Suicide attempt and completed suicide in adolescents and young people on from the social health determinants: A systematic review.

Introduction: Suicidal behavior is an important health problem, frequently studied from a risk perspective. Evidence that transcends this hegemonic view is required. Objective: To identify the structural and intermediate social health determinants associated with attempted suicide and completed suicide in Latin American adolescents and youth, according to published literature. Materials and Methods: Systematic review following PRISMA recommendations, performed in LILACS, Google academic and Pubmed using keywords. Primary ecological studies performed in Latin America were included, which were evaluated for confounding bias, data quality and ecological fallacy. Results: Initially, 23,770 documents were located, and 10 were finally included. The structural determinants associated with suicide include being male, aged 15-24 years, having a high Gini index, having a low Gross Domestic Product (GDP) per capita, and being Catholic or Evangelical. While the suicide attempt was due to educational backwardness, being a woman, and living in the municipal seat. The intermediate determinants for suicide attempts were tobacco and alcohol consumption, violent episodes, and depression. Discussion: The proposed theoretical model offers a novel view of the problem, moving away from individual responsibility and giving an active role to lifestyle-related conditions contributing to health inequities. Conclusion: Social determinants offer a novel view for developing new prevention actions; however, empirical evidence from Latin America remains contradictory, and half of the studies reviewed were affected by confounding bias. Therefore, these associations should be interpreted with caution.