Do the Social Determinants of Health (SDOH) Impact Suicide Risk?

Summary: Yes, the social determinants of health (SDOH) impact suicide risk in at least two ways:

As protective factors that decrease likelihood of suicidal behavior
As risk factors that increase likelihood of suicidal behavior.

Key Points:

The social determinants of health (SDOH) include:

Why Are the Social Determinants of Health Important?

The Healthy People 2030 initiative led by the U.S Department of Health and Human Services (HHS) offers this definition of the SDOH, which includes an initial glimpse at the broad impact of the SDOH on health and wellbeing:

“The social determinants of health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.”

Studies on the social determinants of health indicate they may have as strong an influence on overall health – including mental, emotional, and behavioral health – as lifestyle factors or health care itself. In this article, we’ll review the impact of the SDOH on one aspect of mental health that’s a major public health issue in 2025: suicidality.

New Research: SDOH and Suicide Risk

In a study published in early 2025, a group of researchers identified a significant public health issue in the U.S. – the dramatic increase in suicidality over the past twenty years – and analyzed data from 46 separate publications, with one clear question in mind:

What are the associations of SDOH with suicidality?

Suicidality includes the following three behaviors:

Thinking about/talking about suicide, i.e. passive suicidal ideation
Planning a suicide attempt, i.e. active suicidal ideation
Attempting suicide

We’ll share the results of the study now, which assessed the impact of the SDOH on suicide fatalities (mortality), attempts, and ideation. The researchers identified specific, individual-level factors that affected suicide risk. We’ll connect each of those factors with their corresponding SDOH(s), with prevalence data when available, to determine which category or type of SDOH has the strongest influence on suicidality.

SDOH Risk Factors: Increased Mortality Risk

Justice system–involved individuals in the community:
- SDOH: Social, Community, and Family Factors
Exposure to any suicide:
- SDOH: Social, Community, and Family Factors
Exposure to parental suicide:
- SDOH: Social, Community, and Family Factors
Firearm accessibility:
- SDOH: Social, Community, and Family Factors
Divorce:
- SDOH: Social, Community, and Family Factors
Living in foster care:
- SDOH: Social, Community, and Family Factors
Recent release from incarceration:
- SDOH: Social, Community, and Family Factors and Neighborhood/Physical Environment
Midlife unemployment:
- SDOH: Economic Stability

Protective Factors: Decreased Mortality Risk

Religious affiliation/spirituality:
- SDOH: Social, Community, and Family Factors
Being married:
- SDOH: Social, Community, and Family Factors

Risk Factors: Increased Risk of Suicide Attempts

History of childhood abuse and/or mistreatment:
- SDOH: Social, Community, and Family Factors
History of sexual assault during childhood, adolescence, or adulthood:
- SDOH(s): Social, Community, and Family Factors and Neighborhood/Physical Environment
Identifying as gender minority:
- SDOH: Social and Community Context
Identifying as sexual minority:
- SDOH: Social, Community, and Family Factors
Experiencing suicide of parent:
- SDOH: Social, Community, and Family Factors

Prevalence of Suicide Attempts By SDOH-Related Group

Homeless people: 28.9%
- SDOH: Neighborhood/Physical Environment and Social, Community, and Family Factors
Incarcerated females under age 18: 27%
- SDOH: Neighborhood/Physical Environment and Social, Community, and Family Factors

SDOH Risk Factors: Suicidal Ideation

Identification as bisexual:
- SDOH: Social, Community, and Family Factors
Experience of intimate partner violence (women):
- SDOH: Social, Community, and Family Factors

Lifetime Prevalence of Suicidal Ideation

Highest in homeless people: 41.6%
- SDOH: Neighborhood/Physical Environment and Social, Community, and Family Factors

SDOH Protective Factors: Reduced Risk of Suicide Attempts and Suicidal Ideation

School connectedness:
- SDOH: Social, Community, and Family Factors

What These Results Mean and How They Help: SDOH and Suicide Risk

These results show, in no uncertain terms, the SDOH(s) that have the greatest impact on suicide risk:

Social, community, and family factors impacted all risk and protective metrics.
Neighborhood/physical environment, in combination with social, community, and family factors, impacted two of the risk and protective metrics.

This means that when our goal is to decrease suicidality – meaning reduce risk factors and increase protective factors – the first thing we should focus on his how social, community, and family factors influence the emotions and behaviors of our patients. Next, we should pay close attention to their neighborhood and physical environment, in order to understand their impact on emotion, thought, behavior, and, ultimately, suicidality.

This knowledge adds to our understanding of how external factors influence the internal lives of our patients and can lead to mental health problems such as suicidality. It helps us because suicide is preventable, and we now know more about how tailor our treatment to prevent and reduce suicidal behavior.

Resources: Finding Support for Suicidality

If you or someone you care about is at risk of suicide, please get help immediately:

If risk of harm is imminent, call 911 now.
If in crisis but harm not imminent, call or text the 988 Suicide & Crisis Lifeline at 988.
988 connects people in crisis to trained professionals who can assess needs and connect you to local support.
The Trevor Project (designed for LGBTQIA+ Youth and Teens)

- Phone (24/7/365): 1-866-488-7386
- Trevor Project Text (24/7/365): Text START to 678678
- The Trevor Project Chat: CLICK HERE