Age-specific Suicide Rates Research Articles

Suicide Rates by Age and Time Among American Indian and Alaskan Native Veterans

Objective: Although recent work has highlighted high rates of suicide among American Indian and Alaska Native individuals who served in the US military, to date, a comprehensive evaluation of age-specific suicide rates, over time, has yet to be conducted. Methods: Population-based retrospective cohort study. Average annual suicide rates (2005–2020) were computed. The cohort included 207,955 Native Veterans who were alive as of January 1, 2005, and separated from military service on or before December 31, 2020. Suicide was identified via National Death Index codes. Results: Between 2005 and 2020, average annual, age-specific suicide rates among Native Veterans ranged from 16.32/100,000 (55+ y) to 64.49/100,000 (18–34 y). Compared with other age-related cohorts, the rate among those in the youngest age cohort (18–34y) was the highest between 2005 and 2018. The 2019–2020 average annual rate for 18- to 34-year-olds (41.86/100,000) dropped below that of the middle-aged cohort (35–45 y; 44.66/100,000). Across all age cohorts, firearms were the most used method of suicide [57.2% (18–34 and 35–54 y) to 66.17% (55+y)]; however, a notable percentage of Veterans died by suffocation, 16.54% (55 y and older), 26.71% (35–54 y), and 33.21% (18–34 y). Conclusions: Findings highlight differences in suicide rates by age groups overtime for Native Veterans irrespective of Veterans Health Administration use and across service eras, as well as means of suicide, which also differed across groups. Increased efforts are needed to identify culturally and age-relevant intervention strategies, as well as factors associated with risk, to reduce deaths among Native Veterans.

Suicide mortality among individuals in federal prisons compared with the general population: a retrospective cohort study in the USA from 2009 to 2020

IntroductionSuicide is one of the leading causes of death in US prisons. Yet, administrative data lags years behind and reporting rarely accounts for differing age distributions between suicide rates between...

Suicide mortality in Italy during the first year of the COVID-19 pandemic

BackgroundItaly was severely hit by COVID-19 during 2020 and great concern about the possible increase of suicide rates in the population has arisen since early pandemic phases. Analyses limited to March–April have shown a drop in suicides in both sexes. This study aims to analyze suicide mortality in Italy during the whole 2020 making comparisons with the pre-pandemic period 2015–19, by sex, age and geographic area. MethodsOfficial cause-of-death data with national coverage were used to analyze suicide mortality by sex, month, age class and geographic area in the population aged ≥10 years (54,595,179). The monthly number of suicide deaths in 2020 was compared to the average number in 2015–19. Age-specific and age-adjusted suicide rates in 2020 and in 2015–19 were compared using rate-ratios with 95 % confidence intervals. ResultsCompared to 2015–19 a non-significant reduction of the overall suicide rate was observed during 2020, both in males (−3 %) and females (−7 %). Suicide rates non-significantly decreased in most age groups; an increase, although not statistically significant, was found among males aged ≥75 years and females aged ≥85 years. Suicide deaths reduced mainly in Central-Southern areas and the Islands, while they slightly increased in the North especially among males. LimitationsStudy limitations include accuracy of death certification and the relatively brief observation period. ConclusionsThe study contributes to the analysis of early effects of the COVID-19 pandemic on suicide mortality in the whole population highlighting sex, age and territorial differences and suggesting to monitor possible increases in a longer observation period.

Farmer Suicides Among States Reporting Violent Deaths, 2003 - 2017.

