Suicide in the elderly: approach to social determinants of health in the Dahlgren and Whitehead model

Rev Bras Enferm. 2020 Nov 6;73(suppl 3):e20200332. doi: 10.1590/0034-7167-2020-0332. eCollection 2020.
[Article in English, Portuguese]

Abstract

Objective: Identify in literature the social determinants of health related to suicide in the elderly, according to the model proposed by Dahlgren and Whitehead.

Method: Integrative review of articles indexed in the databases BDENF, CINAHL, LILACS, and MEDLINE, with the following main descriptors: aged, suicide, social determinants of health, and risk factors. Primary studies were included which addressed social determinants of health and suicide in the elderly.

Results: From the 19 articles analyzed, three categories emerged: proximal social determinants of health (male gender, mental disorders, physical illnesses, white race, 70-74 years old); intermediate social determinants of health (substance abuse, use of alcohol or psychotropic drugs, marital status, marital, social, and family problems, violence, previous suicide attempt, history of admission to psychiatric service); and distal social determinants of health (schooling, economic issues, sanitation, stressful events).

Conclusion: Proximal determinants have more effects on suicide. Intermediate determinants are composed mainly of changeable factors. Distal determinants showed lesser associations.

Publication types

  • Review

MeSH terms

  • Aged
  • Humans
  • Male
  • Risk Factors
  • Social Determinants of Health*
  • Substance-Related Disorders*
  • Suicide, Attempted
  • Violence