Factors predicting suicide among Russians in Estonia in comparison with Estonians: case-control study

Aim

To explore differences between suicide victims among Russian immigrants in Estonia and native Estonians, according to socio-demographic background, substance use pattern, and recent life events to find out immigration-specific factors predicting suicide.

Methods

The psychological autopsy study included 427 people who committed suicide in 1999 and 427 randomly selected controls matched by region, gender, age, and nationality.

Results

The only variable that differed significantly between Russian and Estonian suicide cases was substance use pattern. Logistic regression models showed that factors associated with suicide for both nationalities were substance dependence and abuse (Russians: odds ratio OR], 12.9; 95% confidence interval 95% CI], 4.2-39.2; Estonians: OR, 8.1; 95% CI, 3.9-16.4), economical inactivity Russians: OR 5.5; 95% CI, 1.3-22.9; Estonians: OR, 3.1; 95% CI, 1.3-7.1), and recent family discord (Russians: OR, 3.2; 95% CI, 1.1-9.9; Estonians: OR, 4.5; 95%, CI, 2.1-9.8). The variables that remained significant in the final model were having no partner (Estonians: OR, 3.0; 95% CI, 1.6-5.5), being unemployed (Estonians: OR, 5.5; 95% CI, 2.0-15.4), and being an abstainer (Estonians: OR, 6.7; 95% CI, 2.5-17.6) for Estonians, and somatic illness (Russians: OR, 4.1; 95% CI, 1.4-11.7), separation (Russians: OR, 32.3; 95% CI, 2.9-364.1), and death of a close person (Russians: OR, 0.2; 95% CI, 0.04-0.7) for Russians.

Conclusion

Although the predicting factors of suicide were similar among the Estonian Russians and Estonians, there were still some differences in the nature of recent life events. Higher suicide rate among Estonian Russians in 1999 could be at least partly attributable to their higher substance consumption.Several studies compared suicide rates of immigrant population, native population in the host country, and population in the country of origin. Previous research has shown variance in the suicide rates of immigrant groups with different ethnic background, as well as different suicide rates in their home countries (1-8). Differences between suicide rates of immigrant groups and native population are not quite clear, but most of the immigrant groups have higher suicide rates than the population in their countries of origin. A number of studies found that migrants who had high suicide rates came from countries with high rates and vice versa (1,2,4,9,10).Reports from England and Wales (3), Canada (5), and Sweden (6,11) showed very high suicide rates among Russian immigrants compared with the rates of the population both in their country of origin and in the host country. Johansson et al (11) found that suicide rate of Russian male immigrants in Sweden was 201.9 per 100 000 in comparison with 41.4 in Russian men in Russia and 44.5 in Swedish men in 1986-1989.Värnik et al (12) compared suicide rates of Russians in Estonia, Estonians in Estonia, and inhabitants of Russia before (1983-1990) and after (1991-1998) Estonia gained independence. Suicide rates of Russian immigrants were lowest in the period before Estonian independence and highest in the period after reestablishing independence. In 1998, Russian and Estonian suicide rates were similar (12), but in the 1991-2001period, mean suicide rates in Estonian Russians were higher than in Estonians (38.2 and 31.9 per 100 000, respectively) (13).There is a lack of studies on specific suicide risk factors for immigrants on the individual level. As far as we know, the only study available was a psychological autopsy study on suicides of Ethiopian immigrants to Israel (14). They found that 67% of suicide victims were dissatisfied with their employment, 50% with their economic status, 44% with their marital relationships, and 53% with their fluency in the host language. However, in this study no controls were used.Since there were differences in suicide rates between Russian immigrants in Estonia and native Estonians, the purpose of the present study was to explore possible differences between suicide victims of these two main ethnic groups in Estonia according to socio-demographic background, substance use pattern, and recent life events to find out immigration-specific factors predicting suicide on the individual level.