Research suggests that farmer suicide rates are at least two-fold higher than the general population. In estimating rates, prior research considered suicide events among farmers together with farmworkers, fishing, and forestry occupations and included non-farming populations in the defined at-risk populations (i.e., denominators). In this study, we sought to define and differentiate farmer suicide decedents from other agricultural occupations, estimate U.S. farmer suicide rates, and evaluate rate time trends. Farmer suicide decedents were ascertained from the 36 states in the National Violent Death Reporting System (NVDRS) from 2003-2017 using NVDRS occupation data. Farmers were defined as persons responsible for day-to-day farm decisions and operations. An expert panel was convened to classify farmer occupations. Rates were calculated using Census of Agriculture-identified farmers as the rate denominator, and time trends were evaluated using regression. Due to a low number of female decedents, female farmer suicide rates were not estimated. We identified1,575 male farmer suicide decedents and 77 female farmer decedents from the NVDRS during the study period. Aggregated age-specific male farmer suicide rates were highest among farmers ages 65 years and older (22.0/100,000). Estimated suicide rates for male farmers were highest during 2003 (31.8/100,000) and lowest during 2005 (19.2/100,000). Trend analysis revealed a statistically significant 2.4% annual percent change (APC) in rates over the 15-year study period. Suicide rates among male farmers showed evidence of an increase from 2003-2017. Farmer suicide rates parallel the rates of the U.S. population; thus, farmer suicide remains a public health concern.

Trends in Suicide Methods in Korea; 1997-1999 and 2017-2019

Objectives: The aim of this study was to examine trend of the gender and age death rate of intentional self-harm in Korea 1997-1999 and 2017-2019. The analysis was based on data of intentional self-harm deaths from the 1997-1999 (21,937 deaths) and 2017-2019 (39,920 deaths) vital statistics of Korea.Methods: We are analyzed annual data from 1997-1999 and 2017-2019 for Korea in order to examine trends in the rates and methods of suicide. Data on suicide methods were obtained from the death certificate data (1997-1999 and 2017-2019) of Korea Statistics.Results: The common methods in 1997-1999 were hanging (37.6%), poisoning (37.2%), and jumping (9.5%). In 2017-2019, hanging (51.9%) has surpassed poisoning (26.2%) as the most often used method. The preferred suicide methods were hanging and poisoning in Korea. Through 2003-2011, the suicide rate (per 100,000 population) increased from 26.0 to 40.7 in male and increased from 10.7 to 16.2 in female, There was a decline in rates of poisoning and drowning in both gender but an increase in hanging and jumping by both gender during the period. Age specific suicide rate increased with advanced age in both gender. The odds (2017-2019) were greater than the odds (1997-1999) in both gender.Conclusions: All age suicide rates of hanging increased in both gender. there was decline in age specific rate of poisoning in both gender.

Trends in suicide rates by race and ethnicity among members of the United States Army.

Efforts were focused on identifying differences in suicide rates and time-dependent hazard rate trends, overall and within age groups, by race and ethnicity among United States Army members who returned from an index deployment (October 2007 to September 2014). This retrospective cohort study was conducted using an existing longitudinal database, the Substance Use and Psychological Injury Combat Study (SUPIC). Demographic (e.g., race and ethnicity) and military data from the Department of Defense compiled within SUPIC, as well as Department of Veterans Affairs data were linked with National Death Index records (through 2018) to identify deaths by suicide including those that occurred after military service. The cohort included 860,930 Army Service members (Active Duty, National Guard, and Reserve). Age-adjusted (using the direct standardization method) and age-specific suicide rates per 100,000 person years were calculated and rate ratios (RR) were used for comparisons. Trends were evaluated using hazard rates over time since the end of individuals' index deployments. Among those aged 18-29 at the end of their index deployment, the suicide rate for American Indian/Alaskan Native (AI/AN) individuals was 1.51 times higher (95% confidence interval [CI]: 1.03, 2.14) compared to White non-Hispanic individuals (WNH), and lower for Hispanic and Black non-Hispanic (BNH) than for WNH individuals (RR = 0.65 [95% CI: 0.55, 0.77] and RR = 0.71 [95% CI: 0.61, 0.82], respectively). However, analyses revealed increasing trends in hazard rates post-deployment (≤ 6.5 years) within groups of Hispanic and BNH individuals (Average Annual Percent Change [APC]: 12.1% [95% CI: 1.3%, 24.1%] and 11.4% [95% CI: 6.9%, 16.0%], respectively) with a smaller, increase for WNH individuals (APC: 3.1%; 95% CI: 0.1%, 6.1%). Findings highlight key subgroups at risk for post-deployment suicide (i.e., WNH, AI/AN and younger individuals), as well as heterogeneous trends overtime, with rates and trends varying within race and ethnic groups by age groups. Post-deployment suicide prevention efforts that address culturally relevant factors and social determinants of health associated with health inequities are needed.

