Pathways to suicidality across ethnic groups in Canadian adults: the possible role of social stress.
BACKGROUND
Ethnicity is an important determinant of mental health outcomes including suicidality (i.e. suicidal ideation and suicide attempt). Understanding ethnic differences in the pathways to suicidality is important for suicide prevention efforts in ethnically diverse populations. These pathways can be conceptualized within a social stress framework.


METHODS
The study examines ethnic differences in the pathways to suicidality in Canada within a social stress framework. Using data from the Canadian Community Health Survey Cycle 1.1 (CCHS 1.1) and path analysis, we examined the hypotheses that variations in (1) socio-economic status (SES), (2) sense of community belonging (SCB), (3) SES and SCB combined, and (4) SES, SCB and clinical factors combined can explain ethnic differences in suicidality.


RESULTS
Francophone whites and Aboriginals were more likely to report suicidality compared to Anglophone whites whereas visible minorities and Foreign-born whites were least likely. Disadvantages in income, income and education, income and its combined effect with depression and alcohol dependence/abuse led to high rates even among the low-risk visible minority group. Indirect pathways for Asians differed from that of Blacks and South Asians, specifically through SCB. With the exception of SCB, Aboriginals were most disadvantaged, which exacerbated their risk for suicidality. However, their strong SCB buffered the risk for suicidality across pathways. Disadvantages in education, income and SCB were associated with the high risk for suicidality in Francophone whites.


CONCLUSIONS
Francophone whites and Aboriginals had higher odds of suicidality compared to Anglophone whites; however, some pathways differed, indicating the need for targeted program planning and prevention efforts.
Clarke
D E
DE
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. dclarke@jhsph.edu
Colantonio
A
A
Rhodes
A E
AE
Escobar
M
M
D000328:Adult; D000367:Age Factors; D002170:Canada / Q000453:epidemiology; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data; D005006:Ethnicity / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data; D044382:Population Groups / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012917:Social Adjustment; D012923:Social Class; D013315:Stress, Psychological / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D013405:Suicide / Q000208:ethnology* / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention