Introduction: Suicide is a serious public health problem worldwide,
with most suicides occurring in low– and middle-income countries. This
nationwide ecological study aimed to explore the relationship between
crude suicide rates of the sexes and gender inequality.
Method: The data on age and gender-stratified crude suicide rates in
all 81 provinces of Türkiye were retracted from the Turkish Statistical
Institute database. Gender inequality was measured using Türkiye’s
provincial-level Gender Equality Index (GEI). Additionally, the following
variables were considered gender inequality indicators: early marriages,
fertility rate, and marriage/divorce rates; data were obtained from the
Turkish Statistical Institute database. Data from 2019 were used to avoid
the confounding effect of the COVID-19 pandemic.
Results: The associations between gender inequality and crude suicide
rate differed between women and men. There was a positive correlation
between crude suicide rate and GEI in men aged 45–64 (r=0.294 p<0.01),
but no correlations were found in other groups of age and gender. Early
marriage rates (r=0.341 p<0.01) and fertility rate (r=0.333 p<0.01) were
positively associated with crude suicide rates in women aged 15–44,
while divorce/marriage rate (r=-0.256 p<0.05) was negatively related
to these rates. Divorce/marriage rate was associated with an increase
in men’s suicides in both the 45–64 (r=0.452 p<0.01) and 65 and over
(r=0.290 p<0.01) age groups.
Conclusion: Gender inequality indicators were related to suicide. That
relationship may vary across different age and gender groups. The findings
may be limited to low– and middle-income countries. Suicide prevention
interventions should be designed to account for age group, gender, and
cultural characteristics of the place of residence concerning gender.
Keywords: Fertility, gender inequality, marriage, sex differences, suicide