Trends in socioeconomic inequalities in suicide mortality over the six past decades (1960–2021): A systematic review of 49 time-trends studies

Abstract

Suicide rates has steadily and significantly declined over the past decades worldwide, but this global decline may hide a more complex trends by socioeconomic status. Our systematic review aimed to summarize the existing literature on time-trends in socioeconomic inequalities in suicide mortality over the past decades. An electronic search was performed in 5 databases on March 2024 with no restrictions on location or year of publication. Studies were included if they assessed socioeconomic inequalities through a measure of education level, income level, deprivation level, or occupation class, and time-trends with respect to suicide mortality. A total of 49 articles of overall good quality met the criteria for inclusion. The study period ranged from 1960 to 2021. Study settings were primarily Europe (n = 26) and Asia (n = 11). The majority of studies demonstrated an overall increase or stability in socioeconomic inequalities in suicide mortality, particularly among the middle-aged and especially in Asia. Inequalities based on occupational status showed the strongest tendency to increase. Mental health promotion programs targeting suicidal behaviors in the most-deprived and less-educated populations are urgently warranted.