Distribution of Suicides in India: A Decadal Data Analysis (2011-2020)

Abstract Background India accounts for a significant proportion of suicide deaths globally. As per the Global Burden of Disease Study, India’s share of global suicides from 1990 to 2016 increased from 25·3% to 36·6% among women and 18·7% to 24·3% among men. However, medical factors are not the sole contributors to the suicide burden. Methods I analyze decadal data (2011-2020) on suicides in India provided by National Crime Records Bureau. This data contains the distribution of suicidal deaths based on age groups, causes, professions, gender, and residence zones. Results The analysis suggests that individuals aged ‘15-29 years’ were most affected (35.05%) by suicides, followed by those aged ‘30-44 years’ (32.61%). Family problems contribute to the highest burden of suicides among both these age groups. Such deaths can be attributed to personal reasons. Suicides due to dowry disputes are exclusive to women. Also, women report the highest instances of suicides due to marriage-related issues. While suicides due to drug abuse, bankruptcy, unemployment, poverty, and property disputes were mainly reported among males. In 2020, the rise in annual suicide rate was found to be highest among business persons (29.43%), especially tradesmen (49.9%) and vendors (26.11%) against other businesses (12.13%). Other professions which witnessed a steep rise in annual suicide rates in 2020 were agricultural laborers (17.90%) and daily wage earners (15.76%). This increase in suicide rates may be linked to economic reasons post lockdown imposition during the Covid-19 outbreak in 2020. Conclusions Women commit suicide mainly due to marriage-related causes, while men are more vulnerable to suicide due to economic factors. Not all suicides can be traced back to diagnosed mental illnesses. A significant proportion of suicides are attributed to personal, economic, and social problems. The insights generated from this analysis can help identify the vulnerable groups and target the much-needed interventions. Key messages • Suicide is a multifaceted problem involving various personal, economic, cultural, and social factors, besides medical reasons. • Multidimensional strategies targeted at vulnerable groups could be potentially effective in curbing suicide rate.

The COVID-19 pandemic has resulted in an unprecedent range of negative mental health outcomes across populations worldwide. Such effects are increasingly being documented, however an evidence gap persists on the consequences on most vulnerable groups, as certain subgroups of migrants. These populations already suffer from increased psychological burden, and the pandemic effects may potentially exacerbate adverse experiences and outcomes. This study aims to uncover the perceived impact of the COVID-19 pandemic on the mental health of migrants in Portugal and the associated sociodemographic aspects. A survey was conducted with a community-based sample of 1126 adult migrants in Portugal, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on mental health. Association between sociodemographics and mental health indicators was measured through bivariable analysis. In total, 1126 adult migrants were surveyed: 53.4% female, mean age of 35.8 years (range 18-77), 48.9% from African countries, 29.5% from Middle East/Asian countries, 21.6% from Brazil. Most participants (80%) reported feelings of agitation, anxiety or sadness during the pandemic period with 26.4% experiencing these feelings most days. The pandemic had a disproportionate impact on women (86.9% reported negative impact compared to 72.5% of men, p < 0.05), those undocumented (83.3% vs 75.4%, p < 0.05), those whose financial situation got worse since the pandemic (82.8% vs. 77.3%, p < 0.05) and those who had increased food shortages (84.4% vs 79%, p < 0.05). Migrants perceived an elevated deterioration of their mental health during the COVID-19 pandemic. In addition, particular groups such as women and those with a more insecure income or residence status are particularly susceptible to experiencing negative mental health outcomes.

Key messages:
There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular migrant groups and to develop interventions that target their unique needs.
Investigating sociodemographic and migration aspects could help identifying migrants at a higher risk of experiencing mental health distress.

Background:
India accounts for a significant proportion of suicide deaths globally. As per the Global Burden of Disease Study, India's share of global suicides from 1990 to 2016 increased from 25Á3% to 36Á6% among women and 18Á7% to 24Á3% among men. However, medical factors are not the sole contributors to the suicide burden. Methods: I analyze decadal data (2011-2020) on suicides in India provided by National Crime Records Bureau. This data contains the distribution of suicidal deaths based on age groups, causes, professions, gender, and residence zones.

