Pathways to suicide prevention: a population-based cohort study of the mediating role of Bolsa Família in psychosocial stressors in the 100 million Brazilian cohort
Abstract
Abstract Introduction Suicide is a major public health concern in Brazil, and its risk is heightened by psychosocial stressors disproportionately affecting socioeconomically vulnerable groups. This study aimed to investigate how the cash transfer Bolsa Família Programme (BFP) mediates the relationship between psychosocial stressors and suicide risk among low-income individuals in Brazil. Methods We analysed data from the 100 Million Brazilian Cohort (2008–2015), which includes individuals registered in the Cadastro Único (national registry of low-income families) linked to hospitalisation and mortality records through deterministic and probabilistic methods. Psychosocial stressors were defined as: (1) violence (hospitalisation for interpersonal violence); (2) impulsivity (unintentional injury hospitalisations); and (3) psychiatric hospitalisation (International Classification of Diseases, 10th Revision (ICD-10):F00–F99). Suicide mortality (ICD-10 X60–X84) was the outcome. Analyses included individuals aged ≥10 years and applied structural equation models adjusted for sociodemographic confounders. Results Data from over 22 million participants revealed that 54% were female, 53% self-identified as Pardo/Brown, and 38% were enrolled in BFP. Individuals exposed to violence, impulsivity or mental disorders showed higher risk of suicide (β=0.418, 0.246 and 0.395, respectively; all p<0.001). We confirmed that BFP mediated the association for violence and mental disorders (indirect…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 22 participants or records.
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