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Jeanette Westman, RN, BS; Jan Hasselström, MD, PhD; Sven-Erik Johansson, PhD; Jan Sundquist, MD, PhD

Arch Gen Psychiatry. 2003;60:409-414.

Background  Our knowledge of the influence of place of birth and socioeconomic status on attempted suicide in a defined national population is limited.

Methods  The study population at baseline in 1993 included approximately 4.5 million Swedish persons aged 25 to 64 years, of whom 570 000 had been born abroad. Each individual was tracked until attempted suicide, remigration, death, or the end of the study on December 31, 1998. The Cox regression was used in the analysis.

Results  Labor migrants from Finland and other OECD (Organisation for Economic Cooperation and Development) countries and refugees from Poland and Iran had higher hazard ratios of attempted suicide than Swedish-born control subjects. Women born in Latin America, Asia, and Eastern Europe had significantly higher hazard ratios of attempted suicide than Swedish-born women. In contrast, men born in southern Europe and Asia had significantly lower hazard ratios of attempted suicide. The hazard ratios of attempted suicide among women from Iran, Asia, southern Europe, Latin America, and eastern Europe considerably exceeded those of men from the same country of origin. When socioeconomic status was included in the final model, the hazard ratios remained high for women, while the risk of attempted suicide among men declined sharply with increased income.

Conclusions  Place of birth, socioeconomic status, and sex are associated with attempted suicide. Socioeconomic status explains only part of the association between place of birth and attempted suicide.

From the Karolinska Institutet, MigraMed, Family Medicine Stockholm, Stockholm, Sweden.

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