placestats

Out-of-pocket health spending vs. Suicide rate

Holds up after adjusting for income

Across 178 countries, Out-of-pocket health spending and Suicide rate rise and fall together at r = -0.35 (on a scale from −1 to +1, where 0 means no link). It holds up almost unchanged when only countries with similar income (GDP per person) are compared (r = -0.30, q = 0.049, allowing for the many pairs tested).

Comparing countries across the middle half of suicide rate, 4.21 to 11.9 per 100,000, out-of-pocket health spending is better by 8.15% of health spending at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 6.71% of health spending.

Link before adjusting (r)-0.346p = 2.3e-6 · 178 countries
After adjusting for national income-0.299p = 5.4e-5 · likely range [-0.43, -0.16]
p, allowing for regions0.000standard error 0.038 · 7 regions
Check for luck (q)0.049across 13,797 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Out-of-pocket health spending · % of health spendinglink with income -0.34 · moderate
Suicide rate · per 100,000link with income +0.23 · independent

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Out-of-pocket health spending · % of health spending →Suicide rate · per 100,000 →2.58%80.5%0.4128.7Afghanistan: 77.1% of health spending, 3.6 per 100,000Angola: 32.5% of health spending, 8.11 per 100,000Albania: 48.3% of health spending, 2.75 per 100,000United Arab Emirates: 9.67% of health spending, 1.71 per 100,000Argentina: 24.5% of health spending, 7.94 per 100,000Armenia: 80.5% of health spending, 2.46 per 100,000Antigua and Barbuda: 20.8% of health spending, 1.46 per 100,000Australia: 15.8% of health spending, 13.1 per 100,000Austria: 16.5% of health spending, 14.5 per 100,000Azerbaijan: 64.6% of health spending, 1.56 per 100,000Burundi: 24.5% of health spending, 7.65 per 100,000Belgium: 21.5% of health spending, 18.4 per 100,000Benin: 42.4% of health spending, 7.12 per 100,000Burkina Faso: 43.8% of health spending, 8.5 per 100,000Bangladesh: 79.3% of health spending, 2.81 per 100,000Bulgaria: 35.5% of health spending, 9.51 per 100,000Bahrain: 28.7% of health spending, 4.66 per 100,000Bahamas, The: 27.5% of health spending, 3.25 per 100,000Bosnia and Herzegovina: 31% of health spending, 8.97 per 100,000Belarus: 28.5% of health spending, 15.6 per 100,000Belize: 26.8% of health spending, 4.18 per 100,000Bolivia: 27.3% of health spending, 4.2 per 100,000Brazil: 26.2% of health spending, 7.59 per 100,000Barbados: 49.5% of health spending, 3.5 per 100,000Brunei Darussalam: 7.41% of health spending, 3.05 per 100,000Bhutan: 25.5% of health spending, 4.9 per 100,000Botswana: 4.26% of health spending, 8.35 per 100,000Central African Republic: 45% of health spending, 9.19 per 100,000Canada: 15.3% of health spending, 9.44 per 100,000Switzerland: 22% of health spending, 14 per 100,000Chile: 39.1% of health spending, 7.69 per 100,000China: 32.2% of health spending, 8.95 per 100,000Cote d'Ivoire: 32% of health spending, 7.39 per 100,000Cameroon: 67.7% of health spending, 8.5 per 100,000Congo, Dem. Rep.: 38% of health spending, 8.77 per 100,000Congo, Rep.: 28% of health spending, 6.71 per 100,000Colombia: 14.7% of health spending, 4.96 per 100,000Comoros: 56.6% of health spending, 6 per 100,000Cabo Verde: 25.7% of health spending, 14.9 per 100,000Costa Rica: 24.1% of health spending, 8.06 per 100,000Cyprus: 17.9% of health spending, 3.02 per 100,000Czechia: 14.1% of health spending, 13.3 per 100,000Germany: 10.7% of health spending, 12.9 per 100,000Djibouti: 28.8% of health