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Poverty and suicide research in low- and middle-income countries: systematic mapping of literature published in English and a proposed research agenda

机译:中低收入国家的贫困与自杀研究:系统地绘制英文出版物的文献以及拟议的研究议程

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摘要

Approximately 75% of suicides occur in low- and middle-income countries (LMICs) where rates of poverty are high. Evidence suggests a relationship between economic variables and suicidal behaviour. To plan effective suicide prevention interventions in LMICs we need to understand the relationship between poverty and suicidal behaviour and how contextual factors may mediate this relationship. We conducted a systematic mapping of the English literature on poverty and suicidal behaviour in LMICs, to provide an overview of what is known about this topic, highlight gaps in literature, and consider the implications of current knowledge for research and policy. Eleven databases were searched using a combination of key words for suicidal ideation and behaviours, poverty and LMICs to identify articles published in English between January 2004 and April 2014. Narrative analysis was performed for the 84 studies meeting inclusion criteria. Most English studies in this area come from South Asia and Middle, East and North Africa, with a relative dearth of studies from countries in Sub-Saharan Africa. Most of the available evidence comes from upper middle-income countries; only 6% of studies come from low-income countries. Most studies focused on poverty measures such as unemployment and economic status, while neglecting dimensions such as debt, relative and absolute poverty, and support from welfare systems. Most studies are conducted within a risk-factor paradigm and employ descriptive statistics thus providing little insight into the nature of the relationship. More robust evidence is needed in this area, with theory-driven studies focussing on a wider range of poverty dimensions, and employing more sophisticated statistical methods.
机译:大约75%的自杀发生在贫困率很高的中低收入国家(LMIC)中。有证据表明,经济变量与自杀行为之间存在关联。为了规划中低收入国家的有效自杀预防干预措施,我们需要了解贫困与自杀行为之间的关系以及背景因素如何介导这种关系。我们对中低收入国家的贫困和自杀行为进行了英语文献的系统映射,以概述有关该主题的知识,突出文献中的空白,并考虑当前知识对研究和政策的影响。使用自杀意念和行为,贫困和低收入和中低收入国家(LMIC)这两个关键词组合搜索了11个数据库,以识别2004年1月至2014年4月之间以英文发表的文章。对符合纳入标准的84项研究进行了叙事分析。该地区的大多数英语研究都来自南亚和中,东,北非,而撒哈拉以南非洲国家的研究相对较少。现有证据大部分来自中等偏上收入国家;只有6%的研究来自低收入国家。大多数研究集中在诸如失业和经济状况之类的贫困衡量标准上,而忽略了债务,相对和绝对贫困以及福利体系的支持等方面。大多数研究都是在风险因素范式下进行的,并采用描述性统计数据,因此对这种关系的本质了解甚少。在这一领域,需要更强有力的证据,以理论为基础的研究集中于更广泛的贫困领域,并采用更复杂的统计方法。

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