New PAHO study highlights drivers behind suicide in the Americas

A new study by the Pan American Health Organization (PAHO) and partners published on February 23, 2023 in The Lancet Regional Health – Americas highlights the importance of considering gender-specific social determinants of suicide when developing risk reduction interventions and prevention strategies.

The article Contextual factors associated with country-level suicide mortality in the Americas, 2000-2019, identified that while homicide and the use of alcohol and other substances are associated with an increase in suicide mortality among males, educational inequality was the main factor among females, a PAHO release states.

For both sexes, unemployment was associated with an increase in suicide mortality.

“In order to prevent suicide we must go beyond limiting access to methods of suicide, strengthening socio-emotional skills, and improving access to mental health care,” Dr. Renato Oliveira e Souza, head of Mental Health and Substance Use at PAHO, and one of the authors of the article, said. “We must also address the contextual factors that affect men and women differently, which require an all-of-society approach.”

Increasing employment opportunities, improving access to and availability of health services including those for substance use, could potentially reduce suicide mortality rates. Enhancing social connections in rural and under-populated areas is also a recommended suicide prevention strategy.

Despite efforts to reduce suicide globally, the Americas is the only region in the world where suicide mortality has been increasing since 2000. The majority (79%) of suicides in the Americas occur among men, but suicide among women has also been increasing. In 2019 there were more than 97,000 suicides in the region.

The analysis published in The Lancet also highlights that the average suicide mortality rate among males in the region declined as per capita health spending grew, while that of females declined as the number of physicians employed per 10,000 population increased. For both sexes, the rate declined as moderate population density grew, a cautionary note highlighting the need to support people living in isolated rural areas.

“Cultural expectations around gender largely determine the sex difference in suicide mortality,” Dr. Shannon Lange, a scientist at the Institute for Mental Health Policy Research (CAMH) in Canada and lead author of the paper said. “Multi-sectoral measures aimed at the health and well-being of society should be emphasized in prevention efforts.”

PAHO works to improve the mental health of the population of the Americas and reduce suicide mortality. The Organization provides technical cooperation in suicide prevention to countries through the application of WHO’s Live Life guide, which proposes evidence-based interventions and a comprehensive national response to prevent suicide.