spending, 7.96 per 100,000Denmark: 13.9% of health spending, 10.5 per 100,000Dominican Republic: 25.1% of health spending, 4.2 per 100,000Algeria: 45% of health spending, 2.18 per 100,000Ecuador: 30.9% of health spending, 7.56 per 100,000Egypt, Arab Rep.: 57.2% of health spending, 0.63 per 100,000Spain: 20.9% of health spending, 8.72 per 100,000Estonia: 21.4% of health spending, 14.9 per 100,000Ethiopia: 46.3% of health spending, 6.07 per 100,000Finland: 14.1% of health spending, 14.6 per 100,000Fiji: 8.31% of health spending, 8.27 per 100,000France: 9.23% of health spending, 16.6 per 100,000Micronesia, Fed. Sts.: 2.58% of health spending, 19.8 per 100,000Gabon: 17.3% of health spending, 7.3 per 100,000United Kingdom: 14.6% of health spending, 9.55 per 100,000Georgia: 58.8% of health spending, 5.1 per 100,000Ghana: 26.7% of health spending, 5.32 per 100,000Guinea: 54.4% of health spending, 4.82 per 100,000Gambia, The: 33.8% of health spending, 4.81 per 100,000Guinea-Bissau: 61.6% of health spending, 7.67 per 100,000Equatorial Guinea: 66% of health spending, 7.03 per 100,000Greece: 34.3% of health spending, 4.68 per 100,000Grenada: 48.5% of health spending, 1.3 per 100,000Guatemala: 57.2% of health spending, 4.94 per 100,000Guyana: 26.3% of health spending, 24.8 per 100,000Honduras: 53.1% of health spending, 2.97 per 100,000Croatia: 9.38% of health spending, 15.7 per 100,000Haiti: 52.4% of health spending, 7.81 per 100,000Hungary: 23.1% of health spending, 16.4 per 100,000Indonesia: 31.1% of health spending, 1.2 per 100,000India: 43.9% of health spending, 12.6 per 100,000Ireland: 10.6% of health spending, 8.55 per 100,000Iran, Islamic Rep.: 43.1% of health spending, 4.07 per 100,000Iraq: 54% of health spending, 2.97 per 100,000Iceland: 14.9% of health spending, 11.9 per 100,000Israel: 20.5% of health spending, 4.37 per 100,000Italy: 22.3% of health spending, 6.99 per 100,000Jamaica: 20.2% of health spending, 1.69 per 100,000Jordan: 34.5% of health spending, 0.6 per 100,000Japan: 12.2% of health spending, 17.4 per 100,000Kazakhstan: 27.6% of health spending, 14.6 per 100,000Kenya: 24.2% of health spending, 4.58 per 100,000Kyrgyz Republic: 42.3% of health spending, 6.8 per 100,000Cambodia: 60.6% of health spending, 4.5 per 100,000Kiribati: 2.91% of health spending, 17.5 per 100,000Korea, Rep.: 33.7% of health spending, 27.5 per 100,000Kuwait: 10% of health spending, 2.31 per 100,000Lao PDR: 44.8% of health spending, 4.58 per 100,000Lebanon: 29.7% of health spending, 0.7 per 100,000Liberia: 63.2% of health spending, 5.97 per 100,000Libya: 19.2% of health spending, 5 per 100,000St. Lucia: 37.1% of health spending, 5.27 per 100,000Sri Lanka: 54.8% of health spending, 14.7 per 100,000Lesotho: 13.2% of health spending, 28.7 per 100,000Lithuania: 31.4% of health spending, 22.1 per 100,000Luxembourg: 8.5% of health spending, 8.22 per 100,000Latvia: 35.1% of health spending, 15.2 per 100,000Morocco: 37.3% of health spending, 2.91 per 100,000Moldova: 27.5% of health spending, 14.1 per 100,000Madagascar: 27.4% of health spending, 6.09 per 100,000Maldives: 18% of health spending, 1.47 per 100,000Mexico: 41.2% of health spending, 6.95 per 100,000North Macedonia: 39.6% of health spending, 5.78 per 100,000Mali: 47.2% of health spending, 4.16 per 100,000Malta: 30.9% of health spending, 6.47 per 100,000Myanmar: 71.1% of health spending, 2.89 per 100,000Montenegro: 26.3% of health spending, 11.3 per 100,000Mongolia: 48.8% of health spending, 18.5 per 100,000Mozambique: 10.4% of health spending, 10.6 per 