Assessment of a Suicide Prevention Gatekeeper Training Program for Nursing Home Staff.

Older adults have one of the highest age-specific suicide rates in France, and the risk of suicide is higher for those living in nursing homes. The aim of our study was to assess the effectiveness of gatekeeper training for nursing home staff on the knowledge and stigmas towards suicidal crisis and the impact on suicidal behaviour rates. A total of 427 nursing or administrative staff from 110 nursing homes received gatekeeper training in the Hauts-de-France French region between September 2016 and June 2018. First, knowledge and stigmas on suicidal crisis were assessed through a pretest and posttest survey. Second, a retrospective survey was conducted to determine suicide behaviour rates before and after training in nursing homes. Then, changes between pre- and posttraining scores and suicide rates were evaluated with a paired samples T test and rate difference calculation (P value of <0.05 was considered statistically significant). A total of 315 trainees completed the questionnaires on knowledge and stigmas related to suicidal crisis, and we found a significant difference in the total scores (P < 0.01). Moreover, we found a significant decrease in the incidence of suicide attempts (SAs) after training (P = 0.002), but the incidence of deaths by suicide was not significantly different prior to and after the training course (P = 0.46). We highlighted an improvement in knowledge and stigmas after training and a reduction in the rates of SAs with our gatekeeper suicide prevention program. Future research is needed to improve suicide prevention for nursing home residents.

Sex differences in suicide mortality in Newfoundland and Labrador: An observational study with medical examiner data from 1997 to 2016.

Globally, the suicide rate is two times higher for males than for females. Previous studies in Newfoundland and Labrador did not examine age-specific rates by sex. The objectives of this study were to determine suicide rates by sex and age group and to compare the demographic and clinical characteristics of males and females who died by suicide. This observational study analyzed a routinely collected dataset based on all medical examiner-determined suicide deaths among people aged 10 years and older in Newfoundland and Labrador, Canada, between 1997 and 2016. Age-standardized and age-specific suicide rates and rate ratios were calculated based on the number of deaths during the period, and descriptive statistics were used to compare demographic and clinical characteristics between males and females. The age-standardized suicide rate was 4.6 times higher among males than females and was higher for males in most age groups. Rates were highest in the young adult age groups for males (20 to 24 years) and females (35 to 39 years). Males who died by suicide were more likely to be from a rural community and to have died by firearm; females were more likely to die by self-poisoning and to have had a mental illness or substance use history. The results are broadly consistent with previous research, though this is the first study to report age-specific suicide rates among females across the life course in Newfoundland and Labrador. The results underscore the need to design public health and clinical interventions that account for sex differences in suicide risks.

Epidemiological changes, demographic drivers, and global years of life lost from suicide over the period 1990-2019.

