Shah Ajit, Bhandarkar Ritesh
University of Central Lancashire, Preston, United Kingdom and Consultant Psychiatrist, West London Mental Health NHS Trust, United Kingdom.
J Inj Violence Res. 2011 Jan;3(1):25-7. doi: 10.5249/jivr.v3i1.70.
Adversity early in life has been suggested as a protective factor for elderly suicides. However, studies examining this relationship in general population suicide rates are scarce.
The relationship between general population suicide rates and four proxy measures of adversity earlier in life was examined using data from the World Health Organization and the United Nations data banks.
General population suicide rates were negatively correlated with the percentage of children under the age of 5 years who were underweight, the percentage of children under the age of 5 years who were under height, the percentage of infants with low birth weight babies, and the percentage of the general population that was undernourished. The only independent predictor general population suicide rates in both sexes, on multiple regression analysis, was the Gini coefficient (a measure of income inequality).
Income inequality may lead to low birth weight, undernourishment, underweight and under height because income inequality results in poor access to healthcare and nutrition. These adversities may increase child mortality rates and reduce life expectancy. Those surviving into adulthood in countries with greater adversity early in life may be at reduced risk of suicide because of selective survival of those at reduced risk of suicide due to constitutional or genetic factors and development of greater tolerance to hardship in adulthood.
早年经历逆境被认为是老年人自杀的一个保护因素。然而，在一般人群自杀率中研究这种关系的研究很少。
使用世界卫生组织和联合国数据库的数据，研究了一般人群自杀率与早年逆境的四种替代指标之间的关系。
一般人群自杀率与体重不足的5岁以下儿童百分比、身高不达标的5岁以下儿童百分比、低体重出生婴儿百分比以及营养不良的一般人群百分比呈负相关。在多元回归分析中，两性一般人群自杀率的唯一独立预测因素是基尼系数（一种收入不平等的衡量指标）。
收入不平等可能导致低体重出生、营养不良、体重不足和身高不达标的情况，因为收入不平等导致获得医疗保健和营养的机会较差。这些逆境可能会增加儿童死亡率并缩短预期寿命。在早年生活中逆境更大的国家中存活到成年的人，由于具有体质或遗传因素而自杀风险较低的人选择性存活下来，以及成年后对苦难的耐受性增强，其自杀风险可能会降低。