100,000Mauritania: 43.8% of health spending, 2.71 per 100,000Mauritius: 45.2% of health spending, 10.5 per 100,000Malawi: 12% of health spending, 7.57 per 100,000Malaysia: 37.1% of health spending, 5.65 per 100,000Namibia: 7.49% of health spending, 8.59 per 100,000Niger: 51.5% of health spending, 4.48 per 100,000Nigeria: 71.9% of health spending, 4.99 per 100,000Nicaragua: 37.6% of health spending, 4.24 per 100,000Netherlands: 11.8% of health spending, 11.5 per 100,000Norway: 13.7% of health spending, 13.2 per 100,000Nepal: 59.4% of health spending, 10.1 per 100,000New Zealand: 12.7% of health spending, 11.9 per 100,000Oman: 6.31% of health spending, 0.91 per 100,000Pakistan: 52.9% of health spending, 5.64 per 100,000Panama: 40.5% of health spending, 3.29 per 100,000Peru: 27% of health spending, 1.54 per 100,000Philippines: 44.4% of health spending, 3.49 per 100,000Papua New Guinea: 8.55% of health spending, 1.82 per 100,000Poland: 16.2% of health spending, 13.7 per 100,000Portugal: 28.2% of health spending, 11.5 per 100,000Paraguay: 36.3% of health spending, 6.36 per 100,000West Bank and Gaza: 42.1% of health spending, 0.65 per 100,000Qatar: 7.43% of health spending, 4.7 per 100,000Romania: 23% of health spending, 9.62 per 100,000Russian Federation: 28.4% of health spending, 21.4 per 100,000Rwanda: 4.1% of health spending, 8.68 per 100,000Saudi Arabia: 14.1% of health spending, 0.95 per 100,000Sudan: 57.4% of health spending, 3.16 per 100,000Senegal: 44.3% of health spending, 6.76 per 100,000Singapore: 25.4% of health spending, 8.1 per 100,000Solomon Islands: 3.16% of health spending, 19.6 per 100,000Sierra Leone: 54.5% of health spending, 6.14 per 100,000El Salvador: 32.5% of health spending, 7.63 per 100,000Somalia, Fed. Rep.: 30.8% of health spending, 7.96 per 100,000Serbia: 32.1% of health spending, 15.1 per 100,000Sao Tome and Principe: 16.7% of health spending, 0.86 per 100,000Suriname: 19.7% of health spending, 22.3 per 100,000Slovak Republic: 20.2% of health spending, 9.91 per 100,000Slovenia: 11.7% of health spending, 18.9 per 100,000Sweden: 13.4% of health spending, 13.8 per 100,000Eswatini: 11% of health spending, 27.2 per 100,000Seychelles: 28% of health spending, 4.27 per 100,000Syrian Arab Republic: 72.4% of health spending, 0.59 per 100,000Chad: 51.7% of health spending, 5.21 per 100,000Togo: 64.3% of health spending, 9.34 per 100,000Thailand: 9.93% of health spending, 16.6 per 100,000Tajikistan: 62.4% of health spending, 2.43 per 100,000Turkmenistan: 77.4% of health spending, 6.83 per 100,000Timor-Leste: 6.99% of health spending, 3.56 per 100,000Tonga: 5.86% of health spending, 4.73 per 100,000Trinidad and Tobago: 45.3% of health spending, 13.3 per 100,000Tunisia: 37.9% of health spending, 1.84 per 100,000Turkiye: 19% of health spending, 2.69 per 100,000Tanzania: 27.9% of health spending, 5.1 per 100,000Uganda: 32.2% of health spending, 5.5 per 100,000Ukraine: 45.3% of health spending, 21.2 per 100,000Uruguay: 17.1% of health spending, 24.8 per 100,000United States: 10.9% of health spending, 15.6 per 100,000Uzbekistan: 64.1% of health spending, 8.34 per 100,000St. Vincent and the Grenadines: 26.6% of health spending, 0.41 per 100,000Viet Nam: 39.2% of health spending, 7.3 per 100,000Vanuatu: 8.38% of health spending, 15.7 per 100,000Samoa: 13.4% of health spending, 12 per 100,000South Africa: 6.69% of health spending, 22.3 per 100,000Zambia: 10.3% of health spending, 7.13 per 100,000Zimbabwe: 10.6% of health spending, 17.3 per 100,000AREARMBGDKORLSOMNGOMNPNGSWZSYRUKRZAF

