Effect of the Brazilian cash transfer programme on suicide rates: a longitudinal analysis of the Brazilian municipalities

  • Flávia Jôse Oliveira AlvesEmail author
  • Daiane Borges Machado
  • Maurício L. Barreto
Original Paper



There is a growing awareness of the economic and contextual factors that may play a role in the aetiology of suicide. The Programa Bolsa Família (PBF) the Brazilian conditional cash transfer programme, established in 2004, aims to attenuate the effects of poverty of Brazilians. Our study aims to evaluate the effect of Bolsa Família Programme (BFP) coverage on suicide rates in Brazilian municipalities.


We conducted an ecological study using 2004–2012 panel data for 5507 Brazilian municipalities. We calculated age-standardized suicide rates for each municipality and year. BFP coverage was categorized according to three levels (< 30%, ≥ 30% and < 70% and ≥ 70%) and duration (coverage ≤ 70% for all years, ≥ 70% for 1 year, ≥ 70% for 2 years, ≥ 70% for 3 or more years). We used negative binomial regression models with fixed effects, adjusting for socio-economic, demographic and social welfare co-variables.


An increase in BFP coverage was associated with a reduction in suicide rates. The strongest effect was observed when in addition to greater municipal coverage (RR 0.942, 95% CI 0.936–0.947), the duration of the high coverage was maintained for 3 years or more (RR 0.952 95% CI 0.950–0.954).


The results provide evidence that the conditional cash transfer programme may reduce suicide in Brazilian municipalities, mitigating the effect of poverty on suicide incidence.


Conditional cash transfer programme Suicide Attempted suicide Impact evaluation 


Compliance with ethical standards

Conflict of interest

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

Supplementary material

127_2018_1627_MOESM1_ESM.docx (46 kb)
Supplementary material 1 (DOCX 46 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Flávia Jôse Oliveira Alves
    • 1
    • 2
    Email author
  • Daiane Borges Machado
    • 1
    • 3
  • Maurício L. Barreto
    • 1
    • 2
  1. 1.Centre for Data and Knowledge Integration for Health (CIDACS)Instituto Gonçalo Muniz, Fundação Oswaldo Cruz (FIOCRUZ)SalvadorBrazil
  2. 2.Institute of Collective HealthFederal University of Bahia (UFBA)SalvadorBrazil
  3. 3.Centre for Global Mental health (CGMH)London School of Hygiene and Tropical MedicineLondonUK

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