To quantify the contributions of epidemiological changes (age- and gender-specific suicide rates) and demographic forces (population growth and aging) to global changes in years of life lost (YLLs) from suicide over the last 30years. A decomposition analysis was used to assess the impacts of population growth, population aging, and suicide prevalence on global changes in YLLs from suicide between 1990 and 2019. From 1990 to 2019, global YLLs from suicide reduced by 2,073,714 years (5.9%), from 35,246,316years to 33,172,602years. This was mainly due to the decline in age-specific suicide rates, which reduced the overall YLLs from suicide by 20,185,691years (973.4%). However, this decline was offset by the impacts of population growth and population aging, which increased global YLLs from suicide by 14,949,110years (-720.9%) and 3,442,074years (-166.0%), respectively. The combined effects of epidemiological and demographic drivers were also reflected in different trends in YLLs from suicide across genders and World Bank income level regions, with particularly notable increases in low- income and lower-middle income countries and the aging population. With the significant effects of epidemiological and demographic drivers, global and regional YLLs from suicide may be expected to change greatly in the future. Efforts to reduce the burden of suicide require appropriate allocation of resources for suicide-prevention strategies and further consideration of demographic factors.

Suicide Among American Indian and Alaska Native Veterans Who Use Veterans Health Administration Care: 2004-2018.

Background:American Indian and Alaska Natives (AI/ANs) veterans may be at elevated risk for suicide, but little is known about suicide among this population.Methods:We conducted a retrospective cohort analysis of AI/AN veterans who received health care services provided or paid for by the Veterans Health Administration (VHA) between October 1, 2002, and September 30, 2014, and who were alive as of September 30, 2003. Age-specific and age-adjusted suicide rates through 2018, per 100,000 person-years (PY) at risk and 95% confidence intervals were computed.Results:Age-adjusted suicide rates among AI/AN veterans in this cohort more than doubled (19.1–47.0/100,000 PY) over the 15-year observation period. In the most recent observation period (2014–2018), the age-adjusted suicide rate was 47.0 per 100,000 PY, with the youngest age group (18–39) exhibiting the highest suicide rate (66.0/100,000 PY). The most frequently used lethal means was firearms (58.8%), followed by suffocation (19.3%), poisoning (17.2%), and other (4.7%).Conclusions:Results suggest that: (1) suicide is an increasing problem among AI/AN VHA veterans; and (2) younger AI/AN VHA veterans are at particularly high risk and warrant focused prevention efforts. Findings are similar to those observed in general AI/AN population. There is a compelling need to review and strengthen VHA suicide prevention efforts directed towards AI/AN veterans.

Demographic and epidemiological decomposition analysis of global changes in suicide rates and numbers over the period 1990–2019

BackgroundSuicide presents an ongoing public health challenge internationally. Nearly 800 000 people around the world lose their life to suicide every year, and many more attempt suicide.MethodsA decomposition analysis was...

Suicide in Newfoundland and Labrador, Canada: a time trend analysis from 1981 to 2018

BackgroundThe suicide rate in Canada decreased by 24% during the past four decades. However, rates vary between provinces and territories, and not all jurisdictions experienced the same changes. This study examined suicide rates over time in the province of Newfoundland and Labrador.MethodsWe used cross-sectional surveillance data from the Canadian Vital Statistics Death Database to examine suicide rates in Newfoundland and Labrador from 1981 to 2018. We calculated annual age-standardized suicide mortality rates and used joinpoint regression to estimate the average annual percent change (AAPC) in suicide rates overall and by sex, age group, and means of suicide.ResultsFrom 1981 to 2018, 1759 deaths by suicide were recorded among people in Newfoundland and Labrador. The age-standardized suicide mortality rate increased more than threefold over the study period, from 4.6 to 15.4 deaths per 100,000. The suicide rate was higher among males than females, and accounted for 83.1% of suicide deaths (n = 1462); the male-to-female ratio of suicide deaths was 4.9 to 1. The average annual percent change in suicide rates was higher among females than males (6.3% versus 2.0%). Age-specific suicide rates increased significantly for all age groups, except seniors (aged 65 or older); the largest increase was among youth aged 10 to 24 years old (AAPC 3.5; 95% CI, 1.6 to 5.5). The predominant means of suicide was hanging/strangulation/suffocation, which accounted for 43.8% of all deaths by suicide.ConclusionsThe suicide rate in Newfoundland and Labrador increased steadily between 1981 and 2018, which was in contrast to the national rate decline. The disparity between the provincial and national suicide rates and the variations by sex and age underscore the need for a public health approach to prevention that accounts for geographic and demographic differences in the epidemiology of suicide.

