Abstract :
Background There is little evidence on the association
between suicide outcomes (ideation, attempts, self-harm) and
social capital. This paper investigates such associations using
a structural equation model based on health survey data, and
allowing for both individual and contextual risk factors.
Methods Social capital and other major risk factors for
suicide, namely socioeconomic status and social isolation,
aremodelled as latent variables that are proxied (ormeasured)
by observed indicators or question responses for survey
subjects. These latent scales predict suicide risk in the structural
component of the model. Also relevant to explaining
suicide risk are contextual variables, such as area deprivation
and region of residence, as well as the subject’s demographic
status. The analysis is based on the 2007 Adult Psychiatric
Morbidity Survey and includes 7,403 English subjects.
A Bayesian modelling strategy is used.
Results Models with andwithout social capital as a predictor
of suicide risk are applied. A benefit to statistical fit is demonstrated
when social capital is added as a predictor. Social
capital varies significantly by geographic context variables
(neighbourhood deprivation, region), and this impacts on the
direct effects of these contextual variables on suicide risk. In
particular, area deprivation is not confirmed as a distinct significant
influence. The model develops a suicidality risk score
incorporating social capital, and the success of this risk score in
predicting actual suicide events is demonstrated.
Conclusions Social capital as reflected in neighbourhood
perceptions is a significant factor affecting risks of
different types of self-harm and may mediate the effects of
other contextual variables such as area deprivation
