Abstract

Suicide is a complex phenomenon, influenced by several factors and, therefore, generalizations of risk factors are counterproductive. Thus, contextual analyses can point out situations of greater risk and contribute to the formulation of policies to prevent attempts and deaths due to this cause. In order to describe and analyze both the individual and context factors associated with suicide deaths among adults (twenty years old or over), in Brazil from 2010 to 2015, the model of social health determinants proposed by Dahlgren and Whitehead was adopted. Crude suicide mortality rates were calculated using data from the Mortality Information System, according to individual and context variables, and a hierarchical and multilevel approach was performed, with the crude mortality rate by suicide as the outcome variable. A total of 60 440 deaths due to suicide were recorded, with a mortality rate of 7.5 per 1 00 000 inhabitants. Hanging (4.6) was the main means used to commit suicide. Higher risks were observed among the elderly aged 70 or over (8.9), individuals with 0 to 3 years of schooling (7.7), and indigenous people (12.4). Individual factors significantly associated with suicide were: male sex (relative risk 1.34; 95% confidence interval 1.16–1.54); indigenous ethnicity/skin color (2.03; 1.90–2.16); 0 to 3 years of schooling (1.05; 1.03–1.07); agricultural/forestry/fishing workers (1.14; 1.12–1.16). Context factors were: average of less than three residents per household (1.21; 1.19–1.22); absence of Psychosocial Care Center (Caps) (1.14; 1,13–1,16); municipalities with lower urbanization rate (1.38; 1.32–1.44), lower Gini index (1.10; 1.07–1.14), small-sized population (1.86; 1.82–1.89), located in the South of the country (1.60; 1.56–1.64). Context-level characteristics may influence suicidal behaviors above and beyond individual-level effects, although it is difficult to determine how the characteristics of the context level exert such influence.