More than just numbers: Suicide rates and the economic cycle in Portugal (1910-2013).

Suicides are a major concern for public health first and foremost because they are an avoidable cause of death. Moreover, they can be an indicator of self-reported emotional satisfaction and a good marker of overall well-being. In this study we examine how different economic and social aspects affected Portuguese suicide rates for more than one hundred years (1910-2013). We place this exercise in the specific historical context of the XX and early XXI century in Portugal, emphasizing the role of economic recessions and expansions. Controlling for aspects like wars, health care availability, political instability, and demographic changes, we find a strong association between a decline in the growth rate of real output and an increase in suicide rates for the whole population. In this regard, while male suicide rates are non-negligibly influenced by economic downturns, female suicide rates are in general more responsive to a more open political and economic environment. Our results are robust if we consider the mid-term cyclical relationship. Our findings advocate that, during recessions, public health responses should be seen as a crucial component of suicide prevention.