Social Determinants of Health and Suicide-Related Outcomes: A Review of Meta-Analyses
Preventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide. To examine the associations of SDOH with suicide-relat...
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| Vydané v: | JAMA psychiatry (Chicago, Ill.) Ročník 82; číslo 4; s. 337 |
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| Hlavní autori: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.04.2025
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| ISSN: | 2168-6238, 2168-6238 |
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| Abstract | Preventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide.
To examine the associations of SDOH with suicide-related outcomes.
Studies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023.
We included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes.
Three independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses.
The main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation.
A total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system-involved individuals in the community, exposure to others' and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation.
Tailoring interventions and future research for identified priority subpopulations, such as justice system-involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk. |
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| AbstractList | Preventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide.ImportancePreventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide.To examine the associations of SDOH with suicide-related outcomes.ObjectiveTo examine the associations of SDOH with suicide-related outcomes.Studies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023.Data SourcesStudies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023.We included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes.Study SelectionWe included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes.Three independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses.Data Extraction and SynthesisThree independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses.The main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation.Main Outcomes and MeasuresThe main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation.A total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system-involved individuals in the community, exposure to others' and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation.ResultsA total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system-involved individuals in the community, exposure to others' and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation.Tailoring interventions and future research for identified priority subpopulations, such as justice system-involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk.Conclusions and RelevanceTailoring interventions and future research for identified priority subpopulations, such as justice system-involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk. Preventing suicide is one of the top priorities in public health policy. Identifying key social determinants of health (SDOH) in suicide risk is critical for informing clinical practices, future research, and policy solutions to prevent suicide. To examine the associations of SDOH with suicide-related outcomes. Studies published before July 2023 were searched through PubMed, PsycINFO, Embase, and Web of Science. The date of the search was August 4, 2023. We included the most up-to-date meta-analyses reporting associations between SDOH and suicide-related outcomes. Three independent reviewers extracted data and conducted quality assessment using the Joanna Briggs Institute Checklist for Systematic Reviews and Research Syntheses. The main outcomes of interest were suicide mortality, suicide attempt, and suicidal ideation. A total of 46 meta-analyses met inclusion criteria. For suicide mortality, justice system-involved individuals in the community, exposure to others' and parental suicide, firearm accessibility, divorce, experience in foster care, release from incarceration, and midlife (age 35-65 years) unemployment were the SDOH with consistently strong effects. Individuals released from incarceration demonstrated a high prevalence of suicide mortality (114.5 per 100 000 persons). With regard to suicide attempt, experience of childhood abuse and maltreatment and sexual assault, gender and sexual minority status, and parental suicide mortality were the strongest risk factors. The prevalence of suicide attempt among homeless individuals (28.9%; 95% CI, 21.7%-37.2%) and incarcerated female youths (27%; 95% CI, 20%-34%) and adults (12.2%; 95% CI, 7.1%-17.2%) was high. For suicidal ideation, identification as bisexual and intimate partner violence in women were the strongest risk factors. The prevalence of lifetime suicidal ideation in homeless individuals was 41.6% (95% CI, 28.6%-56.0%). Protective factors associated with reduced risk of suicide mortality were religious affiliation and being married. School connectedness showed protective associations against suicide attempt and suicidal ideation. Tailoring interventions and future research for identified priority subpopulations, such as justice system-involved individuals in the community, and implementing policy measures addressing the SDOH that showed strong associations with suicide mortality, attempts, and ideation, such as gun licensing requirements, are critical to counteracting social and environmental forces that increase suicide risk. |
| Author | Jester, Dylan J Jeste, Dilip V Bandara, Piumee Moutier, Christine Y Shin, Jeonghyun Oquendo, Maria A Kim, Jim Yong Na, Peter Jongho Kwak, Ha Rim Lee, Jaewon Pietrzak, Robert H |
| Author_xml | – sequence: 1 givenname: Peter Jongho surname: Na fullname: Na, Peter Jongho organization: Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut – sequence: 2 givenname: Jeonghyun surname: Shin fullname: Shin, Jeonghyun organization: College of Medicine, Seoul National University, Seoul, Republic of Korea – sequence: 3 givenname: Ha Rim surname: Kwak fullname: Kwak, Ha Rim organization: Vagelos College of Physicians and Surgeons, Columbia University, New York, New York – sequence: 4 givenname: Jaewon surname: Lee fullname: Lee, Jaewon organization: Department of Psychiatry, University of Rochester, Rochester, New York – sequence: 5 givenname: Dylan J surname: Jester fullname: Jester, Dylan J organization: Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California – sequence: 6 givenname: Piumee surname: Bandara fullname: Bandara, Piumee organization: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom – sequence: 7 givenname: Jim Yong surname: Kim fullname: Kim, Jim Yong organization: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts – sequence: 8 givenname: Christine Y surname: Moutier fullname: Moutier, Christine Y organization: American Foundation for Suicide Prevention, New York, New York – sequence: 9 givenname: Robert H surname: Pietrzak fullname: Pietrzak, Robert H organization: Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut – sequence: 10 givenname: Maria A surname: Oquendo fullname: Oquendo, Maria A organization: Perelman School of Medicine, University of Pennsylvania, Philadelphia – sequence: 11 givenname: Dilip V surname: Jeste fullname: Jeste, Dilip V organization: Global Research Network on Social Determinants of Mental Health and Exposomics, La Jolla, California |
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| Title | Social Determinants of Health and Suicide-Related Outcomes: A Review of Meta-Analyses |
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