Suicide in developing countries (1): frequency, distribution, and association with socioeconomic indicators.
OBJECTIVE
Suicide is a global public health problem, but relatively little epidemiological investigation of the phenomenon has occurred in developing countries. This paper aims to (1) examine the availability of rate data in developing countries, (2) provide a description of the frequency and distribution of suicide in those countries for which data are available, and (3) explore the relationship between country-level socioeconomic factors and suicide rates. It is accompanied by two companion papers that consider risk factors and preventive efforts associated with suicide in developing countries, respectively.


METHODS
Using World Health Organization data, we calculated the average annual male, female, and total suicide rates during the 1990s for individual countries and regions (classified according to the Human Development Index [HDI]), and examined the association between a range of socioeconomic indicators and suicide rates.


RESULTS
For reasons of data availability, we concentrated on medium HDI countries. Suicide rates in these countries were variable. They were generally comparable with those in high HDI countries from the same region, with some exceptions. High education levels, high telephone density, and high per capita levels of cigarette consumption were associated with high suicide rates; high levels of inequality were associated with low suicide rates.


CONCLUSIONS
Epidemiological investigations of this kind have the potential to inform suicide prevention efforts in developing countries, and should be encouraged.
Vijayakumar
Lakshmi
L
SNEHA & VHS, Chennai, India. dr_svk@vsnl.com
Nagaraj
K
K
Pirkis
Jane
J
Whiteford
Harvey
H
D002423:Cause of Death; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D012306:Risk; D012737:Sex Factors; D012922:Social Change; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013405:Suicide / Q000706:statistics & numerical data*