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Pathways to suicidality across ethnic groups in Canadian adults: the possible role of social stress

Published online by Cambridge University Press:  02 November 2007

D. E. Clarke ,
A. Colantonio ,
A. E. Rhodes  and
M. Escobar
D. E. Clarke*
Affiliation:
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Department of Psychiatry, University of Toronto, Toronto, Canada Graduate Department of Public Health Sciences, University of Toronto, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada
A. Colantonio
Affiliation:
Graduate Department of Public Health Sciences, University of Toronto, Toronto, Canada Toronto Rehabilitation Institute, Toronto, Canada Department of Occupational Science and Occupational Therapy, University of Toronto, Canada
A. E. Rhodes
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Graduate Department of Public Health Sciences, University of Toronto, Toronto, Canada Suicide Studies Unit, St Michael's Hospital, Toronto, Canada Centre for Research on Inner City Health, St Michael's Hospital, Toronto, Canada Institute for Clinical Evaluative Sciences, Sunnybrook and Women's College Hospital, Canada
M. Escobar
Affiliation:
Graduate Department of Public Health Sciences, University of Toronto, Toronto, Canada
*
*Address for correspondence: D. E. Clarke, Ph.D., Research Associate, Department of Mental Health, Johns Hopkins School of Public Health, Hampton House, Room 802, 624 N. Broadway, Box 495, Baltimore, MD 21205, USA. (Email: [email protected])
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Abstract

Background

Ethnicity is an important determinant of mental health outcomes including suicidality (i.e. suicidal ideation and suicide attempt). Understanding ethnic differences in the pathways to suicidality is important for suicide prevention efforts in ethnically diverse populations. These pathways can be conceptualized within a social stress framework.

Method

The study examines ethnic differences in the pathways to suicidality in Canada within a social stress framework. Using data from the Canadian Community Health Survey Cycle 1.1 (CCHS 1.1) and path analysis, we examined the hypotheses that variations in (1) socio-economic status (SES), (2) sense of community belonging (SCB), (3) SES and SCB combined, and (4) SES, SCB and clinical factors combined can explain ethnic differences in suicidality.

Results

Francophone whites and Aboriginals were more likely to report suicidality compared to Anglophone whites whereas visible minorities and Foreign-born whites were least likely. Disadvantages in income, income and education, income and its combined effect with depression and alcohol dependence/abuse led to high rates even among the low-risk visible minority group. Indirect pathways for Asians differed from that of Blacks and South Asians, specifically through SCB. With the exception of SCB, Aboriginals were most disadvantaged, which exacerbated their risk for suicidality. However, their strong SCB buffered the risk for suicidality across pathways. Disadvantages in education, income and SCB were associated with the high risk for suicidality in Francophone whites.

Conclusions

Francophone whites and Aboriginals had higher odds of suicidality compared to Anglophone whites; however, some pathways differed, indicating the need for targeted program planning and prevention efforts.

Keywords

Aboriginalsethnicitystress processsuicidalityvisible minorities
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 3 , March 2008 , pp. 419 - 431
Copyright
Copyright © Cambridge University Press 2007

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