Articlebronze2015

Association Between Social Integration and Suicide Among Women in the United States

Alexander C. Tsai · Michel Lucas · Ichiro I. Kawachi

127 citations0/0 files storedJAMA Psychiatry

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Suicide and Self-Harm Studies Health disparities and outcomes Health and Well-being Studies

Abstract

IMPORTANCE: Suicide is one of the top 10 leading causes of mortality among middle-aged women. Most work in the field emphasizes the psychiatric, psychological, or biological determinants of suicide. OBJECTIVE: To estimate the association between social integration and suicide. DESIGN, SETTING, AND PARTICIPANTS: We used data from the Nurses' Health Study, an ongoing nationwide prospective cohort study of nurses in the United States. Beginning in 1992, a population-based sample of 72 607 nurses 46 to 71 years of age were surveyed about their social relationships. The vital status of study participants was ascertained through June 1, 2010. EXPOSURES: Social integration was measured with a 7-item index that included marital status, social network size, frequency of contact with social ties, and participation in religious or other social groups. MAIN OUTCOMES AND MEASURES: The primary outcome of interest was suicide, defined as deaths classified using the codes E950 to E959 from the International Classification of Diseases, Eighth Revision. RESULTS: During more than 1.2 million person-years of follow-up (1992-2010), there were 43 suicide events. The incidence of suicide decreased with increasing social integration. In a multivariable Cox proportional hazards regression model, the relative hazard of suicide was lowest among participants in the highest category of social integration (adjusted hazard ratio, 0.23 [95% CI, 0.09-0.58]) and second-highest category of social integration (adjusted hazard ratio, 0.26 [95% CI, 0.09-0.74]). Increasing or consistently high levels of social integration were associated with a lower risk of suicide. These findings were robust to sensitivity analyses that accounted for poor mental health and serious physical illness. CONCLUSIONS AND RELEVANCE: Women who were socially well integrated had a more than 3-fold lower risk for suicide over 18 years of follow-up.

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References

1995The need to belong: Desire for interpersonal attachments as a fundamental human motivation.2012Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 2006Projections of Global Mortality and Burden of Disease from 2002 to 2030 1979SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS 2010The interpersonal theory of suicide.2000From social integration to health: Durkheim in the new millennium 2011Mechanisms Linking Social Ties and Support to Physical and Mental Health 2008Suicide and Suicidal Behavior

Cited by

2017The experience of social exclusion in women with a history of suicidal acts: a neuroimaging study 2017Resilience to suicide ideation: A cross‐cultural test of the buffering hypothesis 2019Peer‐adult network structure and suicide attempts in 38 high schools: implications for network‐informed suicide prevention 2021Marital status, educational attainment, and suicide risk: a Norwegian register-based population study

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