NEW YORK (Reuters Health) - Men who have more social connections such as through marriage and religious participation tend to have a lower risk of suicide, according to a new study.

Participants who had the most connections had less than half the risk of suicide over 24 years as those with the fewest social ties, researchers found.

"I've been noticing that in a lot of my patients' stories that social isolation, lack of supports and those types of things figure very prominently," said Dr. Alexander Tsai, the study's lead author from the Center for Global Health at Massachusetts General Hospital in Boston.

"It was just something I couldn't avoid," he said of the new study.

Deaths resulting from self harm increased worldwide by more than 30 percent between 1990 and 2010, Tsai and his colleagues write in the Annals of Internal Medicine.

In 2010, suicide was the tenth leading cause of death in the U.S. with 12 deaths per 100,000 people, according to the Centers for Disease Control and Prevention.

While many studies focus on how mental and physical health affect suicide risk, few studies have been able to look at whether social integration plays a role, the researchers write.

For the new report, they used data from a study of 34,901 male health professionals who were between the ages of 40 and 75 years when they entered the study in 1988.

The researchers measured men's social integration using a series of questions about marital status, social network size, frequency of contact with social ties, religious participation and participation with other social groups.

They separated the participants into four groups based on their level of social integration and then looked at how many committed suicide by February 2012.

Overall, there were 147 suicides during the 24 years of follow-up - about two suicides per 10,000 participants per year.

There were about four suicides per 10,000 people per year among the participants in the lowest social integration category. That compared to about 1.5 suicides per 10,000 people per year among those with the highest level of social integration.

Tsai said he wasn't surprised by the finding because it matched what he had noticed with his patients, but he was a little surprised by the robustness of the effect.

"It's more than a two-fold difference, which suggests it's a pretty sizable effect," he said.

He cautioned that the results may not be applicable to the average person, however. The participants were all well-educated men who appeared to be healthier than the general public, because there were fewer suicides reported than the national average for the age group.

The study may also not apply to women, who might respond differently to social integration than men, Tsai added.

"I think what this demonstrates is that there are factors in everybody's lives that potentially play a huge role in whether people take their own lives and that's whether people have psychiatric diagnoses or not," said Kerry Knox, who wrote an editorial accompanying the new study.

Those factors could include financial troubles or difficulties within families, said Knox, from the University of Rochester Medical Center in New York.

She said there needs to be a culture change so that the community, which includes friends, families and coworkers, is comfortable asking people who may be in distress whether they're okay.

"Certainly asking is a good thing to do," she said. "The way you ask is very important. You don't want to ask a person, 'You're not thinking of killing yourself?' The answer would probably be no."

Instead, she said asking whether people are thinking of harming themselves or if they want to talk about any difficulties in their life are better alternatives.

"Life is difficult for everyone," she said. "There are ways we can all help each other cope."

SOURCE: http://bit.ly/1nJOdTl and http://bit.ly/1nJOjtZ Annals of Internal Medicine, online July 14, 2014.