Abstract
BackgroundMale suicide rates continued to increase in Scotland when rates in England and Wales declined. Female rates decreased, but at a slower rate than in England and Wales. Previous work has suggested higher than average rates in some rural areas of Scotland. This paper describes trends in suicide and undetermined death in Scotland by age, gender, geographical area and method for 1981 – 1999.MethodsDeaths from suicide and undetermined cause in Scotland from 1981 – 1999 were identified using the records of the General Registrar Office. The deaths of people not resident in Scotland were excluded from the analysis. Death rates were calculated by area of residence, age group, gender, and method. Standardised Mortality Ratios (SMRs) and 95% confidence intervals were calculated for rates by geographical area.ResultsMale rates of death by suicide and undetermined death increased by 35% between 1981 – 1985 and 1996 – 1999. The largest increases were in the youngest age groups. All age female rates decreased by 7% in the same period, although there were increases in younger female age groups.The commonest methods of suicide in men were hanging, self-poisoning and car exhaust fumes. Hanging in males increased by 96.8% from 45 per million to 89 per million, compared to a 30.7% increase for self-poisoning deaths. In females, the commonest method of suicide was self-poisoning. Female hanging death rates increased in the time period.Male SMRs for 1981 – 1999 were significantly elevated in Western Isles (SMR 138, 95% CI 112 – 171), Highland (135, CI 125 – 147), and Greater Glasgow (120, CI 115 – 125). The female SMR was significantly high only in Greater Glasgow (120, CI 112 – 128).ConclusionAll age suicide rates increased in men and decreased in women in Scotland in 1981 – 1999. Previous findings of higher than expected male rates in some rural areas were supported. Rates were also high in Greater Glasgow, one of the most deprived areas of Scotland. There were changes in the methods used, with an increase in hanging deaths in men, and a smaller increase in hanging in women. Altered choice of method may have contributed to the increased male deaths.
Highlights
Male suicide rates continued to increase in Scotland when rates in England and Wales declined
We used anonymised information on deaths by suicide and undetermined deaths provided by the General Register Office for Scotland (GROS)
There were 14502 deaths recorded as suicide or undetermined cause in the time period
Summary
Male suicide rates continued to increase in Scotland when rates in England and Wales declined. But at a slower rate than in England and Wales. Scotland had a low suicide rate through most of the twentieth century [1]. This did not appear to be explained by differences in recording of suicide [2]. Rates in younger men continued to increase in the late 1980s [5] and early 1990s [6], at a time when male rates in England declined [7,8]. Female rates decreased in Scotland, not as rapidly as in England and Wales [3]. There was an increase in hanging and motor vehicle exhaust fumes as methods of male suicide in 1970 – 1989 and Pounder [5]
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