM and suicide may inform etiologic understanding and intervention design. Objective: To identify factors associated with interstate SIM and suicide rate variation and to assess potential for differential suicide misclassification. Design, setting, and participants: This cross-sectional study used a partial panel time series with underlying cause-of-death data from 50 US states and the District of Columbia for 1999-2000, 2007-2008, 2013-2014 and 2018-2019. Applying data from the Centers for Disease Control and Prevention, SIM includes all suicides and the preponderance of unintentional and undetermined drug intoxication deaths, reflecting self-harm behaviors. Data were analyzed from February to June 2021. Exposures: Exposures included inequity, isolation, demographic characteristics, injury mechanism, health care access, and medicolegal death investigation system type. Main outcomes and measures: The main outcome, SIM, was assessed using unstandardized regression coefficients of interstate variation associations, identified by the least absolute shrinkage and selection operator; ratios of crude SIM to suicide rates per 100 000 population were assessed for potential differential suicide misclassification. Results: A total of 101 325 SIMs were identified, including 74 506 (73.5%) among males and 26 819 (26.5%) among females. SIM to suicide rate ratios trended upwards, with an accelerating increase in overdose fatalities classified as unintentional or undetermined (SIM to suicide rate ratio, 1999-2000: 1.39; 95% CI, 1.38-1.41; 2018-2019: 2.12; 95% CI, 2.11-2.14). Eight states recorded a SIM to suicide rate ratio less than 1.50 in 2018-2019 vs 39 states in 1999-2000. Northeastern states concentrated in the highest category (range, 2.10-6.00); only the West remained unrepresented. Least absolute shrinkage and selection operator identified 8 factors associated with the SIM rate in 2018-2019: centralized medical examiner system (β = 4.362), labor underutilization rate (β = 0.728), manufacturing employment (β = -0.056), homelessness rate (β = -0.125), percentage nonreligious (β = 0.041), non-Hispanic White race and ethnicity (β = 0.087), prescribed opioids for 30 days or more (β = 0.117), and percentage without health insurance (β = -0.013) and 5 factors associated with the suicide rate: percentage male (β = 1.046), military veteran (β = 0.747), rural (β = 0.031), firearm ownership (β = 0.030), and pain reliever misuse (β = 1.131). Conclusions and relevance: These findings suggest that SIM rates were associated with modifiable, upstream factors. Although embedded in SIM, suicide unexpectedly deviated in proposed social and environmental determinants. Heterogeneity in medicolegal death investigation processes and data assurance needs further characterization, with the goal of providing the highest-quality reports for developing and tracking public health policies and practices.
... As females enter the workforce, they should become more socially integrated, which would negate any of the harms that were theorized by the status integration theory of suicide. Research has demonstrated that social integration is predictive of lower suicide rates (Kelly et al. 2009;M€ oller-Leimk€ uhler, 2003;Recker & Moore, 2016;Smith and Kawachi 2014). ...
Article
Suicide is one of the leading causes of death globally and is increasing in many countries across the world. Gender inequality has been demonstrated to be predictive of suicide. However, scholars have argued over the direction of gender inequality’s impact on suicide. Using the gender inequality index the results indicate that as countries become more equal, the suicide rate increases for males and females. Furthermore, the findings illustrate that as female educational levels and female labor force participation increase, suicide increases. These findings provide support for the status integration theory of suicide.
... Utah ranks 5th in the nation for deaths by suicide and is part of the "suicide belt" with other western states with high rates of suicide (e.g., Montana, Idaho, Wyoming, and Arizona; Smith & Kawachi, 2014). Previous research suggests that Utah's relatively high rates of suicide may be related to greater access to firearms, the presence of rural communities, population density, and higher altitude (Betz et al., 2011;Brenner, Cheng, Clark, & Camargo, 2011;Haws et al., 2009;Hirsch & Cukrowicz, 2014;Irwin, Coleman, Fisher, & Marasco, 2014;Kim et al., 2011;Kious, Kondo, & Renshaw, 2018;Poon & Saewyc, 2009). ...
Article
Current research suggests that sexual minorities living in Utah may be at higher risk for experiencing suicidal/self-harming thoughts and suicide attempts than heterosexuals in Utah. However, to date no research has been conducted examining potential reasons sexual minorities living in Utah may be at higher risk. Using two representative samples of Utahns, we examine (a) disparities in adverse childhood experiences (ACEs) between sexual minorities and heterosexual Utahn, (b) how ACEs and sexual orientation may predict recent suicidal/self-harming thoughts and lifetime prevalence of suicide attempts, and (c) how sexual orientation and ACEs might interact to predict suicidal outcomes. Results with each sample showed that sexual minority Utahns reported higher levels of ACEs and suicidal/self-harming thoughts than heterosexual Utahns. Both sexual orientation and ACEs uniquely predicted suicidality when both were entered into regression models, but no interaction effects were found between these predictors.
... They concluded that national income inequality was bad for trustful citizens; the effect of income inequality is nearly absent among people with low social trust, but it is negative among people with high social trust. In terms of sub-dimensions of social capital, evidence suggests that community organizations (for white women) and group membership (for white men) were particularly strongly associated with lower suicide risk in 50 States in the U.S. (Smith & Kawachi, 2014). ...
Article
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We tested associations between social capital or vulnerability and health outcome measures of adult obesity, adult diabetes, and life expectancy at the county level in the United States with data from 2015 to 2018. This ecological cross-sectional study utilized secondary data from four open access databases: The Geography of Social Capital (U.S. Congress, 2018), County Health Rankings (2018), CDC's Behavioral Risk Factor Surveillance System (BRFSS, 2018) and the Kaiser Family Foundation (KFF, 2015). Our dependent variables were adult obesity, adult diabetes, and life expectancy. We identified the highest and lowest states' prevalence for each of three health outcomes in each of the four U.S. regions—Northeast, South, Midwest, and West. Each dependent variable was assessed using a sample of 32 counties (N = 32). Data analysis consisted of bivariate and regression analysis. Our results showed that the most consistent measure of “vulnerability” linked significantly to all three health conditions studied was percent births to unmarried women (Obesity p < .001; Diabetes p = .049; Life Expectancy p = .019). The most consistent measure of “social capital” linked to all three health conditions was recreation establishments per 1,000 inhabitants (Obesity p = .006; Diabetes p = .005; Life Expectancy p = .018). We concluded that measures of vulnerability were strongly associated with obesity, diabetes, and life expectancy when compared with social capital indicators. However, measures of social capital consistently accounted for the second-greatest proportion of the variance. Social and community contexts should be constantly addressed by both public health governmental- and scholarly-research agendas in the United States.
