Suicide and poverty in low-income and middle-income countries: a systematic review

Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low- and middle-income countries where most of the world’s poor live. Nonetheless, evidence on the relationship between suicide and poverty in low- and middle-income countries is limited. We conducted a systematic review to understand the relationship between suicidal ideations and behaviours (SIB) and economic poverty in low- and middle-income countries. We identified 37 studies meeting inclusion criteria. In 18 studies reporting the relationship between completed suicide and poverty, 31 relationships were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal SIB and poverty, 36 relationships were explored. Again, the majority of studies reported a positive relationship. However, when considering each poverty dimension separately, we found substantial variations. Findings suggest a relatively consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth and unemployment is associated with SIB. At the country level, there are insufficient data to draw clear conclusions. Available evidence suggests potential benefits in addressing economic poverty within suicide prevention strategies, with attention to both chronic poverty and acute economic events.