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

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

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 reflects a broad range of mental health problems.

Methods

Suicides in the four big cities in the Netherlands during 2000–2011 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 findings support the beneficial influence 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 influence of ethnic density as measured on population level may have been underestimated.

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Acknowledgments

The authors like to thank Statistics Netherlands (Centraal Bureau voor de Statistiek, CBS) for kindly providing the data necessary for the present analysis.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Public Health, Municipality of Utrecht, PO Box 2423, 3500 GK, Utrecht, The Netherlands

    Fabian Termorshuizen & Erik J. C. van Ameijden

  2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Fabian Termorshuizen

  3. Department of Emergency Psychiatry, Altrecht Mental Health Care, Lange Nieuwstraat 119, 3512 PG, Utrecht, The Netherlands

    Arjan W. Braam

  4. Department of Specialist Training, Altrecht Mental Health Care, Lange Nieuwstraat 119, 3512 PG, Utrecht, The Netherlands

    Arjan W. Braam

Authors
  1. Fabian Termorshuizen
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  2. Arjan W. Braam
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  3. Erik J. C. van Ameijden
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Correspondence to Fabian Termorshuizen.

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Termorshuizen, F., Braam, A.W. & van Ameijden, E.J.C. Neighborhood ethnic density and suicide risk among different migrant groups in the four big cities in the Netherlands. Soc Psychiatry Psychiatr Epidemiol 50, 951–962 (2015). https://doi.org/10.1007/s00127-014-0993-y

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  • DOI: https://doi.org/10.1007/s00127-014-0993-y

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