Neighborhood ethnic density and suicide risk among different migrant groups in the four big cities in the Netherlands

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Web End = Soc Psychiatry Psychiatr Epidemiol (2015) 50:951962 DOI 10.1007/s00127-014-0993-y

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Web End = Neighborhood ethnic density and suicide risk among different migrant groups in the four big cities in the Netherlands

Fabian Termorshuizen Arjan W. Braam

Erik J. C. van Ameijden

Received: 26 August 2014 / Accepted: 30 November 2014 / Published online: 10 December 2014 Springer-Verlag Berlin Heidelberg 2014

AbstractPurpose Recent studies suggested a favorable association between the ethnic density of the neighborhood and the risk of psychotic disorders among ethnic minorities. In this study, it was investigated whether this so-called ethnic density hypothesis is also relevant to suicide risk, which is not sensitive to bias associated with ethnic differences in access to health care and reects a broad range of mental health problems.

Methods Suicides in the four big cities in the Netherlands during 20002011 were ascertained using the cause of death register of Statistics Netherlands and analyzed in a multilevel Poisson model in relation to individual- and neighborhood-level characteristics.

Results With increasing non-Western minority density, the adjusted rate ratio (RR) of suicide in non-Western immigrants compared to native Dutch persons decreased from 0.69 to 0.39 (P \ 0.001). This was explained by higher suicide rates among Dutch persons (RR = 1.28,

P = 0.048) and lower rates among non-Western persons (RR = 0.72, P = 0.004) in neighborhoods with high ([55.9 %) compared to neighborhoods with low non-

Western minority density (\36.5 %). Similar results were found for Turkish, Moroccan, Surinamese/Antillean and other non-Western subgroups separately. Compared to personally matched controls, non-Western cases (i.e., those who committed suicide) more often moved house to own-group high-dense areas and less often to own-group low-dense areas in the 5 years prior to suicide.

Conclusions Our ndings support the benecial inuence of the presence of the own ethnic group in the neighborhood on suicide risk among non-Western minorities. As moving to minority more dense areas prior to suicide was observed, this inuence of ethnic density as measured on population level may have been underestimated.

Keywords Suicide Ethnic minority density