Suicide has become a pressing public health issue, especially in the Region of the Americas, where the suicide mortality rate increased between 2000 and 2019, despite national and international efforts to reduce it. The suicide mortality rate varies considerably within the region, with the North American region having the highest rate and the Andean Area region having the lowest rate, possibly due to sociocultural differences between regions. There are also significant differences in the suicide mortality rate between countries, with Guyana having the highest rate and Barbados having the lowest rate.
According to a study in The Lancet Regional Health, there has been little research on the environmental elements that lead to a country’s high or low suicide mortality rate. This has had a remarkable impact on the Americas. The primary goal of this study was to determine what variables contributed to the high rate of sex-related suicide in the Americas from 2000 to 2019. The study’s authors hope that health officials will use the findings to focus on specific areas of suicide prevention and to guide the establishment and execution of national public health programs.
The social and cultural elements contributing to the disparity in male and female suicide rates may differ by gender in various nations. By applying sex-specific contextual factor analysis, suicide prevention initiatives may benefit from a better knowledge of the variables that may be more significantly affecting one sex’s suicide mortality rate than the other.
Previous research has demonstrated the influence of community-level contextual variables on mental health, leading to suggestions for population-based methods of suicide prevention. Lund created a conceptual framework for the social determinants of mental diseases, including demographic, economic, neighborhood, environmental, and social and cultural domains, and was used to inform a literature review-based study of macro-level variables linked with suicide.
The findings of this study are critical for reducing suicide in general and for developing public health policies and efforts explicitly geared at preventing suicide in the Americas. Suicide mortality rates in the Region of the Americas have been increasing, especially among females, highlighting the urgent need for enhanced prevention efforts.
The study found that between 2000 and 2019, the suicide mortality rate among males in the region showed an overall upward trend, while the rate among females significantly increased annually on average by 1.25%. Most countries in the region showed a notably higher suicide mortality rate among males than females.
The study also identified population-level contextual factors associated with suicide that can inform targeted suicide prevention efforts. The findings of the study may help health authorities determine their focus for public health strategies targeting suicide prevention and aid in the development and tailoring of national suicide prevention efforts to maximize benefits.
The researchers uncovered contextual factors in the Americas that correlate to suicide deaths. Men’s suicide mortality rates, on the other hand, tend to climb in parallel with rates of murder, intravenous drug use, risk-adjusted alcohol consumption, and unemployment. Female suicide rates tend to fall when the number of physicians per 10,000 people and the fraction of the country with a moderate population density rise, as do relative education inequality and the unemployment rate.
The suicide mortality rate in both sexes was also shown to be substantially related to population density and unemployment rate. This study underscores the need to consider sex-specific differences in suicidal behavior when developing, implementing, and evaluating interventions to lower suicide risk and when developing national suicide prevention strategies.
The findings support the World Health Organization’s Live Life Strategy for Suicide Prevention, emphasizing scenario analysis and cross-sector collaboration. This method emphasizes that the contextual factors associated with suicide mortality vary by population group, necessitating whole-society collaboration and action that brings together diverse representatives from sectors such as Social Affairs and Welfare, Planning and Development, Education, and Labor/Employment, as well as people who have lived experience with mental health issues and suicide.
Yet, the researchers point out that their findings have limitations, such as that their estimations of contextual variables at the national level are simply an approximation based on the population as a whole. Moreover, the data used were acquired from only one sex, and other potential confounding variables were not considered. This study could also not prove causation due to its ecological character and data-driven approach to variable selection. Yet, the research design allowed for the investigation of exposure data previously only available at the national level.
Overall, the study as a whole suggests that, in addition to other suicide prevention strategies such as addressing alcohol and substance use, health expenditure per capita, homicide, unemployment, and educational inequality, which are all linked to suicide, improving social connectedness and civic opportunities may be worth investigating as potential suicide prevention strategies.