Income-related inequality in completed suicide across the provinces of Iran.

Mohammad Hassan Kazemi-Galougahi,Asieh Mansouri,Rahmatollah Moradzadeh,Mahmood Bakhtiyari,Samaneh Akbarpour,Majid Sartipi

doi:10.4178/epih.e2018012

Abstract

OBJECTIVESThe aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran.METHODSThis ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran.RESULTSThe Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06).CONCLUSIONSThis study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.

Highlights

Suicide is defined as a conscious effort to carry out self-damage that can lead to death [1]
In Ilam Province in Iran, which has a high prevalence of suicide, the attempted suicide rates were found to be highest in females, adolescents and young adults (15-24 years) and single individuals, while completed suicide was found to be most frequent in males, the elderly (≥ 65 years), divorced people, and widowers
The concentration index is a bivariate index of inequality, calculated as twice the covariance of the health-related outcome variable and the fractional rank in the socioeconomic status (SES)-related variable divided by the mean of the health-related outcome [21]

Summary

Introduction

Suicide is defined as a conscious effort to carry out self-damage that can lead to death [1]. The risk of suicide has been associated with many factors, such as mental disorders, unemployment, low income, ethnicity, genetic loading, sex, age, and life events [9,10]. These factors may influence attempted and completed suicide differently [3]. Akbari et al [2] reported that people with higher intrinsic religious beliefs committed suicide significantly less often They explained this finding in terms of the greater social support received by such people in Iran [2]

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