Educational inequalities in suicide in a middle-income country: A socioeconomic approach of mental health

OBJECTIVE

This research aims to describe trends in inequalities in suicide mortality by educational level in Colombia between 1998 and 2015.

METHOD

Standardized suicide mortality rates (SMR) were calculated by educational level, sex, and age in adult men and women over 25 years of age. Poisson regression models were used to calculate the RR (rate ratio) with those highly educated as a reference, and the RII (relative index of inequality).

RESULTS

The number of reported deaths by suicide between 1998 and 2015 was 24,654, of which 84.7% were men. By age-group, 48.5% of suicides were among young adult men and women (25-44). Men had higher suicide rates than women (SMR men = 10.44/100,000; SMR women = 1.72/100,000). The age-standardized mortality rates (SMR) were higher in the groups with the lowest educational level in both sexes and all age-groups, except for senior adult women (65+). Broadly, while SMR reduced throughout most of the period, inequalities grew.

CONCLUSIONS

We found that the educational inequities associated with suicide in Colombia grew slightly. This suggests the need to work on suicide prevention strategies that go beyond the individual risk factors. Socioeconomic issues need to be considered as a key tool to prevent suicide by improving peoples' quality of life and their mental health.

National Intelligence, Suicide Rate, and Subjective Well-Being

Across 73 countries around the world, national intelligence estimates predicted significant increments in the variance of male and female suicide rates over and above the predictive contributions of the cognitive and hedonic facets of subjective well-being (life satisfaction, happiness, and unhappiness). This new result adds to current evidence for cognitive ability as an ecologic (aggregate-level) correlate of suicide prevalence.

Suicide Rates, National Intelligence Estimates, and Differential K Theory

In a nation sample of 75 countries around the world, higher suicide rates of the total, male, and female population corresponded to higher levels on the superordinate K factor from differential K theory, thought to reflect a set of mutually interrelated life history and reproductive strategy traits. Countries ranking high on suicide rates concurrently ranked high on national intelligence estimates, longevity, and affluence, whilst low on rates of births, infant mortality, HIV/AIDS, and crimes (rape, serious assault, and homicide). These findings integrate previously reported positive population-level associations between suicide rates and cognitive ability variables into the conceptual space of differential K theory. The propensity toward suicidal behavior is a positive correlate of the K superfactor.

Cross-National Social Ecology of Intelligence and Suicide Prevalence: Integration, Refinement, and Update of Studies

This study integrates, refines, and updates previous findings pertaining to positive ecologic (population-level) associations between intelligence and suicide prevalence across nations by using corrected and revised national IQ estimates and, further, a quality-of-human-conditions index, both recently published by Lynn and Vanhanen. Across a global 85-nation sample of sex-specific total suicide rates and a Eurasian 48-nation sample of sex-specific elderly suicide rates, these were positively associated with updated national IQ estimates. The associations were stronger for the general population than for elderly persons, independent of the quality of human conditions, and notedly stronger in exponential fitting of suicide rates with national IQ than in linear fitting, thereby indicating that shifts or differences in national IQ correspond to proportional, not absolute, changes in suicide rates. Implications of these findings and the question of generalizability of such associations to the individual level are discussed.