Factors in the neighborhood as risks of suicide in rural China: a multilevel analysis.

To estimate the effect of social factors in the neighborhood environment on suicide risks, we studied 392 suicides and 416 controls, all aged 15-34 years, consecutively and randomly selected from 16 rural counties in three provinces of China. The social factors in the village neighborhood were measured by the WHO scale of Community Stress and Problems. The individual scores as well as the sum scores of the Community Stress Problems were compared between the suicides and the controls, and multilevel logit regressions were performed for the social structural stresses and community behavioral problems and other confounding variables to test the roles of community stress and problems in Chinese rural young suicide risks. It is found that neighborhood stresses and problems increase rural Chinese suicide risks, while certain problems, such as in health care, alcohol abuse, job security, family dispute, and transportation, play more important roles than others to increase rural Chinese suicide risks. Social risk factors such as the community stresses and problems can be another area to work on for the suicide prevention.