Suicide rates for young Aboriginal and Torres Strait Islander people: the influence of community level cultural connectedness.

To examine associations between community cultural connectedness indicators and suicide mortality rates for young Aboriginal and Torres Strait Islander people. Retrospective mortality study. Suicide deaths of people aged 10-19 years recorded by the Queensland Suicide Register, 2001-2015. Age-standardised suicide death rates, by Indigenous status, sex, and age group; age-standardised suicide death rates for young First Nations people by area level remoteness and Index of Relative Socioeconomic Advantage and Disadvantage, and by cultural connectedness indicators (at statistical area level 2): cultural social capital index score, community Indigenous language use, and reported discrimination. The age-specific suicide rate was 21.1 deaths per 100 000 persons/year for First Nations young people and 5.0 deaths per 100000 persons/year for non-Indigenous young people (rate ratio [RR], 4.3; 95% CI, 3.5-5.1). The rate for Aboriginal and Torres Strait Islander young people was higher in areas with low levels of cultural social capital (greater participation of community members in cultural events, ceremonies, organisations, and community activities) than in areas classified as having high levels (RR, 1.8; 95% CI, 1.2-2.7), and also in communities with high levels of reported discrimination (RR, 2.7; 95% CI, 1.7-4.3). Associations with proportions of Indigenous language speakers and area level socio-economic resource levels were not statistically significant. We found that suicide mortality rates for Aboriginal and Torres Strait Islander young people in Queensland were influenced by community level culturally specific risk and protective factors. Our findings suggest that strategies for increasing community cultural connectedness at the community level and reducing institutional and personal discrimination could reduce suicide rates.

Trends in suicides among italian youth aged 10 to 25: A nationwide register study

IntroductionSuicide continues to be a significant cause of mortality in most countries worldwide, especially among youth. Documenting current trends and sources of variation in youth suicide rates is critical to inform prevention strategies.ObjectivesWe aimed to 1. document suicide mortality trends among Italian youth from 1981 to 2016 2. describe age, sex, and urbanization specific suicide rates in this period, and 3. describe suicide methods and their change over time.MethodsWe relyed on official mortality data for the period 1981-2016 for adolescents and young adults (ages 10-25 years). We estimated standardized all-cause and suicide mortality rates per 100,000 individuals and used Joinpoint regression analysis to determine annual mortality trends and statistically significant changes in rate trends. Analyses were reported by sex, age group, urbanization level and suicide method.ResultsFrom 1981 to 2016, 1,752 suicides were identified among youth aged 10-17 (boys/girls ratio in 2016, 5.3) and 9,897 among youth aged 18-25 years (boys/girls ratio in 2016, 4.0). While the all-cause mortality rate decreased over time for both boys and girls, overall suicide rates remained stable for boys and showed a small decrease for girls. For boys, suicide was most common in rural than to metropolitan areas, while it was the opposite for girls. The most common method for boys was hanging, while for girls was fall.ConclusionsDifferently from other countries, youth suicides were stable (boys) or slightly declining (girls). We found differences according to the urban vs. rural areas. Factors influencing these trends and sex differences are crucial in delivering prevention strategies.DisclosureNo significant relationships.

