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Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross sectional study of 165,000 individuals

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Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross sectional study of 165,000 individuals. / Knipe, Dee; Gunnell, David; Pieris, R; Priyadarshana, C ; Hawton, K; Eddleston, M; Metcalfe, Chris.

In: BMJ Open, Vol. 7, No. 3, e014006, 03.2017.

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@article{c7c26c28a2e24c3490b87de312b8005b,
title = "Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross sectional study of 165,000 individuals",
abstract = "BackgroundLower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is unclear in low and middle income countries.MethodsWe investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment, and young (≤40 years) female headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the last year were recorded. Random effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide.ResultsHouseholds reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2 95{\%} CI 2.4, 4.4) and having a daily wage labourer (i.e. insecure/low income job) (OR 2.3 95{\%} CI 1.6, 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared to farmers. The strongest associations were with low levels of education (OR 4.6 95{\%} CI 2.5, 8.4), with a stronger association in men than women. ConclusionWe found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association.",
keywords = "Suicide, Sri Lanka, Socioeconomic position, Self-harm, Asia",
author = "Dee Knipe and David Gunnell and R Pieris and C Priyadarshana and K Hawton and M Eddleston and Chris Metcalfe",
year = "2017",
month = "3",
doi = "10.1136/bmjopen-2016-014006",
language = "English",
volume = "7",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "3",

}

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TY - JOUR

T1 - Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross sectional study of 165,000 individuals

AU - Knipe, Dee

AU - Gunnell, David

AU - Pieris, R

AU - Priyadarshana, C

AU - Hawton, K

AU - Eddleston, M

AU - Metcalfe, Chris

PY - 2017/3

Y1 - 2017/3

N2 - BackgroundLower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is unclear in low and middle income countries.MethodsWe investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment, and young (≤40 years) female headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the last year were recorded. Random effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide.ResultsHouseholds reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2 95% CI 2.4, 4.4) and having a daily wage labourer (i.e. insecure/low income job) (OR 2.3 95% CI 1.6, 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared to farmers. The strongest associations were with low levels of education (OR 4.6 95% CI 2.5, 8.4), with a stronger association in men than women. ConclusionWe found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association.

AB - BackgroundLower socioeconomic position (SEP) is associated with an increased risk of suicidal behaviour in high income countries, but this association is unclear in low and middle income countries.MethodsWe investigated the association of SEP with attempted suicide in a cross-sectional survey of 165 233 Sri Lankans. SEP data were collected at the household (assets, social standing (highest occupation of a household member), foreign employment, and young (≤40 years) female headed households) and individual level (education and occupation). Respondent-reported data on suicide attempts in the last year were recorded. Random effects logistic regression models, accounting for clustering, were used to investigate the association of SEP with attempted suicide.ResultsHouseholds reported 398 attempted suicides in the preceding year (239 per 100 000). Fewer assets (OR 3.2 95% CI 2.4, 4.4) and having a daily wage labourer (i.e. insecure/low income job) (OR 2.3 95% CI 1.6, 3.2) as the highest occupation increased the risk of an attempted suicide within households. At an individual level, daily wage labourers were at an increased risk of attempted suicide compared to farmers. The strongest associations were with low levels of education (OR 4.6 95% CI 2.5, 8.4), with a stronger association in men than women. ConclusionWe found that indicators of lower SEP are associated with increased risk of attempted suicide in rural Sri Lanka. Longitudinal studies with objective measures of suicide attempts are needed to confirm this association.

KW - Suicide

KW - Sri Lanka

KW - Socioeconomic position

KW - Self-harm

KW - Asia

U2 - 10.1136/bmjopen-2016-014006

DO - 10.1136/bmjopen-2016-014006

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 3

M1 - e014006

ER -