Regional Variation and Socio-Economic Determinants of Suicide Mortality in Greece before and during Economic Crisis

Abstract

Background. Suicide mortality increased in Greece after the 2008 financial crisis. This study aimed to explore the regional variation of suicide mortality before and after the economic crisis, and its correlation with socio-economic and mental health-related variables factors. Methods. This is a quasi-experimental ecological study. Data from the national mortality statistics were analyzed, and standardized death rates and age-specific mortality rates were calculated. The effect of economic crisis was explored by comparing mortality rates before and after crisis onset. Pearson’s and Spearman’s correlation coefficients and multiple linear regression were used to assess the impact of socioeconomic and mental health-related factors on suicide mortality. Results. Trends of suicide mortality showed a rise during 2011–2014, followed by a decline during 2015–2016. Significant differences were observed between regions, ranging from 27.6% lower to 54% higher than the national average. Unemployment, income, and change of gross domestic product were significantly correlated with regional variation. No association was found with mental disorder mortality rates and psychotropic drug consumption. Conclusions. Socio-economic factors explained only a part of the suicide mortality variation. Mental health-related factors were not significantly correlated with suicide mortality. More research is needed to investigate other possible determinants of suicides.

Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review

“…Altogether, 19 studies found increased suicide rates at the level of the total population after the start of the crisis. These were conducted on the populations of Italy (Milan) 116 (suicides as a result of mental and behavioural disorders, Italy 117 ), Greece, 118 – 123 Spain 124 (suicide attempts in Spain 125 ), the European Union, 126 – 128 Canada, 126 England, 128 – 130 the USA 131 – 133 and South Korea. 134 …”

“…Altogether, 19 studies found increased suicide rates at the level of the total population after the start of the crisis. These were conducted on the populations of Italy (Milan) 116 (suicides as a result of mental and behavioural disorders, Italy 117 ), Greece, [118][119][120][121][122][123] Spain 124 (suicide attempts in Spain 125 ), the European Union, [126][127][128] Canada, 126 England, [128][129][130] the USA [131][132][133] and South Korea. 134 Some studies reported increases in suicide rates in specific population subgroups, 135,136 among men [137][138][139] or attributable to specific factors such as unemployment.…”

The debt crisis, austerity measures, and suicide in Greece

“…Our findings and their implications must be interpreted in the context of study limitations. Similar to other studies (e.g., Harper and Bruckner 2017), we used aggregate, nationwide data to conduct the analysis, which may mask important regional heterogeneity in suicide rates (Zilidis et al 2020) as well as variation in the economic consequences of the debt crisis and austerity measures. Unknown, then, is whether (and to what extent) the debt crisis impacted suicide rates differently in different parts of Greece.…”

“…to suicide via deteriorating mental health conditions among the population of Greece, including growing depression, stress, and strain as a result of economic hardship (Zilidis, Papagiannis, and Rachiotis 2020). Mental health depends on a variety of socio-economic and environmental factors (Herrman and Saxena 2005), and financial difficulties can lead to mental health problems (Mucci et al 2016).…”

“…Several arguments provide a theoretical backdrop upon which to consider how Greece's economic crisis and related austerity measures may have impacted suicide rates. One argument links the debt crisis to suicide via deteriorating mental health conditions among the population of Greece, including growing depression, stress, and strain as a result of economic hardship (Zilidis, Papagiannis, and Rachiotis 2020). Mental health depends on a variety of socio‐economic and environmental factors (Herrman and Saxena 2005), and financial difficulties can lead to mental health problems (Mucci et al.…”