Macro-level Social Determinants of Suicide among Women in the WHO Eastern Mediterranean Region

Background: The World Health Organization (WHO) revealed that about 800 000 people die because of suicide each year. This study aim to identify the configurational effects of macro-level socioeconomic conditions on suicide rate among women living in the EMRO region. Method: A fuzzy set qualitative comparative analysis (fsQCA) was used to identify the conditions linking to high rate of suicide in women across 19 countries from EMRO region. The outcome was age-standardized suicide rates (per 100 000 population) among women. Considering of SDGs and the SDH conceptual framework, the potential causal conditions were level of (1) Country economic development (GDP), (2) Education, (3) Health expenditure and(4) Gender Inequality. The data were obtained from the human development report (2018). Results: The fsQCA truth table analysis indicated three pathways to high rate of suicides death among women: (a) high-level gender inequality interestingly combined with high-level health expenditure and high-level GDP. (b) combination of low GDP and high-level health expenditure and high-level education (c) combination of gender inequality and low level of health expenditure and low GDP and low-level of education. Based on fsQCA technique, these pathways specified configuration of macro-level socioeconomic conditions that were (usually) sufficient to explain high-rate of suicide among women in the EMRO region (solution coverage: 0.61 , solution consistency: 0.87).The case of IRAN with a high level of economic development (fuzzy score=0.98), high level of health expenditure (fuzzy score=0.9), high-level of education (fuzzy score=0.96) and a relatively high level of gender inequality (fuzzy score=0.78) linked to the set of countries with high rates of suicide deaths among women in the EMRO region (fuzzy score=0.74).Conclusion: The macro-level social determinants that highlighted by SDH commission may responsible for a part of suicides among women.Message for policymakers Female suicide rates are higher in countries with more gender inequality. Gender inequality identified as a potential causal factor for suicide. The disadvantages facing women and girls are a significant source of inequality. Women are discriminated in many areas such as health, education , labour market and political representation. Thus, Strategies to health promotion, women empowerment and the labour force participation may eliminate gender discrimination and help to prevent suicides among women.

کلیدواژه ها:

fsQCA ، Suicide ، Women ، Gender Inequality ، Social Determinants of Health.