ArticlePloS one2021
Socioeconomic disparities in suicide: Causation or confounding?
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 16 citations in OpenAlex.
- Prevalence and correlates of suicidal behaviours among patients with depression and anxiety disorders in a multi-ethnic Asian setting.Frontiers in psychiatry · 2026Article
- Analyzing Social Factors to Enhance Suicide Prevention Across Population Groups.Proceedings. IEEE International Conference on Healthcare Informatics · 2024Article
- The social determinants of mental health and disorder: evidence, prevention and recommendations.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Self-reported suicidal behaviours and associated factors in the general population of Latvia (2010-2018).The International journal of social psychiatry · 2023Article
- The shared genetic architecture of suicidal behaviour and psychiatric disorders: A genomic structural equation modelling study.Frontiers in genetics · 2023Article
- Prevalence and Associated Factors of Suicidal Behavior Among Patients and Residents in Northwest Ethiopia.Frontiers in psychiatry · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite an overall reduction in suicide, educational disparities in suicide have not decreased over the last decade. The mechanisms behind educational disparities in suicide, however, remain unclear: low educational status may increase the risk of suicide ("causation") or low educational status and suicide may share confounders. This paper assesses whether educational disparities in suicide (EDS) are more likely to be due to causation.
methodThe DEMETRIQ study collected and harmonized register-based data on mortality follow-up from forty population censuses from twelve European populations. More than 102,000 suicides were registered over 392 million person-years. Three analyses were carried out. First, we applied an instrumental variable approach that exploits changes in the legislation on compulsory educational age to instrument educational status. Second, we analyzed EDS by age under the hypothesis that increasing EDS over the life cycle supports causation. Finally, we compared EDS in men and women under the assumption that greater EDS in women would support causation.
findingsThe instrumental variable analysis showed no evidence for causation between higher education and suicide, for men or women. The life-cycle analysis showed that the decrease of educational inequalities in suicide between the baseline 1991 period and the 2001 follow-up period was more pronounced and statistically significant in the first three younger age groups. The gender analysis indicated that EDS were systematic and greater in men than in women: the rate ratio of suicide for men with low level of education (RR = 2.51; 95%CI:2.44-2.58) was higher than the rate ratio in women (RR = 1.32; 95CI%:1.26-1.38).
interpretationOverall, there was little support for the causation hypothesis, suggesting that the association between education and suicide is confounded. Educational inequalities in suicide should be addressed in early life by early targeting of groups who struggle to complete their education and display higher risk of mental disorder or of mental health vulnerabilities.
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