Suicide in a Global World: An Empirical Examination of the Relationship Between Globalisation, Social-Ecological Factors, and Suicide Mortality in 35 Countries.

Abstract

Globalisation is recognised as an important population-level influence on health, responsible for altering the structural and psycho-social conditions in which human wellbeing is embedded. It has also been acknowledged that the economic, social and technological processes involved in globalisation may have implications for suicide mortality. This premise was investigated using a cross-sectional time-series database on 35 countries, measured over the period 1980–2006. The first step in establishing the relationship between globalisation and suicide was to develop a globalisation “index”, comprising economic, social and technological variables. Countries in the sample were assigned an annual globalisation “rank”, which allowed the process to be measured in each country over a 26-year period. Panel data regression techniques were used to investigate the effect of the globalisation index on age-standardised male and female suicide rates using a Least-Squared Dummy Variable (LSDV) fixedeffects model, a Generalised Least Squares (GLS) random-effects model and a population-averaged estimation models. The influence of globalisation on male and female age-standardised suicide rates was measured in two ways. First, the total globalisation index was entered into an analysis which also controlled for “traditional” ecological predictors of suicide. Second, the index was divided into four separate “levels” (low, medium, high and very high) to establish whether different stages of the globalisation process produced different outcomes on male and female suicide rates. As in the first analysis, this also included “traditional” ecological predictors. Further analysis was conducted to assess the association of eight geo-cultural regions (East- Central Europe, Western Europe, the Baltic States, Asia, South America, countries of Anglo-Saxon origin, Scandinavia, and Southern Europe) with male and female suicide rates.