... 3,4 31 It has been speculated that these hardships can affect the mental health of residents, [5][6][7] 32 potentially leading to increased risk of suicidal ideation, suicide attempts, or suicide. 8-12 33 Several studies have already reported increased risks of suicide or suicidal 34 ideation during the COVID-19 pandemic in Western and Asian countries including 35 Japan. [13][14][15][16][17] However, fewer studies have evaluated associations between the COVID-19 36 pandemic and suicide attempts, which may be a more specific marker of mental 37 hardship within the general population. ...
Article
Background: Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. Methods: This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019 and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. Results: The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25–49 years. Among women aged 25–49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. Conclusions: The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25–49 years. This increase may be partly explained by hardships such as economic losses or reduced social ties during the COVID-19 outbreak.
... The consistently higher suicide rate among non-Hispanic White populations compared with non-Hispanic Black populations and the large variation in RRs aligns with suicide research at the state level, which showed that social capital from activities such as engagement with community organizations or clubs may protect against suicide; evidence of its protective effects on non-Hispanic White populations, however, were mixed. 41,42 At the county level, some evidence suggests that social capital may be more protective among non-Hispanic Black populations than among non-Hispanic White populations. 41 Investigations of suicide at the city level conducted outside the United States showed that social support protects against suicide, whereas income inequality is associated with a higher risk for suicide. ...
Article
Objectives Suicide is a leading cause of death in the United States, and rates vary by race and ethnicity. An analysis of suicide across large US cities is absent from the literature. The objective of this study was to examine suicide rates among the total population, non-Hispanic Black population, and non-Hispanic White population in the United States and in the 30 largest US cities. Methods We used data from the National Vital Statistics System to calculate non-Hispanic White, non-Hispanic Black, and total age-adjusted suicide rates for the 30 largest US cities and for the entire nation during 2 periods: 2008-2012 and 2013-2017. We also examined absolute and relative differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations in each city. Results The overall age-adjusted suicide rate per 100 000 population in the United States increased significantly from 12.3 in 2008-2012 to 13.5 in 2013-2017. Total suicide rates were stable in most cities; rates increased significantly in only 1 city (Louisville), and rates decreased significantly in 2 cities (Boston and Memphis). The non-Hispanic White suicide rate was significantly higher—1.3 to 4.3 times higher—than the non-Hispanic Black suicide rate in 24 of 26 study cities during 2013-2017. From 2008-2012 to 2013-2017, non-Hispanic White suicide rates decreased significantly in 3 cities and increased significantly in 3 cities; non-Hispanic Black suicide rates increased significantly in 5 cities and decreased in none. Absolute differences in suicide rates among non-Hispanic White populations and non-Hispanic Black populations increased significantly in 1 city (Louisville) and decreased significantly in 2 cities (Memphis and Boston). Conclusions Our study may inform the use of evidence-based programs and practices to address population-level risk factors for suicide.
... There are various studies on the economic consequences of social capital from different perspectives. These are related to economic growth (Fukuyama, 1995;Iyer et al., 2005;Knack & Keefer, 1997;Postelnicu & Hermes, 2018), related to higher education (Coleman, 1988), and higher financial development (Grootaert, 1999;Guiso et al., 2004), related to agriculture (Bayramoğlu & Bozdemir, 2020), related to innovation (Akar & Ay, 2018;Akçomak & Weel, 2009), related to lower crime and homicide rates (La Porta et al., 1997;Rosenfeld et al., 2001), related to lower suicide rates (Helliwell, 2007;Smith & Kawachi, 2014), better public health facilities (Gönç Şavran, 2018;Kawachi et al., 2004) and studies by companies that show positive results on higher value creation and productivity (Przybyła, 2020). In addition, some scientists have also mentioned the possible negative effects of social capital (Fukuyama, 1995;Portes, 1998). ...
Article
The aim of this study is to empirically examine the relationship between credit growth, credit quality and social capital of all commercial banks operating in Turkey for a period of twelve years between 2007 and 2018 on the basis of 81 provinces. In order to measure social capital on a provincial basis, the independent variable SC1 was obtained by applying principal component analysis to the variables consisting of 2 network and 2 norm variables. In addition, province-based organ donation rate was used as an alternative social capital variable. Changes in Total Loans (ΔTL), Changes in Real Estate Loans (ΔREL), Changes in Commercial and Industrial Loans (ΔCIL), Changes in Construction Loans (ΔCL), Changes in Non-Performing Loans (ΔNPL), Ratio of Non-Performing Loans to Total Loans (NPL/TL) and Ratio of Non-Performing Loans to Total Assets (NPL/TA) were determined as the dependent variable. The relationship between the level of social capital (SC1) and seven dependent variables on a provincial basis in Turkey was analyzed and measured using panel data techniques. The results of the analysis show that the relationship between the social capital level of the provinces, credit growth and non-performing loans are negative and significant. The results of the study show that the level of social capital is important and decisive in terms of credit growth and credit risk of banks.
... In addition, research on social capital has demonstrated that an increase in community bonds positively affects the health of the population [25]. In particular, studies have explained that social capital and suicide have a negative correlation, and high social capital is associated with a lower suicide rate [26,27]. Durkheim studied the increased probability of suicide with low social integration, and Congdon developed Dukheim's research to emphasize the increased suicide rate in societies having social fragmentation [19,28,29]. ...
Article
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In 2018, the suicide rate in South Korea was the highest among the Organisation for Economic Co-operation and Development countries, and socioeconomic inequality has intensified. This study analyzes the impact relationship between suicidal impulses and economic inequality in South Korea. This study measures suicidal impulses thoughts National Health Survey Data and economic inequality based on the housing prices gap in the country. The primary analysis results were as follows: First, suicidal impulses were positively associated with the high index of housing price inequality; this correlation has become tight in recent years. Second, it was confirmed that the higher the income level, the higher the correlation between suicidal impulses with the index of housing price inequality. Third, the correlation between housing price inequality with suicidal impulse increased consistently in highly urbanized areas, but the statistical significance was low in non-urban areas.
... However, while suicide attempts made with firearms result in death over 90% of the time, there is not actually a statistically significant difference in death rates between suicide attempts made by firearms and hanging, the second most deadly method of suicide (Kleck, 2019). In any event, individual level, cross sectional work tends to continue to find associations between firearm availability and suicide risk (Anglemyer et al., 2014;Smith and Kawachi, 2014;Stack, 2000aStack, , 2018. A systematic review of 16 observational studies found strong support linking firearm availability with higher risk of suicide. ...