Results:
The analysis suggests that individuals aged '15-29 years' were most affected (35.05%) by suicides, followed by those aged '30-44 years' (32.61%). Family problems contribute to the highest burden of suicides among both these age groups. Such deaths can be attributed to personal reasons. Suicides due to dowry disputes are exclusive to women. Also, women report the highest instances of suicides due to marriage-related issues. While suicides due to drug abuse, bankruptcy, unemployment, poverty, and property disputes were mainly reported among males. In 2020, the rise in annual suicide rate was found to be highest among business persons (29.43%), especially tradesmen (49.9%) and vendors (26.11%) against other businesses 15th European Public Health Conference 2022 (12.13%). Other professions which witnessed a steep rise in annual suicide rates in 2020 were agricultural laborers (17.90%) and daily wage earners (15.76%). This increase in suicide rates may be linked to economic reasons post lockdown imposition during the Covid-19 outbreak in 2020.

Conclusions:
Women commit suicide mainly due to marriage-related causes, while men are more vulnerable to suicide due to economic factors. Not all suicides can be traced back to diagnosed mental illnesses. A significant proportion of suicides are attributed to personal, economic, and social problems. The insights generated from this analysis can help identify the vulnerable groups and target the much-needed interventions.

Background:
Studies show that people with a migration background are often uncertain concerning the kinds of health services that are offered and where to turn to with which health concerns. Some factors, like fears or obstacles (e.g. deductibles), lead to the health system not being used (on time). This is particularly true for those who are socioeconomically or socially disadvantaged. The aim of the project was to get an insight into the information needs of this population group as a basis for producing and disseminating good health information in the future.

Methods:
In this qualitative study co-researchers conducted guided focus groups (separated by sex) or interviews in their first languages. In total, more than 100 people from 16 different countries of origin were involved in the survey.

Results:
In general, a substantial need for multilingual health information prepared in easy-to-understand language was expressed. Some health topics (e.g. the Austrian health system, mental health and available support) were mentioned by many participants. Other issues were relevant for few groups only (e.g. TCM). Gender differences can be seen in some groups but not in all. Besides acquaintances/relatives, general practitioners were named as main source of information. Indications can be derived on how health information should be prepared, designed and distributed. Besides multilingual health information, translation services are needed during appointments but also for the medical reports.

Conclusions:
When searching for health information, but also when trying to understand it, language barriers are a major obstacle. Multilingual and culture-sensitive explainer videos on selected topics are an appropriate medium for reaching a broad group of people. Low-threshold multilingual regional contact points could provide an important contribution to health equity, as a guide in the health system, providing information and translation services, and setting health promotion offers. Key messages: Language barriers represent a major obstacle for vulnerable population groups with migration background in all stages of the health care process.
There is a substantial need for adequately prepared multilingual health information.
Abstract citation ID: ckac131.504 The influence of social support on subjective health among people with selected citizenships

Background:
Social support as a psychosocial resource has a significant impact on health. However, data on the association between social support and subjective health among people with a migration history is scarce. The aim of this analysis was to examine this association among a sample of people with selected citizenships in consideration of socio-demographic and migration-related factors.

Methods:
Data from the project ''Improving Health Monitoring in Migrant Populations (IMIRA)'' was used, including people with Croatian, Polish, Romanian, Syrian, and Turkish citizenship. Descriptive and logistic regression analyses were conducted to analyse the effect of socio-demographic (gender, age, socio-economic status (SES)) and migrationrelated factors (length of residence, residence status, German language proficiency) on the association between social support and subjective health (very good/good).

Results:
A total of 60.8% of participants with a low level of social support, indicated good subjective health in comparison to 78.8% among those who reported strong support. Participants with a length of residence of over 20 years (aOR = 0,29) and (very) poor German language proficiency (aOR = 0,39) were less likely to report good health. A high SES had the strongest impact on good subjective health (aOR = 5,42).

Conclusions:
Overall, the results confirm the findings for the general population in a sample of people with selected citizenships. The fact that people with a migration history more often face structural and health related barriers and that the existence of resources is helpful in overcoming these, a differentiated consideration of the relationship between social support and subjective health seems necessary in order to establish targeted prevention measures. Key messages: Among people with selected citizenships, good social support has a positive impact on subjective health. Results remain consistent when considering socio-economic and migration-related factors.