International Psychogeriatrics

Research Article

Social inclusion affects elderly suicide mortality

Andriy Yur`yeva1 c1, Lauri Leppika2, Liina-Mai Toodinga3, Merike Sisaska1, Peeter Värnika1, Jing Wua1 and Airi Värnika1

a1 Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Center of Behavioural and Health Sciences and Tallinn University, Tallinn, Estonia

a2 Tallinn University, Tallinn, Estonia

a3 University of Tartu, Tartu, Estonia


Background: National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared.

Methods: For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens’ attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database.

Results: Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicide rates are lower in countries where the elderly live with their families more often. Elderly suicide mortality and labor-market exit age are inversely correlated. In Eastern European countries, elderly people's status and economic contribution are seen as less important. Western Europeans regard the elderly with more admiration, consider them more friendly and more often have elderly relatives in the family. The data also show gender differences.

Conclusions: Society's attitudes influence elderly suicide mortality; attitudes towards the elderly are more favorable among Western European citizens; and extended labor-market inclusion of the elderly is a suicide-protective factor.

(Received May 06 2010)

(Revised June 10 2010)

(Revised July 02 2010)

(Accepted July 04 2010)

(Online publication September 14 2010)


c1 Correspondence should be addressed to: Dr. Andriy Yur`yev, MD, MA, Estonian-Swedish Mental Health and Suicidology Institute, Õie 39, Tallinn 11615, Estonia. Phone/Fax: +3726516550. Email:;