Article
This review summarizes recent research in four environmental areas affecting risk of deaths by suicide. Politically, the weight of the evidence suggests that laws increasing social welfare expenditures and other policies assisting persons with low incomes (e.g., minimum wage) tend to lower suicide rates. Other legal changes such as those restricting firearms and alcohol availability can also prevent suicides. The social institutions of marriage, as well as parenting, continue to serve as protective factors against suicide, although the degree of protection is often gendered. Religiousness tends to be inversely associated with suicide deaths at the individual level of analysis, but the mediators need exploration to determine what accounts for the association: social support, better mental health, better physical health, less divorce, or other covariates. Cultural definitions of the traditional male role (e.g., breadwinner culture) continue to help explain the high male to female suicide ratio. New work on the "culture of suicide" shows promise. The degree of approval of suicide is sometimes the single most important factor in predicting suicide. At the individual level of analysis, two of the strongest predictors of suicide are economic ones: unemployment and low socio-economic status. Attention is drawn to enhancing the minimum wage as a policy known to lower state suicide rates. Limitations of research include model mis-specification, conflicting results especially when ecological data are employed, and a need for more research exploring moderators of established patterns such as that between religiousness and suicide.
... Research has identi ed a number of factors placing rural communities at greater suicide risk, including greater geographic or social isolation, economic strain, access to lethal means such as guns, and long distances to and/or limited availability of mental health treatment resources compared to urban or suburban communities [10]. In the US, Western mountain states have been labeled the "suicide belt", with both higher suicide rates compared to other US states [11]. The vast majority of communities in these states are rural and have signi cantly greater barriers to accessing mental health care, including stigma, cost, and inability to schedule appointments. ...
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Cognitive Behavior Therapy (CBT) is an evidence-based psychotherapy for mental disorders, including depression. Internet-based CBT (iCBT) programs increasingly are showing similar impact to clinician-delivered CBT. We assessed the impact of Thrive, a fully-automated iCBT depression treatment program on suicidal thinking. Participants were randomly assigned to Thrive (n=218) or a waitlist control group (WLC, n= 230). Intent-to-treat analyses tested for group differences at 8-weeks in suicidal thinking (CHRT-SR3 subscale, primary outcome), and secondary outcomes including depression symptoms (PHQ-9), anxiety symptoms (GADS-7), work and social adjustment (WSAS), and resilience (CD-RISC-10). Using self-reports, participants were evaluated at baseline, 4 and 8 weeks for each outcome. Thrive program adherence (n = 218) was assessed by number of lessons completed. The Thrive group was 38.7% less likely than the control group to present with suicidal thinking at 8 weeks (odds ratio 0.61, p = 0.10). Comparison of 8-week depression symptom slopes showed statistically significant effects favoring the Thrive group (WLC = -3.04 vs. Thrive = -4.32, p = 0.007) (d = 0.08); no other significant group differences were observed. Lessons completed were significantly related to lower PHQ-9 (p = 0.026) and GAD-7 scores (p < 0.01). Study results are consistent with a previous study showing nonsignificant effect of an automated iCBT program for reducing suicidal thinking, but a significant positive impact on depression symptoms among rural US adults. Future studies should test whether strategies for boosting lesson completion are successful in enhancing the efficacy of Thrive to reduce suicide risk.
Article
Background: Suicide is an important public health concern worldwide. Among various factors, social capital has been suggested to be an effective factor to prevent and reduce suicide. Aims: The purpose of this study was to investigate the association between social capital and suicide rates in Seoul, South Korea, using panel data from 2005 to 2018 at the administrative-district level. Methods: Data for the current study were obtained from Seoul Statistics. The within estimator and the system generalized methods of moments estimator were used. Results: The results showed that there was an inverse association between community facility and suicide rates. This result remained the same even after considering the dynamic relationship between social capital and suicide rates ( B = −0.57, 95% CI: −1.10, −0.04) while adjusting for dynamic panel bias. A 10% increase in community facility per 1,000 population was associated with 5.2% reduction in age-standardized suicide rates per 100,000 population. Limitations: In this study, only a structural dimension of social capital was utilized due to the lack of available data. Conclusion: The results indicate that facilitating opportunities for social interactions and community lives has a potential to prevent and reduce suicide.
Article
From 1999 through 2017, age-adjusted suicide rates in the United States rose by 33% (from 10.5 to 14.0 per 100 000 population). Social capital, a key social determinant of health, could protect against suicide, but empirical evidence on this association is limited. Using multilevel data from the Centers for Disease Control and Prevention, we explored state- and county-level social capital as predictors of age-adjusted suicide rates pooled from 2010 through 2017 across 2112 US counties. In addition, we tested for causal mediation of these associations by state-level prevalence of depression. A 1-standard deviation increase in state-level social capital predicted lower county-level suicide mortality rates almost 2 decades later (0.87 fewer suicides per 100 000 population; P = .04). This association was present among non-Hispanic Black people and among men but not among non-Hispanic White people and women. We also found evidence of partial mediation by prevalence of depression. Our findings suggest that elevating state- and county-level social capital, such as through policy and local initiatives, may help to reverse the trend of rising suicide rates in the United States.
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Background: The relation of income and socioeconomic status with suicide rates remains unclear. Most previous studies have focused on the relationship between suicide rates and macroeconomic factors (e.g., economic growth rate). Therefore, we aimed to identify the relationship between individuals' socioeconomic position and suicide risk. Methods: We analyzed suicide mortality rates across socioeconomic positions to identify potential trends using observational data on suicide mortality collected between January 2003 and December 2013 from 1,025,340 national health insurance enrollees. We followed the subjects for 123.5 months on average. Socioeconomic position was estimated using insurance premium levels. To examine the hazard ratios of suicide mortality in various socioeconomic positions, we used Cox proportional hazard models. Results: We found that the hazard ratios of suicide showed an increasing trend as socioeconomic position decreased. After adjusting for gender, age, geographic location, and disability level, Medicaid recipients had the highest suicide hazard ratio (2.28; 95% CI, 1.87-2.77). Among the Medicaid recipients, men had higher hazard ratios than women (2.79; 95% CI, 2.17-3.59 vs. 1.71; 95% CI, 1.25-2.34). Hazard ratios also varied across age groups. The highest hazard ratio was found in the 40-59-year-old group (3.19; 95% CI, 2.31-4.43), whereas the lowest ratio was found in those 60 years and older (1.44; 95% CI, 1.09-1.87). Conclusions: Our results illuminate the relationship between socioeconomic position and suicide rates and can be used to design and implement future policies on suicide prevention.
