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      Risk of suicide in households threatened with eviction: the role of banks and social support

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          Abstract

          Background

          One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate the risk of suicide among victims of eviction and investigate whether it is associated with specific characteristics of households and interviewees, the eviction process and social support, and health needs.

          Methods

          A total of 205 participants from households threatened with eviction in Granada, Spain, and 673 being the total number of members of these households, were interviewed in one-on-one sessions between April 2013 and May 2014. Through a questionnaire, information was obtained on physical and mental health, characteristics of their eviction process and support networks, and the use of health services.

          Results

          Almost half of the sample (46.7%) were at low (11.8%), moderate (16.9%), or high suicide risk (17.9%). Household and interviewee features had a limited association with suicide risk. On the contrary, the risk of suicide is greater with a longer exposure to the eviction process. In addition, threatening phone calls from banks increased significantly the risk of suicide, especially among men. Suicide risk was also associated with low social support, especially among women. Interviewees at risk of suicide received more help from nongovernmental organizations than those who were not at risk. In interviewees at risk, the main unmet needs were emotional and psychological help, especially in men. A high percentage of those at risk of suicide declare having large unmeet health needs. Finally, there was a tendency among the evicted at risk of suicide to visit emergency room and primary care more often than those not at risk, especially among women.

          Conclusions

          To our knowledge, this is the first study showing that when banks adopt a threatening attitude, suicide risk increases among the evicted. As hypothesized, when the evicted felt socially supported, suicide risk decreased. Emotional help was the main mediator of suicide risk and the main unmet need, especially among men.

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          Most cited references58

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          Suicide and suicidal behavior.

          Suicidal behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such behavior is important for policy-making and prevention. The authors reviewed government data on suicide and suicidal behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for suicidal behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of suicidal behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal suicidal behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of suicidal persons over the past decade, incidence rates of suicidal behavior have remained largely unchanged. Most epidemiologic research on suicidal behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by suicidal behavior.
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            The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health.

            In this review, the authors examine the evidence linking social support to physiological processes and characterize the potential mechanisms responsible for these covariations. A review of 81 studies revealed that social support was reliably related to beneficial effects on aspects of the cardiovascular, endocrine, and immune systems. An analysis of potential mechanisms underlying these associations revealed that (a) potential health-related behaviors do not appear to be responsible for these associations; (b) stress-buffering effects operate in some studies; (c) familial sources of support may be important; and (d) emotional support appears to be at least 1 important dimension of social support. Recommendations and directions for future research include the importance of conceptualizing social support as a multidimensional construct, examination of potential mechanisms across levels of analyses, and attention to the physiological process of interest.
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              The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients.

              A 14-item, self-administered, multidimensional, functional social support questionnaire was designed and evaluated on 401 patients attending a family medicine clinic. Patients were selected from randomized time-frame sampling blocks during regular office hours. The population was predominantly white, female, married, and under age 45. Eleven items remained after test-retest reliability was assessed over a 1- to 4-week follow-up period. Factor analysis and item remainder analysis reduced the remaining 11 items to a brief and easy-to-complete two-scale, eight-item functional social support instrument. Construct validity, concurrent validity, and discriminant validity are demonstrated for the two scales (confidant support--five items and affective support--three items). Factor analysis and correlations with other measures of social support suggest that the three remaining items (visits, instrumental support, and praise) are distinct entities that may need further study.
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                Author and article information

                Contributors
                inmaculada.mateo.easp@juntadeandalucia.es
                laura.miccoli@gmail.com
                antonio.daponte.easp@juntadeandalucia.es
                julia.bolivar.easp@juntadeandalucia.es
                cecilia.escudero.easp@juntadeandalucia.es
                mcfersan@ugr.es
                jvila@ugr.es
                hrobles@ugr.es
                matamar@ugr.es
                mariola.bernal.solano@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 September 2019
                11 September 2019
                2019
                : 19
                : 1250
                Affiliations
                [1 ]ISNI 0000 0000 9314 1427, GRID grid.413448.e, CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, ; Madrid, Spain
                [2 ]ISNI 0000 0001 2186 2871, GRID grid.413740.5, Andalusian School of Public Health (EASP), ; Granada, Spain
                [3 ]Institute of Biomedicine Research (IBIS) Granada, Granada, Spain
                [4 ]Andalusian Observatory on Environment and Health (OSMAN), Granada, Spain
                [5 ]ISNI 0000000121678994, GRID grid.4489.1, Mind, Brain, and Behavior Research Center (CIMCYC), , University of Granada, ; Granada, Spain
                [6 ]ISNI 0000 0001 2186 2871, GRID grid.413740.5, Observatorio de Salud y Medio Ambiente de Andalucía, Escuela Andaluza de Salud Pública (EASP), Consejería de Salud y Familias de la Junta de Andalucia, ; Cuesta del Observatorio,4, 18080 Granada, Spain
                Author information
                http://orcid.org/0000-0002-9581-5944
                Article
                7548
                10.1186/s12889-019-7548-9
                6737669
                31510963
                d7c02102-d8fc-43b8-b8be-903fd5b7771d
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 April 2019
                : 26 August 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                evictions,foreclosure,suicide risk,social support,banks
                Public health
                evictions, foreclosure, suicide risk, social support, banks

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