Women’s suicide in low-, middle-, and high-income countries: Do laws discriminating against women matter?

Abstract Background Women’s suicide is a serious public health issue in low- and middle-income countries (LMIC). This study explored whether institutional discrimination against women, as manifested in formal and informal laws, is relevant to country’s income-level variability in women’s suicide mortality. It also examined which discriminatory laws are associated with LMIC women’s suicides. Methods Scores on laws discriminating against women, across 176 countries, were obtained from the Gender, Institutions and Development Database. Male-to-female (M/F) 2017 suicide ratios were the index of women’s propensity for suicide. The mediating role of laws discriminating against women on the association between country’s income level and M/F suicide ratios was analysed by bootstrapping method. Regression analyses examined which discriminatory laws were associated with LMIC women’s suicide rates. Results LMIC had significantly smaller M/F suicide ratios than high-income countries. Institutional discrimination mediated the association between countries’ income-level and M/F suicide ratios (total effect: β=-0.13, 95% CI [ -0.26, -0.01]; direct effect: β=-0.06, 95% CI [ -0.20, 0.08]; indirect effect: β= -0.07, 95% CI [ -0.15, -0.02]). In LMIC, higher levels of discrimination against women in laws about access to productive and financial resources (β=-0.69, p Conclusions The relatively high suicide rates recorded among women in LMIC might be related to the higher level of institutional discrimination women experience in these countries. In LMIC, where, by law, women had restricted access to productive and financial assets and to justice, and unequal citizenship, household responsibilities, divorce, and inheritance rights, M/F suicide ratios were lower—that is, women’s suicide rates were higher. Suicide theory, research, and prevention targeting women should incorporate social-context and social-justice perspectives.