The relationship between population density and suicide: a systematic review and meta-analysis.
Source: PubMed, NCBI / U.S. National Library of Medicine
Higher rates of suicide have been reported in rural areas in some countries suggesting that low population density may be associated with a higher risk of suicide. We examined the relationship between population density and suicide rates across different countries worldwide, and evaluated possible moderating effects by sex and age. A systematic review was conducted by searching the PubMed, Embase and PsychINFO databases for relevant publications following a pre-registered protocol and standard PRISMA methods. A meta-analysis was conducted with the available data. From the 10,916 original non-duplicate articles initially identified, 80, published between 1932 and 2023 and covering time-periods ranging from 1890 to 2019 met the selection criteria. Of them, 83.8 % indicated that lower levels of population density were associated with higher suicide rates. A meta-analysis, based on the data from 8 publications, confirmed a statistically significant association between higher suicide rate and lower population density (OR = 1.87; 95 % CI: 1.53-2.30, z = 6.05, p < 0.001). This association was observed in males (p = 0.009), but not in females (p = 0.091). No consistent age or time effects were found. Context-specific differences in suicide methods were identified. Across diverse socio-economic and cultural settings in the world, living in less densely populated areas involves a higher risk of suicide in the male population.
Abstract
Higher rates of suicide have been reported in rural areas in some countries suggesting that low population density may be associated with a higher risk of suicide. We examined the relationship between population density and suicide rates across different countries worldwide, and evaluated possible moderating effects by sex and age. A systematic review was conducted by searching the PubMed, Embase and PsychINFO databases for relevant publications following a pre-registered protocol and standard PRISMA methods. A meta-analysis was conducted with the available data. From the 10,916 original non-duplicate articles initially identified, 80, published between 1932 and 2023 and covering time-periods ranging from 1890 to 2019 met the selection criteria. Of them, 83.8 % indicated that lower levels of population density were associated with higher suicide rates. A meta-analysis, based on the data from 8 publications, confirmed a statistically significant association between higher suicide rate and lower population density (OR = 1.87; 95 % CI: 1.53-2.30, z = 6.05, p < 0.001). This association was observed in males (p = 0.009), but not in females (p = 0.091). No consistent age or time effects were found. Context-specific differences in suicide methods were identified. Across diverse socio-economic and cultural settings in the world, living in less densely populated areas involves a higher risk of suicide in the male population. Men are more sensitive to the suicide risk factors associated with less populated areas and should be a target of preventive interventions. CRD42022345279.