The relationship between credit and suicide in Italy.

OBJECTIVES: to analyse the association between suicide rates and credit to the economy in Italy, and the potential role of social protection measures (SPMs) as buffering mechanism. DESIGN: descriptive study. SETTING AND PARTICIPANTS: data were derived from the Italian National Institute of Statistics and from the Organisation for Economic Co-operation and Development. Fixed-effects panel regressions were run to test the association between male and female suicide rates and the rate of growth of the credit-to-GDP (CTG) ratio. The buffering role of social protection measures was investigated. The observation period was from 1990 to 2014. MAIN OUTCOME MEASURES: regional male and female rates of suicide. RESULTS: male suicide rate is influenced by the rate of growth of the CTG ratio: a one-unit decrease in the latter is associated with 1.26 more suicides every 10,000 people. This marginal effect was significant at 1% for men, but not significant for women. Unemployment rate and periods of mass job loss were not associated with the outcome. With respect to SPMs, only public unemployment spending was able to moderate the association between suicide rate and rate of growth of the CTG ratio. A one-unit increase in the rate of growth of public unemployment spending was associated with 0.12 less suicides every 10,000 people, but only among men. Younger and older men were more affected by credit reduction, namely those aged 15-44 years and 75 years or more. Differently, women were not influenced by credit reduction, but only by increased UR in the group aged 55-64 years. CONCLUSIONS: access to credit is a major determinant of psychological well-being for men, but not for women. The rate of growth of the CTG ratio may be more useful than other macroeconomic indicators at identifying the mental health outcomes of economic crises.