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.3462.3e-6178
By rank (Spearman), not adjusted-0.3393.7e-6178
Standard (Pearson), adjusted for national income-0.2995.4e-5178
By rank (Spearman), adjusted for national income-0.2820.000178

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 178 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.047 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.316 (without KOR) to -0.278 (without LSO). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: LSO (+0.021).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific25-0.30
Europe & Central Asia48-0.35
Latin America & Caribbean29-0.13
Middle East, North Africa, Afghanistan & Pakistan22-0.02
Sub-Saharan Africa46-0.39

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third60-0.49
Middle third59-0.28
Richest third59+0.11

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians108-0.33
Muslims49-0.04

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France25-0.22
Never a European colony21-0.15
Spain20-0.51
United Kingdom59-0.33

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.291 after dropping 5 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 22years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

The link shows up within countries over time (r = -0.121) but mostly disappears in year-to-year changes (r = +0.002). That points to slow trends particular to each country, not the two measures moving together from year to year.

Across countries (adjusted)-0.299for comparison
Within countries-0.021each country vs itself
…and vs the same year elsewhere-0.121q = 0.002 · 182 countries
Year-on-year changes+0.002q = 0.955
Read with care.
  • Almost all of this indicator's variation is between countries, not within them, so the within-country estimate rests on a small part of the data.

3,945 country-years (one country in one year), 182 countries, 2000–2021, about 22 years each on average. Share of the variation that happens within countries over time: 8% for Out-of-pocket health spending, 10% for Suicide rate. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.20−0.2-100+10years Suicide rate trails Out-of-pocket health spending →lag -10: r = -0.028 (n = 2,563)lag -9: r = -0.040 (n = 2,741)lag -8: r = -0.047 (n = 2,919)lag -7: r = -0.058 (n = 3,097)lag -6: r = -0.068 (n = 3,275)lag -5: r = -0.079 (n = 3,453)lag -4: r = -0.085 (n = 3,631)lag -3: r = -0.093 (n = 3,809)lag -2: r = -0.095 (n = 3,963)lag -1: r = -0.108 (n = 3,956)lag +0: r = -0.121 (n = 3,945)lag +1: r = -0.134 (n = 3,759)lag +2: r = -0.155 (n = 3,578)lag +3: r = -0.157 (n = 3,397)lag +4: r = -0.163 (n = 3,216)lag +5: r = -0.164 (n = 3,031)lag +6: r = -0.155 (n = 2,851)lag +7: r = -0.145 (n = 2,667)lag +8: r = -0.139 (n = 2,484)lag +9: r = -0.138 (n = 2,306)lag +10: r = -0.128 (n = 2,128)

Same year (lag 0): -0.121. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The data


% of health spending
per 100,000		Years
Armenia ARM80.5%2.462023, 2021
Bangladesh BGD79.3%2.812023, 2021
Turkmenistan TKM77.4%6.832023, 2021
Afghanistan AFG77.1%3.62023, 2021
Syrian Arab Republic SYR72.4%0.592023, 2021
Nigeria NGA71.9%4.992023, 2021
Myanmar MMR71.1%2.892023, 2021
Cameroon CMR67.7%8.52023, 2021
Equatorial Guinea GNQ66%7.032023, 2021
Azerbaijan AZE64.6%1.562023, 2021
Togo TGO64.3%9.342023, 2021
Uzbekistan UZB64.1%8.342023, 2021
Liberia LBR63.2%5.972023, 2021
Tajikistan TJK62.4%2.432023, 2021
Guinea-Bissau GNB61.6%7.672023, 2021

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Out-of-pocket health spending

Out-of-pocket expenditure (% of current health expenditure)

World Health Organization Global Health Expenditure Database · CC BY 4.0 · updated quarterly

The share of a country's health spending paid by patients themselves when they get care. Health spending as a share of GDP is already on the site and shows how much is spent. This shows who pays.

Suicide rate

Suicide mortality rate (per 100,000 population)

World Health Organization Global Health Observatory · CC BY 4.0 · updated quarterly

Estimates from a statistical model. Differences between countries partly reflect how deaths are registered, and how deaths of unclear intent are recorded. Those recording habits are linked to both religion and income.

How this was computed

Data used: most recent value in 2010-2025; values come from 2021–2024. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 13,797 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Out-of-pocket health spending and Suicide rate

This page shows that two measures go together. It does not show that Out-of-pocket health spending changes Suicide rate, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Out-of-pocket health spending or Suicide rate