Year: 2021 Source: BMC Public Health. DOI: SIEC No: 20210656

Background: A detailed community-level understanding of socioeconomic status (SES) and sociocultural status
(SCS) of suicides and suicide attempters (SAs) in a prospective design could have significant implications for
policymakers at the local prevention and treatment levels. The effect of SCS and SES on SAs is poorly understood
and investigated in Iran. The present study aimed to investigate the incidence, trend, and role of SES and SCS on
suicide and SAs.
Methods: A longitudinal study was conducted based on the registry for SAs in Malekan County, Iran, from 2015 to
2018. Demographic characteristics, SES, SCS, incidence rates, and predictors of suicidal behaviors were measured via
structured instruments. Simple and multiple logistic regressions were used to estimate crude and adjusted odds
ratios (ORs) and 95% confidence intervals (CIs).
Results: A total of 853 SAs (32 suicides and 821 attempts) were identified during the study. Trend analysis revealed
that the suicide rate significantly decreased from 2014 (10.28) to 2018 (1.75) per 100,000. In the final multiple
variable models, age (26–40), male sex, unemployment, antisocial activities, history of SA, hanging method, and
season (spring) increased the suicide risk while religious commitment had protective effects on suicide.
Conclusions: Our findings indicated that demographic characteristics, low SES, and SCS are associated with suicide.
In this county, trend of suicide and SA were decreased from 2014 to 2018. This study findings highlight the need to
consider a wide range of contextual variables, socio-demographic, SES, and SCS in suicide prevention strategies.
Improving inter-sectoral collaborations and policymakers’ attitudes are imperative for SA reduction.