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Cited by 205Suicide and Self-Harm StudiesReligion, Spirituality, and PsychologyHomicide, Infanticide, and Child Abuse

Tolerance of suicide, religion and suicide rates: an ecological and individual study in 19 Western countries

NEELEMAN, J., HALPERN, D., LEON, D., LEWIS, G.·1997·Psychological Medicine
DOI 10.1017/s0033291797005357
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Abstract

BACKGROUND: Negative associations between religion and suicide, in individuals and countries, may be mediated by the degree to which suicide is tolerated. METHODS: Linear regression was used to examine ecological associations between suicide tolerance, religion and suicide rates in 19 Western countries in 1989/90. Logistic regression was used to study associations between suicide tolerance and strength of religious belief in 28085 individuals in these countries. The concept of effect modifying function was used to examine whether the strength of the association between suicide tolerance and religious belief in individuals depended on the extent of religious belief in their country. RESULTS: Higher female suicide rates were associated with lower aggregate levels of religious belief and, less strongly, religious attendance. These associations were mostly attributable to the association between higher tolerance of suicide and higher suicide rates. In the 28085 subjects suicide tolerance and the strength of religious belief were negatively associated even after adjustment for other religious and sociodemographic variables and general tolerance levels (odds ratios: men 0.74 (95% CI 0.58-0.94), women 0.72 (95% CI 0.60-0.86)). This negative individual-level association was more pronounced in more highly religious countries but this modifying effect of the religious context was apparent for men only. CONCLUSIONS: Ecological associations between religious variables and suicide rates are stronger for women than men, stronger for measures of belief than observance and mediated by tolerance of suicide. In individuals, stronger religious beliefs are associated with lower tolerance of suicide. Personal religious beliefs and, for men, exposure to a religious environment, may protect against suicide by reducing its acceptability.

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  • Of the 49 highest-rigor studies on R/S and suicide, 39 (80%) reported less suicide, fewer attempts, or more negative attitudes toward suicide among more R/S, and two (4%) found positive relationships.

    “With regard to the 49 studies with the highest methodological rigor, 39 (80%) reported less suicide, fewer suicide attempts, or more negative attitudes toward suicide among the more R/S [155–170] and two (4%) found positive relationships (one study in Delhi, India [171], and one in college students distressed over R/S concerns [172]).”

    From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [157]

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Authors
NEELEMAN, J., HALPERN, D., LEON, D., & LEWIS, G.
Affiliations
University of Groningen (NL)
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
1997-09
Volume
27
Issue
5
Pages
1165-1171
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291797005357
OpenAlex
W2124643414
Cited by
205
References
12
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 47 · 2022: 2 · 2021: 6 · 2020: 7 · 2019: 2 · 2018: 9 · 2017: 5 · 2016: 8 · 2015: 9 · 2014: 8 · 2013: 6 · 2012: 10
FWCI
4.19
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
Wellcome Trust
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
religion, suicide rates, religious beliefs, religious service attendance, sex differences, effect modification, religious context, Western countries
MeSH terms
Adult, Analysis of Variance, Attitude to Health, Cross-Cultural Comparison, Data Collection, Europe, Female, Humans, Male, North America, Regression Analysis, Religion and Psychology, Sampling Studies, Sex Factors, Social Values, Socioeconomic Factors, Suicide, Confidence Intervals, Chi-Square Distribution, Likelihood Functions, Odds Ratio, Databases, Factual

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