Article
Introduction Although spatial examination of mortality and morbidity is becoming more common in health studies, the investigation of suicide death clusters within the neighborhood context is underutilized. The purpose of this ecological study is to detect high- and low-risk clusters of suicide deaths in Florida and determine which neighborhood characteristics distinguish clusters from non-clusters. Methods The scan statistic method was used to detect overall clusters of completed suicides in Florida from 2001 to 2010. Regression analysis was used to investigate the association of neighborhood characteristics with identified clusters. All data synthesis and statistical analyses were conducted in 2015. Results Twenty-four high-risk and 25 low-risk clusters were identified. The risk of suicide was up to 3.4 times higher in high-risk clusters than in areas outside of clusters (relative risk ranged from 1.36 to 3.44, p≤0.05). Low-risk clusters were associated with 30%–94% decreased risk of suicide (relative risk ranged from 0.06 to 0.70, p≤0.05). Areas with high levels of elderly concentration and household singularity were more likely to be in high-risk clusters, whereas areas with higher economic deprivation and residential density were more likely to be in low-risk clusters. Conclusions This study identified general suicide patterns across space in the state of Florida and described the characteristics of those areas.
Article
Introduction: Suicide rates and the proportion of alcohol-involved suicides rose during the 2008-2009 recession. Associations between county-level poverty, foreclosures, and unemployment and suicide rates and proportion of alcohol-involved suicides were investigated. Methods: In 2015, National Violent Death Reporting System data from 16 states in 2005-2011 were utilized to calculate suicide rates and a measure of alcohol involvement in suicides at the county level. Panel models with year and state fixed effects included county-level measures of unemployment, foreclosure, and poverty rates. Results: Poverty rates were strongly associated with suicide rates for both genders and all age groups, were positively associated with alcohol involvement in suicides for men aged 45-64 years, and negatively associated for men aged 20-44 years. Foreclosure rates were negatively associated with suicide rates for women and those aged ≥65 years but positively related for those aged 45-64 years. Unemployment rate effects on suicide rates were mediated by poverty rates in all groups. Conclusions: Population risk of suicide was most clearly associated with county-level poverty rates, indicating that programs addressing area poverty should be targeted for reducing suicide risk. Poverty rates were also associated with increased alcohol involvement for men aged 45-64 years, indicating a role for alcohol in suicide for this working-aged group. However, negative associations between economic indicators and alcohol involvement were found for four groups, suggesting that non-economic factors or more general economic effects not captured by these indicators may have played a larger role in alcohol-related suicide increases.
Article
Objective: Social capital, the collective resources of groups including perceptions of trust and reciprocity, is recognized as an important contributor to suicide. We examined the association of individual- and community-level social capital with suicidal ideation after adjusting for social support among older adults living in the community. Methods: In August 2010 we sent questionnaires to all residents aged 65 years and older living in 3 rural municipalities (N = 21,232) in Okayama Prefecture, Japan; 13,919 questionnaires were returned (response rate: 65.6%). The final analysis included 10,094 participants. The outcome variable was suicidal ideation. Exposure variables were individual-level mistrust and lack of reciprocity (level 1), and the aggregated responses of these variables from 35 communities in the municipalities (level 2). Covariates included age, sex, educational attainment, marital status, the number of cohabitants, years of residence, self-rated socioeconomic status, disability, social support, and psychological distress. Multilevel logistic regression analysis was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Results: After adjusting for social support and psychological distress, we found that mistrust and lack of reciprocity were only associated with suicidal ideation at the individual level. Stratified analysis showed that among subjects with psychological distress, mistrust was associated with suicidal ideation at individual (OR: 1.88; 95% CI: 1.42-2.51) and community levels (OR: 1.98; 95% CI: 1.02-3.81). Conclusions: Our findings show that individual- and community-level social capital is a possible protective factor for suicidal ideation, particularly for people with psychological distress.
Objectives: We clarified collaborations between public health nurses (PHNs) and the private sector, such as nonprofit organizations. Methods: Semi-structured interviews were conducted with 11 private sector organizations and 13 PHNs who collaborate with them between December 2012 to October 2013. Interview guides were: overall suicide preventive measurements, details of collaboration between private sector organizations and PHNs, and suicide prevention outcomes/issues. Data from private sector organizations and PHNs were separately analyzed and categories created using qualitative and inductive design. Private sector organizations' and PHNs' categories were compared and separated into core categories by similarities. Results: Six categories were created: 1. establishing a base of mutual understanding; 2. raising public awareness of each aim/characteristic; 3. competently helping high suicidal risk persons detected during each activity; 4. guarding lives and rehabilitating livelihoods after intervention; 5. restoring suicide attempters/bereaved met in each activity; and 6. continuing/expanding activities with reciprocal cohesion/evaluation. Conclusion: PHNs are required to have the following suicide prevention tasks when collaborating with private sector organizations: understanding the private sector civilization, sharing PHN experiences, improving social determinants of health, meeting basic needs, supporting foundation/difficulties each other (Dear editor. Thank you for kind comments. I was going to explain that PHNs and NPOs support each other their foundation of activity and difficulties in their activities. The foundations include knowledge, information, budgets, manpower etc. The difficulties mean like suffering faced with suicide during activities.), and enhancing local governments' flexibilities/ promptness.
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Objectives This study aimed to analyse trends in socioeconomic inequalities in suicide mortality in Barcelona before and after the start of the economic crisis that started at the end of 2008, including both individual factors and contextual factors of the deceased’s neighbourhood of residence. Design This is a trend study of three time periods: pre-economic crisis (2006–2008), early crisis (2009–2012) and late crisis (2013–2016). Setting Total Barcelona residents between 2006 and 2016 (≥25 years of age) and death data derived from the Judicial Mortality Registry of Barcelona. Participants 996 deaths by suicide between 2006 and 2016 were analysed. Primary and secondary outcome measures The outcomes were age-standardised suicide mortality rates and the associations (relative and absolute risk) between suicide mortality and individual and contextual characteristics for the three time periods. Results From 2006 to 2008, men with a lower educational level were more likely to commit suicide than better educated men (relative risk (RR)=1.46; 95% CI 1.11 to 1.91). This difference disappeared after the onset of the crisis. We found no differences among women. From 2013 to 2016, suicide risk increased among men living in neighbourhoods with higher unemployment levels (RR=1.57; 95% CI 1.09 to 2.25) and among women living in neighbourhoods with a higher proportion of elderly people living alone (RR=2.13; 95% CI 1.15 to 3.93). Conclusions We observed risks for suicide among men living in neighbourhoods of Barcelona with higher unemployment levels and among women living in neighbourhoods with a higher proportion of elderly people living alone. Inequalities in suicide mortality according to educational level tended to disappear during the crisis among men. Thus, it is important to continue to monitor suicide determinants especially in times of economic crisis.
