“…For the men who had experienced much tragedy, it appeared that they turned to alcohol to manage their emotional pain before eventually dying by suicide. Childhood abuse 30 and alcohol abuse 31 are both associated with an increased risk of suicide. Furthermore the self-reliance associated with masculinity has been implicated in suicidal thinking.…”
“…For the men who had experienced much tragedy, it appeared that they turned to alcohol to manage their emotional pain before eventually dying by suicide. Childhood abuse 30 and alcohol abuse 31 are both associated with an increased risk of suicide. Furthermore the self-reliance associated with masculinity has been implicated in suicidal thinking.…”
“…Thus, proximity of alcohol outlets is a relatively unambiguous indicator of alcohol accessibility. Given prior evidence that alcohol consumption and/or intoxication is higher in areas with more alcohol outlets ( Campbell et al, 2009 ), and multiple pathways via which alcohol intoxication and/or AUD can lead to suicidal behavior–including behavioral disinhibition, depressed mood, and aggression ( Kõlves et al, 2022 )–alcohol outlets are a promising target for questions regarding how alcohol accessibility is related to suicidal behavior.…”
Background: Greater alcohol accessibility, for example in the form of a high density of alcohol outlets or low alcohol taxation rates, may be associated with increased risk of suicidal behavior. However, most studies have been conducted at the aggregate level, and some have not accounted for potential confounders such as socioeconomic position or neighborhood quality.
Methods:In a Swedish cohort of young adults aged 18 to 25, we used logistic regressions to evaluate whether living in a neighborhood that included bars, nightclubs, and/ or government alcohol outlets was associated with risk of suicide attempt (SA) or suicide death (SD) during four separate 2-year observation periods. Neighborhoods were defined using pre-established nationwide designations. We conducted combined-sex and sex-stratified analyses, and included as covariates indicators of socioeconomic position, neighborhood deprivation, and aggregate genetic liability to suicidal behavior.Results: Risk of SA was increased in some subsamples of individuals living in a neighborhood with a bar or government alcohol outlet (odds ratios [ORs] = 1.05 to 1.15). Risk of SD was also higher among certain subsamples living in a neighborhood with a government outlet (ORs = 1.47 to 1.56), but lower for those living near a bar (ORs = 0.89 to 0.91).Significant results were driven by, but not exclusive to, the male subsample. Individuals with higher aggregate genetic risk for SA were more sensitive to the effects of a neighborhood government alcohol outlet, pooled across observation periods, in analyses of the sexes combined (relative excess risk due to interaction [RERI] = 0.05; 95% confidence intervals [CI] 0.01; 0.09) and in the male subsample (RERI = 0.06; 95% CI 0.001; 0.12).
Conclusions:Although effect sizes are small, living in a neighborhood with bars and/ or government alcohol outlets may increase suicidal behavior among young adults. Individuals with higher genetic liability for SA are slightly more susceptible to these exposures.
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