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Gender distribution of suicide attempts among immigrant groups in European countries: an international perspective

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Abstract
Background: Studies report high rates of suicide attempts for female immigrants. This study assesses variations in the distribution of suicide attempts across gender in immigrant and non-immigrant groups in Europe. Method: Data on 64 native and immigrant groups, including 17 662 local and 3755 immigrant person-cases collected, between 1989 and 2003, in 24 million person-years were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour. Female-to-male ratios of suicide attempt rates (SARs) were calculated for all groups. Results: The cases were combined into four major categories: hosts; European and other Western immigrants; non-European immigrants; and Russian immigrants. The non-European immigrants included higher female SARs than the Europeans, both hosts and immigrants. Unlike the other groups, the majority of suicide attempters among the Russian immigrants in Estonia and Estonian hosts were male. This was also true for immigrants from Curacao, Iran, Libya and Sri Lanka. When the single groups with a male majority were excluded, the correlation between female and male SARs was relatively high among the European immigrants (r = 0.74, P < 0.0005) and lower among the non-European immigrants (r = 0.55, P < 0.03). Generalized estimating equation analysis yielded a highly significant difference (P < 0.0005) in gender ratios of suicide attempts between hosts (ratio 1.52) and both non-European immigrants (ratio 2.32) and Russian immigrants (0.68), but not the European immigrants. Conclusions: The higher suicide attempt rates in non-European immigrant females compared with males may be indicative of difficulties in the acculturation processes in Europe. Further understanding of factors underlying suicidal behaviour in immigrant and minority groups is necessary for planning effective prevention strategies.
Keywords
ETHNIC-DIFFERENCES, SELF-HARM, RATES, BEHAVIOR, WOMEN, NETHERLANDS, MINORITY, YOUNG

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Chicago
Lipsicas, Cendrine Bursztein, Ilkka Henrik Mäkinen, Danuta Wasserman, Alan Apter, Ad Kerkhof, Konrad Michel, Ellinor Salander Renberg, Cornelis Van Heeringen, Airi Värnik, and Armin Schmidtke. 2013. “Gender Distribution of Suicide Attempts Among Immigrant Groups in European Countries: An International Perspective.” European Journal of Public Health 23 (2): 279–284.
APA
Lipsicas, C. B., Mäkinen, I. H., Wasserman, D., Apter, A., Kerkhof, A., Michel, K., Renberg, E. S., et al. (2013). Gender distribution of suicide attempts among immigrant groups in European countries: an international perspective. EUROPEAN JOURNAL OF PUBLIC HEALTH, 23(2), 279–284.
Vancouver
1.
Lipsicas CB, Mäkinen IH, Wasserman D, Apter A, Kerkhof A, Michel K, et al. Gender distribution of suicide attempts among immigrant groups in European countries: an international perspective. EUROPEAN JOURNAL OF PUBLIC HEALTH. 2013;23(2):279–84.
MLA
Lipsicas, Cendrine Bursztein, Ilkka Henrik Mäkinen, Danuta Wasserman, et al. “Gender Distribution of Suicide Attempts Among Immigrant Groups in European Countries: An International Perspective.” EUROPEAN JOURNAL OF PUBLIC HEALTH 23.2 (2013): 279–284. Print.
@article{4270132,
  abstract     = {Background: Studies report high rates of suicide attempts for female immigrants. This study assesses variations in the distribution of suicide attempts across gender in immigrant and non-immigrant groups in Europe.
Method: Data on 64 native and immigrant groups, including 17 662 local and 3755 immigrant person-cases collected, between 1989 and 2003, in 24 million person-years were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour. Female-to-male ratios of suicide attempt rates (SARs) were calculated for all groups.
Results: The cases were combined into four major categories: hosts; European and other Western immigrants; non-European immigrants; and Russian immigrants. The non-European immigrants included higher female SARs than the Europeans, both hosts and immigrants. Unlike the other groups, the majority of suicide attempters among the Russian immigrants in Estonia and Estonian hosts were male. This was also true for immigrants from Curacao, Iran, Libya and Sri Lanka. When the single groups with a male majority were excluded, the correlation between female and male SARs was relatively high among the European immigrants (r = 0.74, P < 0.0005) and lower among the non-European immigrants (r = 0.55, P < 0.03). Generalized estimating equation analysis yielded a highly significant difference (P < 0.0005) in gender ratios of suicide attempts between hosts (ratio 1.52) and both non-European immigrants (ratio 2.32) and Russian immigrants (0.68), but not the European immigrants.
Conclusions: The higher suicide attempt rates in non-European immigrant females compared with males may be indicative of difficulties in the acculturation processes in Europe. Further understanding of factors underlying suicidal behaviour in immigrant and minority groups is necessary for planning effective prevention strategies.},
  author       = {Lipsicas, Cendrine Bursztein and Mäkinen, Ilkka Henrik and Wasserman, Danuta and Apter, Alan and Kerkhof, Ad and Michel, Konrad and Renberg, Ellinor Salander and Van Heeringen, Cornelis and Värnik, Airi and Schmidtke, Armin},
  issn         = {1101-1262},
  journal      = {EUROPEAN JOURNAL OF PUBLIC HEALTH},
  keywords     = {ETHNIC-DIFFERENCES,SELF-HARM,RATES,BEHAVIOR,WOMEN,NETHERLANDS,MINORITY,YOUNG},
  language     = {eng},
  number       = {2},
  pages        = {279--284},
  title        = {Gender distribution of suicide attempts among immigrant groups in European countries: an international perspective},
  url          = {http://dx.doi.org/10.1093/eurpub/cks029},
  volume       = {23},
  year         = {2013},
}

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