Article
Suicide imposes substantial threats to a community's operation, functioning, and welfare. We propose that social detachment and isolation from community can be a leading risk factor of suicide behaviors. Using a social capital index derived from the principal component analysis, we show that county-level suicide rate in the US from 2005 to 2017 is strongly and significantly correlated with social capital. A one standard deviation improvement in social capital prevents 0.41-0.44 suicide deaths per 100,000 population per year, resulting in an annual benefit of $41.2 to $44.7 per person based on the value of statistical life in 2017 dollars. At the same time, a higher unemployment rate, a larger male-to-female ratio, and a greater proportion of the white population contribute to rising suicides. These findings highlight the joint role of societal factors and personal traits in influencing individual behaviors. (C33, C38, I15, Z13)
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Cognitive behavior therapy (CBT) is an evidence-based psychotherapy for mental disorders, including depression. Internet-based CBT (iCBT) programs increasingly are showing similar impact to clinician-delivered CBT. We assessed the impact of Thrive, a fully-automated iCBT depression treatment program on suicidal thinking. Participants were randomly assigned to the intervention (INT) group (n = 218) or a waitlist control group (WLC, n = 230). Intent-to-treat analyses tested for group differences at 8-weeks in suicidal thinking (CHRT-SR 3 subscale, primary outcome), and secondary outcomes including depression symptoms (PHQ-9), anxiety symptoms (GADS-7), work and social adjustment (WSAS), and resilience (CD-RISC-10). Using self-reports, participants were evaluated at baseline, 4 and 8 weeks for each outcome. Thrive program adherence (n = 218) was assessed by number of lessons completed. Although not statistically significant, the INT group was 38.7% less likely than the control group to present with suicidal thinking at 8 weeks (odds ratio 0.61, p = 0.10). Comparison of 8-week depression symptom slopes showed statistically significant effects favoring the INT group (WLC = − 3.04 vs Thrive = − 4.32, p = 0.007) ( d = 0.08); no other significant group differences were observed. Lessons completed were significantly related to lower PHQ-9 ( p = 0.026) and GAD-7 scores ( p < 0.01). Study results are consistent with a previous study showing nonsignificant effect of an automated iCBT program for reducing suicidal thinking, but a significant positive impact on depression symptoms among rural US adults. Future studies should test whether strategies for boosting lesson completion are successful in enhancing the efficacy of Thrive to reduce suicide risk. Trial Registration : National Institutes of Health Trial ID: NCT03595254.
Article
To date, no suicide behavior data related to school-based peer suicide prevention programs have been published. The Hope Squad program uses trained students to intentionally facilitate help-seeking with distressed peers. Suicide concern contact data (SCCD) from school counseling centers were collected from 2013 to 2017 as part of routine outcome-based program evaluation. Hope Squad school SCCD were organized by student gender, grade, and Hope Squad referral and were cross-tabulated with types of suicide concerns and hospitalizations. Over 1,100 contacts (N = 1,174) across 65 schools in 41 school districts were included in the analysis. The highest rates of all suicide-related contacts were among girls and students in the eighth and ninth grades. Reported attempts peaked in the ninth and tenth grades, then reduced through the 12th grade. Nearly a quarter of all contacts were Hope Squad referrals. These descriptive data provide a general overview of the types and frequencies of Hope Squad school suicide concerns that present in school counseling centers and are not indicative of program effectiveness. Next steps will include a research study comparing outcomes between Hope Squad schools and non-Hope Squad schools, and a study examining implementation adherence using fidelity measures.
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Introduction: Suicide is a complex public health problem in contemporary societies. Macroeconomic downturns derived from the economic crisis have been found to be associated with growing suicide mortality in the United States and in Europe. The present work is aimed to assess the association between the recent economic downturns and suicide patterns using interrupted time series analysis and, particularly, adjusting this relationship by indicators of social cohesion and community values that might provide additional insights on the complex explanation of suicidal trends. Methods: We combined suicide, social and economic data extracted from the National Statistics Institute (INE), the Eurostat database, and the World Values Survey to assess the association between the socio-economic factors and trends in suicide rates. To study the association between the financial crisis and changes in suicide rates in Spain, we used interrupted time series analysis (ITSA). Results: Our findings confirm that suicides increased after the 2011 recession, but remained moderately constant after the 2008 economic downturn. Suicides particularly increased after the 2011 recession in the 10-14, and 45-64 years old intervals between males and females, and apparently in older groups. However, during the 2008-2011 time period suicide rates decreased during working years (specifically among 40-44, 45-49, and 55-59 years old groups). Our results highlight the importance of social protection against unemployment and, to a lesser extent, social protection in disability and family, in reducing suicides, as well as the economic prosperity of the country. Conclusion: This result corroborates that the economic crisis has possibly impacted the growing suicide rates of the most vulnerable groups, but exclusively during the period characterised by economic cuts after the 2011 recession. This study highlights the need to implement tailored policies that protect these collectives against suicide.
Article
Utah ranks fifth in the nation for suicide and has experienced a rapid increase in youth deaths by suicide over the last decade. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth in Utah may be at heightened risk, given the major presence and stances of The Church of Jesus Christ of Latter-day Saints regarding LGBTQ identities and relationships. However, no research has yet examined the differences in or predictors of suicidal thoughts and behaviors (STBs; i.e., suicidal thoughts, plans, and attempts) among LGBTQ youth in Utah. Using a large representative sample of Utah middle and high schoolers (n = 73,982), we found that Latter-day Saint (LDS) and non-LDS LGBTQ groups reported greater levels of STBs than heterosexual/cisgender youth, with non-LDS LGBTQ youth reporting the highest levels of STBs, followed by LDS LGBTQ youth. Path-analyses demonstrated that LGBTQ participants’ reports of higher family conflict and lower parental closeness were tied to higher depression, self-harm, and substance misuse, and these three factors were, in turn, associated with higher levels of STBs for LGBTQ youth in Utah. This path model did not differ significantly due to LDS versus non-LDS religious affiliation. Findings suggest that LGBTQ youth in Utah would be well served if clinicians and advocacy groups pay attention to the ways that religious affiliation and family dynamics might indirectly lead to STBs among adolescents. Public Significance Statement: This study found that both Latter-day Saint and non-Latter-day Saint LGBTQ youth are at higher risk for experiencing suicidal thoughts and behaviors than their heterosexual or cisgender peers. Additionally, for LGBTQ youth, higher levels of family conflict and lower levels of parental closeness were related to more depression, substance misuse, self-harm, suicidal thoughts, and suicide attempts. These findings demonstrate the potential familial and religious risks that LGBTQ youth may experience in Utah.
