The Global Burden of Suicidal Behavior Among People Experiencing Food Insecurity: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Introduction Food insecurity has become a growing burden within a global context where climate change, catastrophes, wars, and insurgencies are increasingly prevalent. Several studies have reported an association between suicidal behaviors (i.e., suicide ideation, plans, and attempts) and food insecurity. This meta-analytic review for the first time, synthesized the available literature to determine the pooled prevalence of suicidal behaviors among individuals experiencing food insecurity, and examined the strength of their association. Objectives To determine the pooled prevalence of suicidal behaviors among individuals experiencing food insecurity, and examine the strength of their association. Methods Databases (Ovid, PubMed, Web of Science, and CINAHL) were searched using the appropriate search term from inception to July 2022. Eligible studies reporting the number/prevalence of suicidal behaviors among individuals experiencing food insecurity or the association between food insecurity and suicidal behaviors were included. The pooled prevalence of suicidal behaviors was determined using the random-effects model. The review was registered with PROSPERO (CRD42022352858). Results A total of 47 studies comprising 75,346 individuals having experienced food insecurity were included. The pooled prevalence was 22.3% for suicide ideation (95% CI: 14.7-29.9; I2=99.6%, p<0.001, k=18), 18.1% for suicide plans (95% CI: 7.0-29.1; I2=99.6%, p<0.001, k=4), 17.2% for suicide attempts (95% CI: 9.6-24.8; I2=99.9%, p<0.001, k=12), and 4.6% for unspecified suicidal behavior (95% CI: 2.8-6.4; I2=85.5%, p<0.001, k=5). There was a positive relationship between experiencing food insecurity and (i) suicide ideation (aOR=1.049 [95% CI: 1.046-1.052; I2=99.6%, p<0.001, k=31]), (ii) suicide plans (aOR=1.480 [95% CI: 1.465-1.496; I2=99.1%, p<0.001, k=5]), and (iii) unspecified suicide behaviors (aOR=1.133 [95% CI: 1.052-1.219; I2=53.0%, p=0.047, k=6]). However, a negative relationship was observed between experiencing food insecurity and suicide attempts (aOR=0.622 [95% CI: 0.617-0.627; I2 = 98.8%, p<0.001, k=15]). The continent and the countries income status where the study was conducted were the common cause of heterogeneity of the differences in the odds of the relationships between experiencing food insecurity and suicidal behaviors - with North America and high-income countries (HICs) having higher odds. For suicide attempts, all non HICs had a negative relationship with food insecurity. Conclusions There is a high prevalence of suicidal behaviors among individuals experiencing food insecurity. Initiatives to reduce food insecurity would likely be beneficial for mental wellbeing and to mitigate the risk of suicidal behaviors among population experiencing food insecurity. The paradoxical finding of suicide attempts having a negative relationship with food insecurity warrants further research. Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.034 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.031 |
| Bibliometrics | 0.011 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".