Suicide and poverty in low-income and middle-income countries: a systematic review
Open accessAbstract
Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events.
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Employment is robustly associated with reduced symptoms of depression and anxiety and decreased suicide risk, especially among men.
“Given the role of financial strain in anxiety 197 , it is not surprising that employment is robustly associated with reduced symptoms of depression and anxiety and decreased suicide risk, especially among men 218-220 .”
From The clinical characterization of the adult patient with an anxiety or related disorder aimed at personalization of management (2021) · cites this paper as [218]
The Unemployment section (page not provided) reports some associations between unemployment and suicidal behavior, but says the findings were mixed, so it does not support calling the association robust. The Discussion says sex differences in this relationship were not explored; the review does not report employment-related reductions in depression or anxiety symptoms. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPoverty and social deprivation are associated with suicide.
“Poverty and social deprivation are also associated with suicide.22, 23”
From Global, regional, and national burden of suicide, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 (2025) · cites this paper as [23]
Many individual and societal factors are associated with suicide, including mental illness, early developmental experiences, social isolation, and economic insecurity.
“Many individual and societal factors are associated with suicide, including mental illness,56 early developmental experiences,18, 23 social isolation,18 and economic insecurity.20”
From Global, regional, and national burden of suicide, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 (2025) · cites this paper as [23]
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- Authors
- Iemmi, V., Bantjes, J., Coast, E., Channer, K., Leone, T., McDaid, D., Palfreyman, A., Stephens, B., & Lund, C.
- Affiliations
- London School of Economics and Political Science (GB)
- Stellenbosch University (ZA)
- Peterborough City Hospital (GB)
- University of Cape Town (ZA)
- Corresponding author
- Iemmi, Valentina
- ORCID
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 3
- Issue
- 8
- Pages
- 774-783
- ISSN
- 2215-0366 (ISSN-L)
- OpenAlex
- W2486428404
- Cited by
- 319
- References
- 68
- Citations by year
- 2026: 31 · 2025: 45 · 2024: 46 · 2023: 32 · 2022: 33 · 2021: 37 · 2020: 30 · 2019: 18 · 2018: 27 · 2017: 17 · 2016: 3
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion)
- Funders
- London School of Economics and Political Science
- National Research Foundation (TTK13070620647)
- Universiteit Stellenbosch
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- suicide, economic poverty, suicidal ideation, suicidal behavior, low- and middle-income countries, unemployment, wealth, chronic poverty, suicide prevention, socioeconomic status
- MeSH terms
- Developing Countries, Humans, Poverty, Risk Factors, Suicide, Randomized Controlled Trials as Topic, Non-Randomized Controlled Trials as Topic
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