Article
Background Suicide rates vary considerably across U.S. counties. Spatial non-stationarity may explain mixed findings on the relationship between suicide and income inequality. Methods This ecological study analyzed county-level income inequality and suicide rates for the timespan 2012-2016. Ordinary least squares regression, multilevel regression, and geographically weighted regression models were constructed while adjusting for age, race/ethnicity, gender, education, median income, unemployment, and urbanicity. Results Ordinary least squares regression and multilevel models found no significant association between income inequality and county suicide rates after adjusting for confounding variables. However, the geographically weighted regression model identified two main areas in which income inequality was negatively associated with suicide rates, as well as several counties across central U.S. in which income inequality was positively associated with suicide rates. Conclusion Income inequality's effect on county suicide rates may vary across space. Future research should consider spatial non-stationarity when studying suicide and macro-level socioeconomic conditions.
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Objective Social capital is a significant predictor of suicidal behaviors among Chinese rural migrants. However, the mechanism, including the impact of employment and mental health, has not been fully understood. This study aims to examine the complex relationships linking social capital to suicidal behaviors. Method Data were collected from a probability sample (n = 1,245) of rural migrants in Wuhan, China. Social capital was used to predict suicidal behaviors, with employment uncertainty as step 1 mediator and anxiety as step 2 mediator. Suicidal ideation and attempt were analyzed separately using a chained moderated mediation model. Years of migration was included as moderator in all models to control its confounding effect. Results Of the total sample, 50.9% were male with mean age of 32.0 (SD = 7.8) years. The association between social capital and suicidal ideation was significantly mediated by employment uncertainty (indirect effect [95% CI] = −0.14 [−0.24, −0.04]), but not for suicidal attempt (−0.02 [−0.20, 0.15]). Anxiety significantly mediated the same association for both suicidal ideation (−0.19 [−0.37, −0.01]) and attempt (−0.20 [−0.40, −0.01]). The chained relationship from social capital to employment uncertainty, anxiety, and suicidal behaviors was also significant with indirect effect of −0.05 [−0.09, −0.01] for both suicidal ideation and attempt. Similar results were observed for bonding and bridging capital. Conclusions Social capital may exert an effect on suicidal behaviors through employment and mental health among rural migrants in China. Social capital–based suicide prevention must consider both employment and mental health problems to obtain better effects. • Highlights • Employment and anxiety mediate social capital–suicidal behavior relation. • Bonding capital affects anxiety and bridging capital affects employment. • There is a chained relation among social capital, employment, anxiety, and suicidal behaviors.
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Background Although previous studies have reported that suicide mortality was associated with social capital, the relation between social capital and suicide mortality has remained controversial. Thus, we evaluated the relation between social capital and suicide mortality in rural areas of Japan, and examined the association between temporal changes in social capital and suicide mortality over the last ten years. Methods We examined the Standardized Mortality Ratio (SMR) for suicide for 26 municipalities of Miyazaki Prefecture and used the data to calculate the average suicide SMRs for two five-year periods: an earlier period, 2004–2008; and a later period, 2012–2016. Social capital (social cohesion and social participation of older people) was measured using information from questionnaire surveys. A multiple linear regression analysis of suicide SMR was conducted for each social capital variable, adjusting for potential confounding factors (population density, the proportion of older people, annual divorce rate, unemployment rate, and proportion of workers engaged in primary industries). Results We demonstrated that male suicide SMR for the earlier period was significantly and positively associated with social cohesion after the adjustment of confounding factors. Temporal changes in male suicide SMRs were significantly and negatively associated with temporal changes in the social participation of older people in the adjusted model. No association was found for female suicide SMRs in either period. Conclusion The present findings suggest that the social participation of older people might reduce suicide among males.
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U.S. suicide rates vary across the states and are higher in the American West than in other regions. Reasons for these patterns have eluded social scientists. This research note examines whether residential stability and population density as ecological contexts for social integration help explain the patterns. Reflecting Durkheimian reasoning, results suggest that residential stability helps explain both the high Western suicide rate and state suicide rates more generally. Final remarks address the theoretical and empirical implications of the findings.
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Social capital is commonly defined as features of social relationships, such as levels of interpersonal trust and norms of reciprocity and mutual aid, that facilitate collective action for mutual benefit. An extended research tradition exists around the contextual effects of social capital at the level of geographical areas such as neighborhoods, but more recently workplace social capital has received growing attention in literature. An overview of the different theoretical approaches and empirical findings of the concept of workplace social capital will be presented. Studies have shown associations between workplace social capital and indicators of mental and physical health, but very few research has focused on the relation with cardiovascular disease. An integrated theoretical model of reciprocity as key aspect of social capital was developed that distinguishes both emotional and instrumental dimensions of reciprocity among coworkers and supervisors at the individual and workplace level. This model has been empirically tested using data from the BELSTRESS study including more than 24.000 middle-aged men and women at work in 32 different workplaces. Data were collected through self-administered questionnaires and bio-clinical examinations. Results will be presented on the impact of workplace social capital on behavioral and clinical cardiovascular risk factors.
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We examined the contextual effect of workplace social capital on systolic blood pressure (SBP). Cross-sectional. A conglomerate from 58 workplaces in Japan. Of the 5844 workers at a Japanese conglomerate from 58 workplaces, 5368 were recruited. Individuals who received drugs for hypertension (n=531) and who lacked information on any variable (n=167) were excluded from the analyses, leaving 4735 individuals (3281 men and 1454 women) for inclusion. PRIMARY AND SECONDARY OUTCOME MEASURES: Systolic blood pressure. The contextual effect of workplace social capital on SBP was examined using a multilevel regression analysis with a random intercept. Coworker support had a contextual effect at the workplace level (coefficient=-1.97, p=0.043), while a lack of trust for coworkers (coefficient=0.27, p=0.039) and lack of helpfulness from coworkers were associated with SBP (coefficient=0.28, p=0.002). The present study suggested that social capital at the workplace level has beneficial effects on SBP.
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Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is an independent not-for-profit organization dedicated to and preserving a digital archive of scholarly journals. For more information regarding JSTOR, please contact support@jstor.org. One of sociology's defining debates centers on explanations of the geographic pat-terning of suicide. This classic debate is revisited using techniques of spatial analy-sis and data for two geographies: late nineteenth-century French departments, and late twentieth-century U.S. counties. Results of the French analysis contradict Durkheim 's claim that "imitation " plays no role in shaping the geographic pattern-ing of suicide. Suicide rates for northern and southern French departments cluster geographically even when the clustering of multiple dimensions of social integration is controlled. These findings are replicated in a contemporary analysis of nonwestern U.S. counties. Results for the American West, however, support the Durkheimian view that suicide clusters in geographic space only because important structural predictors of suicide, including measures of social integration, do so as well. These discrepant findings are reconciled and it is concluded that the geo-graphic patterning of suicide is shaped by both social integration and imitation.
