A replication of the relationship between adversity earlier in life and elderly suicide rates using five years cross-national data

Suicide in the elderly: approach to social determinants of health in the Dahlgren and Whitehead model

OBJECTIVE

Identify in literature the social determinants of health related to suicide in the elderly, according to the model proposed by Dahlgren and Whitehead.

METHOD

Integrative review of articles indexed in the databases BDENF, CINAHL, LILACS, and MEDLINE, with the following main descriptors: aged, suicide, social determinants of health, and risk factors. Primary studies were included which addressed social determinants of health and suicide in the elderly.

RESULTS

From the 19 articles analyzed, three categories emerged: proximal social determinants of health (male gender, mental disorders, physical illnesses, white race, 70-74 years old); intermediate social determinants of health (substance abuse, use of alcohol or psychotropic drugs, marital status, marital, social, and family problems, violence, previous suicide attempt, history of admission to psychiatric service); and distal social determinants of health (schooling, economic issues, sanitation, stressful events).

CONCLUSION

Proximal determinants have more effects on suicide. Intermediate determinants are composed mainly of changeable factors. Distal determinants showed lesser associations.