Wayne State University, USA.
Prev Med. 2021 Nov;152(Pt 1):106498. doi: 10.1016/j.ypmed.2021.106498. Epub 2021 Sep 16.
This review summarizes recent research in four environmental areas affecting risk of deaths by suicide. Politically, the weight of the evidence suggests that laws increasing social welfare expenditures and other policies assisting persons with low incomes (e.g., minimum wage) tend to lower suicide rates. Other legal changes such as those restricting firearms and alcohol availability can also prevent suicides. The social institutions of marriage, as well as parenting, continue to serve as protective factors against suicide, although the degree of protection is often gendered. Religiousness tends to be inversely associated with suicide deaths at the individual level of analysis, but the mediators need exploration to determine what accounts for the association: social support, better mental health, better physical health, less divorce, or other covariates. Cultural definitions of the traditional male role (e.g., breadwinner culture) continue to help explain the high male to female suicide ratio. New work on the "culture of suicide" shows promise. The degree of approval of suicide is sometimes the single most important factor in predicting suicide. At the individual level of analysis, two of the strongest predictors of suicide are economic ones: unemployment and low socio-economic status. Attention is drawn to enhancing the minimum wage as a policy known to lower state suicide rates. Limitations of research include model mis-specification, conflicting results especially when ecological data are employed, and a need for more research exploring moderators of established patterns such as that between religiousness and suicide.
这篇综述总结了四个影响自杀死亡率风险的环境领域的最新研究。从政治角度来看,大量证据表明,增加社会福利支出的法律和帮助低收入人群(如最低工资)的其他政策往往会降低自杀率。其他法律变革,如限制枪支和酒精供应,也可以防止自杀。婚姻和育儿等社会制度仍然是预防自杀的保护因素,尽管保护程度往往存在性别差异。从个体分析层面来看,宗教往往与自杀死亡呈负相关,但需要探索中介因素来确定关联的原因:社会支持、更好的心理健康、更好的身体健康、较少的离婚或其他协变量。传统男性角色的文化定义(如养家糊口文化)继续有助于解释高男性自杀率与女性自杀率的比例。关于“自杀文化”的新研究显示出了希望。对自杀的认可程度有时是预测自杀的最重要因素。在个体分析层面上,两个最强的自杀预测因素是经济因素:失业和低社会经济地位。研究人员呼吁提高最低工资标准,因为提高最低工资标准被认为可以降低州自杀率。研究的局限性包括模型误设定、特别是在使用生态数据时结果相互矛盾,以及需要更多研究来探索宗教与自杀之间的既定模式的调节因素。