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Abstract
Background
Lower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is unclear in low and middle income countries.
Methods
We investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment, and young (≤40 years) female headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the last year were recorded. Random effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide.
Results
Households reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2 95% CI 2.4, 4.4) and having a daily wage labourer (i.e. insecure/low income job) (OR 2.3 95% CI 1.6, 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared to farmers. The strongest associations were with low levels of education (OR 4.6 95% CI 2.5, 8.4), with a stronger association in men than women.
Conclusion
We found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association.
Lower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is unclear in low and middle income countries.
Methods
We investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment, and young (≤40 years) female headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the last year were recorded. Random effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide.
Results
Households reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2 95% CI 2.4, 4.4) and having a daily wage labourer (i.e. insecure/low income job) (OR 2.3 95% CI 1.6, 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared to farmers. The strongest associations were with low levels of education (OR 4.6 95% CI 2.5, 8.4), with a stronger association in men than women.
Conclusion
We found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association.
Original language | English |
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Article number | e014006 |
Number of pages | 10 |
Journal | BMJ Open |
Volume | 7 |
Issue number | 3 |
Early online date | 22 Mar 2017 |
DOIs | |
Publication status | Published - Mar 2017 |
Research Groups and Themes
- Centre for Surgical Research
- SASH
Keywords
- Suicide
- Sri Lanka
- Socioeconomic position
- Self-harm
- Asia
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- 1 Finished
Profiles
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Dr Duleeka Knipe
- Bristol Medical School (PHS) - Associate Professor in Global Mental Health
- Bristol Poverty Institute
- Migration Mobilities Bristol
- Bristol Population Health Science Institute
Person: Academic , Member
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Professor Chris Metcalfe
- Bristol Medical School (PHS) - Professor of Medical Statistics
- Bristol Population Health Science Institute
- Centre for Academic Mental Health
- Cancer
Person: Academic , Member