Suicide as globalisation's Black Swan: global evidence.

OBJECTIVES:This empirical study investigated the relationship between globalisation and suicide rates. We examined whether there is a beneficial or harmful relationship between economic, political and social globalisation and the suicide rate. We also estimated whether this relationship differs in high-, middle- and low-income countries. STUDY DESIGN:Using panel data from 190 countries over the period 1990-2019, we examined the relationship between globalisation and suicide. METHOD:We compared the estimated effect of globalisation on suicide rates using robust fixed-effects models. Our results were robust to dynamic models and models with country-specific time trends. RESULTS:The effect of the KOF Globalisation Index on suicide was initially positive, leading to an increase in the suicide rate before decreasing. Concerning the effects of economic, political, and social dimensions of globalisation, we found a similar inverted U-shaped relationship. Unlike the middle-income and high-income countries, we found a U-shaped relationship for the case of low-income countries, indicating that suicide decreased with globalisation and then increased as globalisation continues to increase. Moreover, the effect of political globalisation disappeared in low-income countries. CONCLUSION:Policy-makers in high- and middle-income countries, below the turning points, and low-income countries, above the turning points, must protect vulnerable groups from globalisation's disruptive forces, which can increase social inequality. Consideration of local and global factors of suicide will potentially stimulate the development of measures that might reduce the suicide rate.