attitude regarding homosexuality, it was determined that for same-sex married men the suicide risk was nearly three times higher than for different-sex married men, even after an adjustment for HIV status. For women, it was shown that there was a tentatively elevated suicide risk for same-sex married women over that of different-sex married women. Religion Compared with other countries, atheist states, such as the People's Republic of China, have the highest suicide rate (25.6 per 100,000 persons). In a global study on atheism, sociologist Phil Zuckerman noted countries with higher levels of atheism had the highest suicide rates compared to countries with "statistically insignificant levels of organic atheism." Social factors Higher levels of social and national cohesion reduce suicide rates. Suicide levels are highest among the retired, unemployed, impoverished, divorced, the childless, urbanites, empty nesters, and other people who live alone. Suicide rates also rise during times of economic uncertainty. (Although poverty is not a direct cause, it can contribute to the risk of suicide). Epidemiological studies generally show a relationship between suicide or suicidal behaviors and socio-economic disadvantage, including limited educational achievement, homelessness, unemployment, economic dependence, and contact with the police or justice system. War is traditionally believed to be associated with a fall in suicide rates; however, this has been questioned in recent studies, showing a more complex picture than previously conceived. A 2015 UK study by the Office for National Statistics, commissioned by Public Health England, which considered 18,998 deaths of people aged between 20 and 64, found that men working in the construction industry and women employed in culture, media and sport, healthcare and primary school teaching were at the highest risk of suicide. Health Depression, either unipolar or as part of bipolar disorder, is an especially common cause. Substance abuse, severe physical disease or infirmity are also recognized causes. An unknown number of suicidal fatalities are falsely presumed to be the consequences of severe illnesses, infectious, malignant, mental et cetera. Body mass index Risk of suicide may decrease with increased weight and is low in obese persons. The connection is not well understood, but it is hypothesized that elevated body weight results in higher circulating levels of tryptophan, serotonin, and leptin, which in turn reduces impulsivity. However, other studies indicate that suicide rates increase with extreme obesity, and it is difficult to control for conflating factors such as BMI-related differences in longevity, which have a