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Since Durkheim's classic work on suicide, sociological attention to understanding the roots of self-destruction has been inconsistent. In this review, we use three historical periods of interest (pre-Durkheim, Durkheim, post-Durkheim) to organize basic findings in the body of sociological knowledge regarding suicide. Much of the twentieth-century research focused on issues of integration and regulation, imitation, and the social construction of suicide rates. Innovations in the twenty-first-century resurgence of sociological research on suicide are described in detail. These newer studies begin to redirect theory and analysis toward a focus on ethnoracial subgroups, individual-level phenomena (e.g., ideation), and age-period-cohort effects. Our analysis of sociology's contributions, limits, and possibilities leads to a recognition of the need to break through bifurcations in individual- and aggregate-level studies, to pursue the translation of Durkheim's original theory into a network perspective as one avenue of guiding micro-macro research, and to attend to the complexity in both multidisciplinary explanations and pragmatic interventions.
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We are interested in the relationship between public policies and outcomes measuring quality of life. There is no outcome more final than the ending of one’s own life. Accordingly, we test the relationship between public policy regimes and suicide rates in the American states. Controlling for other relevant factors (most notably a state’s stock of social capital), we find that states with higher per capita public assistance expenditures tend to have lower suicide rates. This relationship is of significant magnitude when translated into potential lives saved each year. We also find that general state policy liberalism and the governing ideologies of state governments are linked to suicide rates. In response to a growing literature on the importance of non-political factors such as social connectedness in determining quality of life, these findings demonstrate that government policies remain important determinates as well.
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We examined the association between workplace social capital and all-cause mortality in a large occupational cohort from Finland. We linked responses of 28 043 participants to surveys in 2000 to 2002 and in 2004 to national mortality registers through 2009. We used repeated measurements of self- and coworker-assessed social capital. We carried out Cox proportional hazard and fixed-effects logistic regressions. During the 5-year follow-up, 196 employees died. A 1-unit increase in the mean of repeat measurements of self-assessed workplace social capital (range 1-5) was associated with a 19% decrease in the risk of all-cause mortality (age- and gender-adjusted hazard ratio [HR] = 0.81; 95% confidence interval [CI] = 0.66, 0.99). The corresponding point estimate for the mean of coworker-assessed social capital was similar, although the association was less precisely estimated (age- and gender-adjusted HR = 0.77; 95% CI = 0.50, 1.20). In fixed-effects analysis, a 1-unit increase in self-assessed social capital across the 2 time points was associated with a lower mortality risk (odds ratio = 0.81; 95% CI = 0.55, 1.19). Workplace social capital appears to be associated with lowered mortality in the working-aged population.
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Although there is increasing evidence supporting the associations between social capital and health, less is known of potential effects in Latin American countries. Our objective was to examine associations of different components of social capital with self-rated health in Colombia. The study had a cross-sectional design, using data of a survey applied to a nationally representative sample of 3025 respondents, conducted in 2004-2005. Stratified random sampling was performed, based on town size, urban/rural origin, age, and sex. Examined indicators of social capital were interpersonal trust, reciprocity, associational membership, non-electoral political participation, civic activities and volunteering. Principal components analysis including different indicators of social capital distinguished three components: structural-formal (associational membership and non-electoral political participation), structural-informal (civic activities and volunteering) and cognitive (interpersonal trust and reciprocity). Multilevel analyses showed no significant variations of self-rated health at the regional level. After adjusting for sociodemographic covariates, interpersonal trust was statistically significantly associated with lower odds of poor/fair health, as well as the cognitive social capital component. Members of farmers/agricultural or gender-related groups had higher odds of poor/fair health, respectively. Excluding these groups, however, associational membership was associated with lower odds of poor/fair health. Likewise, in Colombians with educational attainment higher than high school, reciprocity was associated with lower odds of fair/poor health. Nevertheless, among rural respondents non-electoral political participation was associated with worse health. In conclusion, cognitive social capital and associational membership were related to better health, and could represent important notions for health promotion. Human rights violations related to political violence and gender based discrimination may explain adverse associations with health.
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Social capital may influence health and the patterns of association differ according its dimension such as cognitive, behavioral, bridging or bonding. There is a few numbers of studies in Latin America which comprise these aspects of social capital and health. The aim of this study was to examine the association between social capital and self-rated health among youth, and distinguish between the different forms of social capital - cognitive versus behavioral, and bonding versus bridging. A cross-sectional study was conducted in 2009 among working adolescents supported by a Brazilian NGO. The sample comprised 363 individuals and data were collected using a validated structured questionnaire. The outcome, self-rated health, was measured as a dichotomous variable (poor/good health) and fourteen social capital indicators were investigated (cognitive, behavioral and bonding/bridging). Data were analyzed using multivariate logistic regression. Cognitive (social support and trust), behavioral (civic participation) and bridging social capital were associated with good self-rated health after adjustment of all the other social capital indicators and confounders (sex, age, skin color and educational background). Social capital was associated with self-rated health and the patterns of association differed according its specific dimensions. Cognitive, behavioral and bridging social capitals were protective for adolescents health living in a developing country context..
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A national cross-sectional survey was conducted in Japan. This is because the growing recognition of the social determinants of health has stimulated research on social capital and mental health. In recent years, systematic reviews have found that social capital may be a useful factor in the prevention of mental illness. Despite these studies, evidence on the association between social capital and mental health is limited as there have been few empirical discussions that adopt a multilevel framework to assess whether social capital at the ecological level is associated with individual mental health. The aim of this study was to use the multilevel approach to investigate the association between neighborhood social capital and mental health after taking into account potential individual confounders. We conducted a multilevel analysis on 5,956 individuals nested within 199 neighborhoods. The outcome variable of self-reported mental health was measured by the one dimension of SF-36 and was summed to calculate a score ranging from 0 to 100. This study showed that high levels of cognitive social capital, measured by trust (regression coefficient = 9.56), and high levels of structural social capital, measured by membership in sports, recreation, hobby, or cultural groups (regression coefficient = 8.72), were associated with better mental health after adjusting for age, sex, household income, and educational attainment. Furthermore, after adjusting for social capital perceptions at the individual level, we found that the association between social capital and mental health also remained. Our findings suggest that both cognitive and structural social capital at the ecological level may influence mental health, even after adjusting for individual potential confounders including social capital perceptions. Promoting social capital may contribute to enhancing the mental health of the Japanese.
