Abstract
Aim: The aim of this study was to assess trends in suicide attempts and mortality between 1998 and 2017 by residential area and gender among northern Swedish youths. Methods: Events of suicide attempts and deaths for each municipality in the four counties of the northern Swedish region, stratified by gender, were retrieved for each year from 1998 to 2017. All cases identified within the registers with the diagnostic codes X60–X84 or Y10–Y34 (International Classification of Diseases, 10th revision) for individuals aged 15–24 years were included. Place of residence at municipal level was categorized into three groups: rural – municipalities with a population of <10,000 inhabitants; semi-rural – those between 10,000 and 50,000; and urban – those with >50,000 inhabitants. Results: The rates of attempted suicides in the northern region were higher in both men and women than in Sweden, while the rates of suicide deaths were slightly higher in young men but similar in young women compared to the national averages. Overall, the risk of suicide attempts was higher in semi-rural municipalities compared to urban ones, particularly among women. A significantly higher risk of mortality was also observed for men and women in semi-rural municipalities, but only in the period 2010–2013. Conclusions: The high rates of attempted and completed suicides among youth in northern Sweden and the higher risks in rural and semi-rural municipalities need close attention. The implementation of suicide prevention programs, especially in rural and semi-rural municipalities, should be intensified.
Highlights
Suicide comprises a serious and sensitive public health problem that is tragic in its own right following the loss of a specific life, and in consideration of the families and communities that are left behind [1]
While the overall rates are lower compared to other age groups, an increase of almost one percent per year has simultaneously occurred for youth suicide deaths since 1994; in 2017, the rate in young men and women was 17.6 and 7.5 per 100,000 population, respectively [3]
Knowledge of the patterning of youth suicidal behaviours across regions and rural–urban settings is currently limited in Sweden. To fill this gap and provide policy-relevant information that could guide the development of locally appropriate interventions, the aim of this study was to assess trends in suicide attempts and mortality between 1998 and 2017 by gender and rural–urban areas among northern Swedish youths
Summary
Suicide comprises a serious and sensitive public health problem that is tragic in its own right following the loss of a specific life, and in consideration of the families and communities that are left behind [1]. In the Scandinavian countries, death by suicide has followed a decreasing trend in the total population over the last 30 years, while upward or stable rates have been observed among young people in certain contexts [2]. This pattern has run in parallel to the growing number of youth aged between 15 and 24 years in the region that have tried to take their own life [2,3,4]. In partial contrast to this trend, suicide attempts in Sweden have followed a
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