title: Suicide and poverty in low-income and middle-income countries: a systematic review.
abstract: Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events.
authors.affiliation: London School of Economics and Political Science, London, UK. Electronic address: v.iemmi@lse.ac.uk.
authors.forename: Valentina
authors.initials: V
authors.lastname: Iemmi
authors.affiliation: Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Jason
authors.initials: J
authors.lastname: Bantjes
authors.affiliation: London School of Economics and Political Science, London, UK.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Coast
authors.affiliation: Peterborough Child Development Centre, Peterborough, UK.
authors.forename: Kerrie
authors.initials: K
authors.lastname: Channer
authors.affiliation: London School of Economics and Political Science, London, UK.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Leone
authors.affiliation: London School of Economics and Political Science, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: McDaid
authors.affiliation: London School of Economics and Political Science, London, UK.
authors.forename: Alexis
authors.initials: A
authors.lastname: Palfreyman
authors.affiliation: Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Bevan
authors.initials: B
authors.lastname: Stephens
authors.affiliation: University of Cape Town, Cape Town, South Africa.
authors.forename: Crick
authors.initials: C
authors.lastname: Lund
mesh_terms: D003906:Developing Countries / Q000706:statistics & numerical data*; D006801:Humans; D065228:Non-Randomized Controlled Trials as Topic; D011203:Poverty / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*