Date of Award

Winter 12-20-2012

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Monica Swahn

Second Advisor

Dr. Sheryl Strasser



Purpose: The intention of this study is to examine and compare the prevalence and correlates of suicide ideation among the youth in four Eastern Mediterranean Region (EMR) countries, namely Morocco, Jordan, United Arab Emirates and Lebanon. The results from this study are a valuable resource for further understanding suicidal behavior among youth in a region where the subject is often understudied and considered taboo. Additionally, findings from the study are important in prevention efforts in order to reduce suicide related behaviors and injuries among youth in EMR countries. The study also examined the correlates and variables associated with suicide ideation as differentiated by gender in an effort to see how these behaviors varied between boys and girls.

Methods: The results of the study were derived using secondary analyses of datasets from the Global School-based Student Health Survey (GSHS) which is conducted by the World Health Organization. The study analyzed data on students who fell primarily between the ages of 12 to 16 from the countries of Jordan (N=2197, 2007), Lebanon (N=5115, 2005), Morocco (N=2670, 2006) and United Arab Emirates (N=15790, 2005). The data was analyzed using logistical regression analyses to determine the associations between suicidal ideation and eight risk factors, which included being a victim of bullying, having a lack of close friends, feeling sad or hopeless, consuming alcohol, using illicit drugs, missing school, being involved in a physical fight, and dealing with hunger. The results of the study were also evaluated to examine differences among genders and the risk factors as associated with suicide ideation as well as differences between age groups.

Results: The results of this study suggest that suicidal ideation among youth in EMR countries may be influenced by social, political, cultural and economic factors. Females showed higher rates of suicide ideation. Several of the eight risk factors analyzed showed significant associations to suicide ideation.

Conclusion: There is a need for increased research into the areas of mental health in the EMR, especially in the area of suicide and suicide related behaviors. Suicide related statistics may be underreported in many nations of the EMR which are predominantly Islamic, where suicide is strongly prohibited by religion. Previous studies indicate that suicide ideation is strongly associated with certain risk factors. This study analyzed eight of these risk factors using a secondary logistical regression analysis of data from the Global Student Health Survey which is conducted annually by the WHO. The risk factors included in the study are bullying victimization, alcohol use, illicit drug use, having no friends, feeling sad, missing school, physical fighting and hunger. Additionally, associations were examined among different age groups ranging from 12 to 17 years and among the two genders. Several of the risk factors were shown to have a strong association to suicide ideation. Suicide ideation was more common among girls than in boys among all the countries studied. The results of this study may be useful to those looking to design and implement educational suicide prevention programs among school-age children in the EMR.