Geographical And Temporal Patterns of Suicide in Lebanon (2021–2025) And Their Association with Baseline District-Level Socioeconomic Conditions and National Crises

Abstract

Background: Suicide is a preventable public health problem worldwide, with higher burden among young people and populations in low- and middle-income countries. Reported rates in the Middle East and North Africa region remain low, with strong evidence of underestimation due to stigma and weak surveillance systems. Lebanon has faced prolonged social, political, and economic crises since 2019, placing pressure on health systems and influencing suicide related outcomes. National research describes trends and psychosocial risk factors, while structural and geographic analyses remain limited. Objective: This study provides the first district level analysis of suicide deaths in Lebanon between 2021 and 2025. It examines associations with socioeconomic deprivation, geographic variation, and exposure to national crises using multilevel models. Methods: This secondary data analysis links Internal Security Forces suicide death records from 2021 to 2025 with district socioeconomic indicators and national crisis measures. Multilevel mixed effects Poisson regression models with district and year random effects estimate incidence rate ratios with population offsets. The analysis includes descriptive assessment of geographic and temporal patterns. Sensitivity analyses test alternative socioeconomic definitions, crisis definitions, model structures, underreporting scenarios, and influential districts. Results: Strong geographic differences in suicide deaths appear across districts. The absence of statistically significant association exists between district socioeconomic deprivation and suicide outcomes after adjustment. Crisis indicators show no consistent association with suicide deaths. No effect modification by socioeconomic status appears. Findings remain stable across all sensitivity analyses.