Influence of social and material individual and area deprivation on suicide mortality among 2.7 million Canadians: A prospective studyReport as inadecuate

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BMC Public Health

, 11:577

Health behavior, health promotion and society


BackgroundFew studies have investigated how area-level deprivation influences the relationship between individual disadvantage and suicide mortality. The aim of this study was to examine individual measures of material and social disadvantage in relation to suicide mortality in Canada and to determine whether these relationships were modified by area deprivation.

MethodsUsing the 1991-2001 Canadian Census Mortality Follow-up Study cohort N = 2,685,400, measures of individual social civil status, family structure, living alone and material education, income, employment disadvantage were entered into Cox proportional hazard models to calculate hazard ratios HR and 95% confidence intervals CI for male and female suicide mortality. Two indices of area deprivation were computed - one capturing social, and the other material, dimensions - and models were run separately for high versus low deprivation.

ResultsAfter accounting for individual and area characteristics, individual social and material disadvantage were associated with higher suicide mortality, especially for individuals not employed, not married, with low education and low income. Associations between social and material area deprivation and suicide mortality largely disappeared upon adjustment for individual-level disadvantage. In stratified analyses, suicide risk was greater for low income females in socially deprived areas and males living alone in materially deprived areas, and there was no evidence of other modifying effects of area deprivation.

ConclusionsIndividual disadvantage was associated with suicide mortality, particularly for males. With some exceptions, there was little evidence that area deprivation modified the influence of individual disadvantage on suicide risk. Prevention strategies should primarily focus on individuals who are unemployed or out of the labour force, and have low education or income. Individuals with low income or who are living alone in deprived areas should also be targeted.

List of abbreviations95% CI95% confidence interval

EAcensus enumeration areas

HRhazard ratio

ICDInternational Classification of Diseases

USUnited States.

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Author: Stephanie Burrows - Nathalie Auger - Philippe Gamache - Danielle St-Laurent - Denis Hamel



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