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Cited by 147Suicide and Self-Harm StudiesReligion, Spirituality, and PsychologyHomicide, Infanticide, and Child Abuse

Suicide, religion, and socioeconomic conditions. An ecological study in 26 countries, 1990.

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Neeleman, J, Lewis, G·1999·Journal of Epidemiology and Community Health
DOI 10.1136/jech.53.4.204PMC PMC1756856
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Abstract

STUDY OBJECTIVE: Relative risks are frequently assumed to be stable across populations but this may not apply in psychiatric epidemiology where sociocultural context may modify them. Such ecological effect modification will give curved associations between aggregated risk factor and outcome. This was examined in connection with the ecological association between suicide rates and an aggregate index of religiosity. DESIGN: Ecological study of associations between suicide rates and an index of religiosity, adjusted for socioeconomic variation. The effect of stratification of the study sample according to levels of religiosity, was examined. SETTING: 26 European and American countries. SUBJECTS: Interview data from 37,688 people aggregated by country. OUTCOME MEASURES: Age and sex specific (1986-1990) suicide rates. MAIN RESULT: Adjusted for socioeconomic variation, negative associations of male suicide rates with religiosity were apparent in the 13 least religious countries only (test for interaction F (1, 25) = 5.6; p = 0.026). Associations between religiosity and female suicide rates did not vary across countries. CONCLUSION: The bent ecological association was apparent only after adjustment for socioeconomic variation suggesting that, rather than confounding, ecological modification of individual level links between religion and male (but not female) suicide risk is the responsible mechanism. This concurs with micro-level findings suggesting that suicide acceptance depends not only on personal but also on contextual levels of religious belief, and that men are more sensitive to this phenomenon than women. In psychiatric epidemiology, relative risks vary with the exposure's prevalence. This has important implications for research and prevention.

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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 [161]

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Research works printed but not linked: 6

  1. Morgenstern H. Ecologic studies. In: Rothman KJ, Greenland S, eds. Modern epidemiology. Philadelphia: Lippincott-Raven, 1998:459-80.
  2. Crombie IK. Trends in suicide and unemployment in Scot- land, 1976-1986. BMJ 1989;298:782-4.
  3. Halman L, De Moor R. Comparative research on values. In: Ester P, Halman L, De Moor R, eds. The individualizing society; value shift in Europe and North America. Tilburg: Tilburg University Press, 1994:21-36.
  4. World Bank. World Bank Development Report; development and environment. Oxford: Oxford University Press, 1992.
  5. Greenland S, Schlesselman JJ, Criqui MH. The fallacy of employing standardized regression coeYcients and correla- tions as measures of eVect. Am J Epidemiol 1986;123:203- 8.
  6. Brugha TS, Bebbington PE, MacCarthy B, et al. Gender, social support and recovery from depression. Psychol Med 1990;20:147-56.

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Authors
Neeleman, J., & Lewis, G.
Affiliations
University of Groningen (NL)
ORCID
Lewis, G
Venue
Journal of Epidemiology and Community Health
Publisher
BMJ
Published
1999-04
Volume
53
Issue
4
Pages
204-210
ISSN
  • 0141-7681 (ISSN-L)
  • 0143-005X
  • 1470-2738
DOI
10.1136/jech.53.4.204
PMC
PMC1756856
OpenAlex
W2047529386
Cited by
147
References
37
Citations by year
2025: 2 · 2024: 5 · 2023: 43 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 3 · 2013: 6 · 2012: 5
FWCI
4.08
Type
journal article
Language
en
Open access
Locations
  • Journal of Epidemiology & Community Health (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Funders
  • University of Essex
  • Wellcome Trust
  • Economic and Social Research Council
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
suicide rates, religiosity, socioeconomic variation, sex differences in suicide, age-specific suicide rates, relative risk, religious beliefs, suicide prevention
MeSH terms
Adolescent, Adult, Aged, Americas, Christianity, Ecology, Europe, Female, Humans, Judaism, Male, Middle Aged, Religion and Psychology, Risk Factors, Socioeconomic Factors, Suicide, Sex Distribution

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