Do social protection programs have a causal effect on suicide mortality? A protocol for a systematic review and meta-analysis

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BMJ open. 2022 Apr 22;12(4):e054677. doi: 10.1136/bmjopen-2021-054677.


INTRODUCTION: Recent international and national strategies to reduce suicide mortality have suggested that social protection programs could be an effective multisectoral response given the link between material deprivation and suicides in observational studies. However, there is a lack of evidence on the causal relationship between social protection programs and suicide, which may hamper the large national budget reallocations needed to implement these policies. Social protection programs are government interventions that ensure adequate income now and in the future, through changes in labor income (for example, an increase in the minimum wage) or social security (through cash transfers or cash equivalents). Our review aims to assess the existing evidence on a causal relationship between social protection programs and suicide mortality by examining all relevant experimental and quasi-experimental studies between January 1980 and November 2021.

METHODS AND ANALYSIS: The review will be conducted in accordance with the Preferred Reporting Elements Guidelines for Systematic Reviews and Meta-Analyses. We will search for references published between January 1, 1980 and November 30, 2021 in 10 electronic databases, including MEDLINE (PubMed), PsycINFO, EMBASE, and Applied Social Sciences Index Abstracts. Seven reviewers will independently participate in screening studies from titles, abstracts and full texts at all stages. Experimental (i.e. randomized controlled trials) and quasi-experimental (i.e. non-randomized interventional studies) studies written in English, French, Spanish, German, Chinese, Korean and Japanese examining the impact of income security programs on suicide mortality were included. Meta-analyses will be conducted if there are at least three studies of similar income security programs.

ETHICS AND DISSEMINATION: Our review proposal does not require ethics approval. Together with our community partners, we will develop a guidance note for stakeholders to support efforts to implement social protection programs to help prevent suicides. Our findings will be presented at conferences, published in a peer-reviewed journal, and promoted on social media platforms.


PMID:35459667 | DOI:10.1136/bmjopen-2021-054677

Joel C. Hicks