Socioeconomics and Spatial Factors Associated with Suicide: Evidence from Brazilian Municipalities

Suicide is an important cause of death in many countries worldwide. During 2019, more than one in every 100 deaths (1.3%) were attributable to suicide. The majority of deaths by suicide occurred in low-and-middle-income countries (77%), where most of the world’s population lives (World Health Organization-WHO, 2021). In Brazil, the number of suicides increased by 43% in the past decade from 9,454 in 2010 to 13,523 in 2019.

Among youth people, this increase was 81%, going from 3.5 suicides per 100 thousand youths to 6.4. The largest suicide rates are observed in the South and Central-West Brazilian regions (Ministry of Health, 2021). The increasing number of deaths by suicide is related to the increased prevalence of psychological diseases such as anxiety and depression, as well as other individual characteristics (Nock et al., 2008). In addition, demographic, economic, cultural, and geographical aspects may also be related to the occurrence of so-called intentional self-harm: educational level, employment status, economic situation, among others (e.g., Min, et. al., 2015; López-Contreras et. al., 2019).

These factors differ socially, temporally, and spatially as well as the characterization of suicide (Alarção et al., 2020). In this regard, this paper aims to analyze the sociodemographic (economics), and spatial determinants of deaths by suicide in Brazilian municipalities. The study group consisted of individuals who died by suicide, 2010, as reported by the Mortality Information System (SIM) of DATASUS, the Computer Department of Sistema Único de Saúde (SUS). Socioeconomic data were extracted population censuses carried out by the Brazilian Institute of Geography and Statistics (Portuguese: Instituto Brasileiro de Geografia e Estatística; IBGE).

Our analysis uses spatial econometric approach to explore the relationship between the number of self-motivated deaths and sociodemographic and economic variables such life expectancy at birth,  Municipal Human Development Index (IDHM), spending on public health, urbanization rate, and population density among Brazilian municipalities. This paper also attempts to explain the spatial distribution of suicide rates across municipalities in Brazil in 2010 (a more updated analysis is still not possible because more detailed of the 2022 Census are not fully available yet). The spatial relationships are analyzed using LISA and spatial regression. The expected results concern the reflection of the Brazilian situation determined by social and economic inequalities, and composed of a distribution of suicides positively related to regions characterized by higher levels of income and education, and with a higher proportion of older individuals. Moreover, the findings of this spatiotemporal evolution of suicide may also contribute to the planning of actions in mental health in Brazil. Then, policymakers may integrate spatial and sociodemographic factors into allocation of public spending suicide prevention plans.