Gender inequality and adolescent suicide ideation across Africa, Asia, the South Pacific and Latin America – a cross-sectional study based on the Global School Health Survey (GSHS)

Abstract

Background: Suicide ideation is a health issue affecting adolescents worldwide. There are significant variations in suicide ideation between countries and genders, which have not been fully explained. Research is especially lacking in countries outside Europe and North America. Gender equality has been shown to matter in other aspects of adolescent mental health, such as life satisfaction, but has not been researched in relation to suicide ideation at national level. Objective: To investigate how national gender inequality is related to self-reported suicide ideation among adolescents, and whether this association differs between boys and girls. Methods: This is a cross-national, cross-sectional study using individual survey data from the Global School-based Student Health Survey, a survey in Africa, Asia, Latin America and the South Pacific, developed and supported by among others the WHO and the CDC; connecting this to national data: the gender inequality index from the UNDP; controlling for GDP per capita and secondary school enrolment. The data was analysed using a multilevel logistic regression method and included 149,306 students from 37 countries. Results: Higher national gender inequality, as measured by the gender inequality index, was significantly associated with a higher likelihood of suicide ideation in both girls and boys (odds ratio: 1.38 p-value: 0.015), but for girls and both sexes this was only after adjusting for selection bias due to secondary school enrolment (as well as GDP/capita). Interaction models showed that this association was stronger in boys than in girls. Conclusions: National gender inequality seems to be associated with higher levels of suicide ideation among adolescents in mainly low-and middle-income countries, especially among boys.

Inequalities in Violent Death across Income Levels among Young Males and Females in Countries of the Americas

“…In a study of young people aged 10 to 24 years from 21 Latin American and Caribbean countries using the WHO-CDC Global School Health Survey (GSHS), Elia et al [ 35 ] found a direct relationship between income and obesity, and then a direct relationship between obesity and suicide ideation with planning, suggesting that overweight/obesity might be on the causal pathway from economic disadvantage to suicide. In another study with worldwide GSHS data, Assarson et al [ 36 ] found a positive association of suicide ideation with gender inequality when controlling for income. Other studies have found a negative gradient or inverse relationship between income and suicide, in the Americas [ 20 , 37 , 38 ] and elsewhere [ 20 , 39 , 40 , 41 ], and yet other studies have described the positive gradient between suicide and income inequality rather than income level [ 37 , 42 , 43 , 44 ].…”

Egalitarian Values and Sexual Behavior—The Role of Country Level Values in Shaping Individual Level Behaviors in Africa, South America and Asia

“…The GSHS questionnaire is a self-reported survey conducted primarily among students between the ages of 13–17 (some students being a couple years older or younger). The samples are selected on a national or regional basis, or sometimes both combined (Assarsson et al., 2018 ; Centers for Disease Control and Prevention, 2013 ).…”

The prevalence of suicidal behaviour and its associated risk factors among school-going adolescents resident in the United Arab Emirates

“…Risk ratios Suicide continues to be regarded as a substantial global health issue which carries a substantial psychological impact that affects the afflicted individuals and their families but also transcends the individual level to impact the larger family and community at economic and social levels [1][2][3][4] . The prevention of suicide has been identified as an important target for organizations tasked with the promotion of large-scale public mental health campaigns; for example, the World Health Organization's (WHO) Mental Health Action Plan has set itself the goal of reducing the incidence of suicide by at least 10% over an 8-year period 5 .…”