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Suicide officially kills approximately 30,000 annually in the United States. Analysis of this leading public health problem is complicated by undercounting. Despite persisting socioeconomic and health disparities, non-Hispanic Blacks and Hispanics register suicide rates less than half that of non-Hispanic Whites. This cross-sectional study uses multiple cause-of-death data from the US National Center for Health Statistics to assess whether race/ethnicity, psychiatric comorbidity documentation, and other decedent characteristics were associated with differential potential for suicide misclassification. Subjects were 105,946 White, Black, and Hispanic residents aged 15 years and older, dying in the US between 2003 and 2005, whose manner of death was recorded as suicide or injury of undetermined intent. The main outcome measure was the relative odds of potential suicide misclassification, a binary measure of manner of death: injury of undetermined intent (includes misclassified suicides) versus suicide. Blacks (adjusted odds ratio [AOR], 2.38; 95% confidence interval [CI], 2.22-2.57) and Hispanics (1.17, 1.07-1.28) manifested excess potential suicide misclassification relative to Whites. Decedents aged 35-54 (AOR, 0.88; 95% CI, 0.84-0.93), 55-74 (0.52, 0.49-0.57), and 75+ years (0.51, 0.46-0.57) showed diminished misclassification potential relative to decedents aged 15-34, while decedents with 0-8 years (1.82, 1.75-1.90) and 9-12 years of education (1.43, 1.40-1.46) showed excess potential relative to the most educated (13+ years). Excess potential suicide misclassification was also apparent for decedents without (AOR, 3.12; 95% CI, 2.78-3.51) versus those with psychiatric comorbidity documented on their death certificates, and for decedents whose mode of injury was "less active" (46.33; 43.32-49.55) versus "more active." Data disparities might explain much of the Black-White suicide rate gap, if not the Hispanic-White gap. Ameliorative action would extend from training in death certification to routine use of psychological autopsies in equivocal-manner-of-death cases.
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"Social capital" refers to the existence of voluntary community networks and relationships based on trust, and the use of these networks and relationships to enable positive social action. Social capital is positively associated with selected indices of mental health. We performed an ecological investigation of the relationship between social trust (as one component of social capital) and national suicide rates in 11 European countries (n=22,227). There was an inverse relationship between social trust and national suicide rates (i.e. the higher the social trust, the lower was the suicide rate), after controlling for gender, age, marriage rates, standardised income and reported sadness. Social capital may have a protective effect against suicide at the national level. Multi-level analysis, taking into account both group-level and individual-level variables, would help clarify this relationship further and guide appropriate interventions at both the group and individual levels.
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Most panel data studies have employed overall suicide rates (male and female) to identify the determinants of suicide. This research has also neglected the use of country specific linear time trends. Neglecting these factors may confound the empirical estimates of socio-economic variables due to the impact of unobserved country specific determinants of suicide that are time-varying. Empirical results from 15 European countries between 1970 and 1998 support this hypothesis. Specifically, economic growth, fertility rate, and alcohol consumption seem to have a significant impact on male and female suicide rates after the inclusion of country specific linear trends. Contrary to prior studies, suicide rates were not sensitive to income levels, female labour participation rates and unemployment. In addition, the effect of divorce rate is specific to gender. Finally, the results also illustrate the importance of employing age-specific suicide rates compared to what has been traditionally used, in trying to evaluate the factors responsible for suicide mortality. In particular, the impact of socio-economic factors is not equal across age groups, and policies aimed at the prevention of suicide should take this into account.
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The objective of this study was to explore correlates of the use of firearms to commit suicide. A national sample of psychiatric patients discharged from Department of Veterans Affairs medical centers was followed from the time of discharge until December 1999. The study explores state-level measures as correlates of overall suicide and suicide by firearm, controlling for individual sociodemographic characteristics and psychiatric diagnosis. The outcomes of interest were completed suicide and suicide by firearm. Patients who were male, Caucasian, and who had a diagnosis of substance abuse or post-traumatic stress disorder were significantly more likely to use a firearm than another means to commit suicide. Multivariable models indicated that veterans living in states with lower rates of gun ownership, more restrictive gun laws, and higher social capital were less likely to commit suicide with a firearm. Gun ownership rates, legislation, and levels of community cohesiveness are significantly associated with the likelihood of psychiatric patients committing suicide with a gun.
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African American women have lower suicide rates than other women and men in the United States They may possess suicide buffers including social support, religiosity, negative attitudes regarding suicide acceptability, and African American culture. To examine the relationships buffers may have with suicide ideation, 300 African American female college students completed measures of suicide ideation and buffers. Three variables accounted for a significant and unique portion of the variance in suicide ideation: family support, a view that suicide is unacceptable, and a collaborative religious problem-solving style. The identification of these factors may help in the assessment, prevention, and intervention of suicide for African American women and other women and men.
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The continual rise in the U.S. military's suicide rate since 2004 is one of the most vexing issues currently facing military leaders, mental health professionals, and suicide experts. Despite considerable efforts to address this problem, however, suicide rates have not decreased. The authors consider possible reasons for this frustrating reality, and question common assumptions and approaches to military suicide prevention. They further argue that suicide prevention efforts that more explicitly embrace the military culture and implement evidence-based strategies across the full spectrum of prevention and treatment could improve success. Several recommendations for augmenting current efforts to prevent military suicide are proposed.
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The association between workplace factors and the development of hypertension remains uncertain. We examined the risk of hypertension as a function of workplace social capital, that is, social cohesion, trust and reciprocity in the workplace. A total of 11 777 male and 49 145 female employees free of chronic hypertension at baseline in 2000-2004 were followed up for incident hypertension until the end of 2005 (the Finnish Public Sector Study). We used survey responses from the participants and their coworkers in the same work unit to assess workplace social capital at baseline. Follow-up for incident hypertension was based on record linkage to national health registers (mean follow-up 3.5 years, 1424 incident hypertension cases). Male employees in work units characterized by low workplace social capital were 40-60% more likely to develop chronic hypertension compared to men in work units with high social capital [age-adjusted hazard ratio 1.57, 95% confidence interval (CI) 1.15-2.14 for self-assessed social capital and 1.41, 95% CI 1.01-1.97 for coworkers' assessment]. According to path analysis adjusted for covariates, the association between low self-reported social capital and hypertension was partially mediated by obesity (P for pathway = 0.02) and alcohol consumption (P = 0.03). For coworker-assessed social capital, the corresponding mediation pathways did not reach statistical significance (P = 0.055 and 0.22, respectively). No association between workplace social capital and hypertension was found for women. These data suggest that low self-reported workplace social capital is associated with increased near-term risk of hypertension in men in part due to unhealthy lifestyle.