Gender Ratio of Intentional Self-harm Death in Korea

Objectives To compare the gender ratio (male/female death rate) of intentional self-harm (suicide) by age and suicide methods. Methods The intentional self-harm (KCD-6: X60-X84) death data (71,739 deaths: aged 10 years and older) of Korea Statistics from 2011 to 2015 were used for this analysis. Gender ratio of suicide and 95 percent confidence interval were calculated by the age specific suicide rate and suicide methods. Results The suicide rate of males (43.5 per population of 100,000) were higher than those of females (19.1). The gender ratio of suicide was 2.28 (95% intervals: 2.24-2.32). Age specific suicide rate increased with advanced age in both gender. The gender ratio of suicide was highest in aged 60-69 years (3.38), and lowest in aged 10-19 years (1.31). The common methods of suicide was hanging, accounting for 51.3 percent of all suicide deaths. The next most common methods for suicide was jumping from a height (15.1 percent), self-poisoning by gas (12.0 percent) and pesticides (11.4 percent), and drowning (3.5 percent). The gender ratio by suicide methods was considerably high in self-poisoning by gas (4.65), 2.49 for hanging, 2.22 for drowning, 1.49 for self-poisoning by pesticides, and 1.25 for jumping from a height. The suicide rates of male were higher than those of female in most of suicide methods and all age groups (10-29 years, 30-59 years and ≥60 years), with the exception for self-poisoning by pesticide in age group 10-29 years (gender ratio: 0.81). The gender ratio of self-poisoning by gas and pesticide, hanging, and drowning increased with advanced age, while gender ratio of jumping from a height decreased with advanced age. Conclusions The gender ratio of suicide increased with advanced age in the majority of suicide methods, with the exception for jumping from a height. There is need to understanding the variations of gender ratio in suicide methods and age group. Key words: Gender ratio, Suicide rate, Intentional self-harm

Epidemiological characteristics of suicide in the Autonomous Province of Vojvodina

Introduction. Suicide is defined as a conscious and deliberate taking of one?s own life, or a self-destructive behavior with a fatal outcome. Every year, millions of people are affected by suicide or the feeling of grief. The aim of our research was to review the basic epidemiological characteristics of suicide in the Autonomous Province of Vojvodina, in order to assist in tar?geted prevention programs. Material and Methods. A retrospec?tive, observational study was conducted. The data were analyzed in chronological order and in accordance with different demo?graphic characteristics and topographic distribution. Basic sta?tistical indicators were used as parameters: non-standardized, standardized and specific mortality rates. Results. During the observed period, from 1991 until the end of 2010, in the Autono?mous Province of Vojvodina, the average annual non-standard?ized suicide rate was 27.9/100,000 inhabitants. The highest sui?cide rate was recorded in 1992 and 1993 (33.7/100,000 and 34.5/100,000, respectively) and in 1999 (31.5/100,000). The high?est age-specific suicide rate was recorded in ? 80 year-old age group (120.5/100,000). The suicide rates were significantly high?er among males, while the most common suicide method for both sexes was by hanging (69.9%). The highest average annual sui?cide rate was recorded among widowers (176.9/100,000) and widows (37.8/100,000). The lowest number of suicides was re?corded in persons with higher level of education. Conclusion. Since in the Autonomous Province of Vojvodina persons at in?creased risk for suicide include males, the elderly population, persons with low education levels, and people who lost their partners, suicide prevention strategies should target these groups, including primary and secondary prevention measures.

The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population

ObjectiveThe effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. Study designObservational study. MethodsA Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991–2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. ResultsThe results show that unemployment increased the suicide rate in men aged 45–64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. ConclusionFollowing the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan.

Revisiting the relationship between suicide and unemployment: Evidence from linear and nonlinear cointegration

This study employs the linear and nonlinear ARDL cointegration methodologies to examine the potential symmetric and asymmetric responses of suicide rates to unemployment rates in the US from 1928 to 2013. Our results suggest that suicide rates are pro-cyclical with respect to the business cycle (measured by changes in the unemployment rate) after extensively controlling for divorce and fertility rates. Unemployment has symmetric long-run effects on the age-adjusted suicide rate and four age-specific (from ages 25–34 to 55–64) suicide rates, while the effect of an economic expansion on suicide rates for those aged over 45 is greater than the effect of an economic recession. These findings imply that the effect of an economic expansion on the decrease of the suicide rate is higher than the effect of an economic recession on the increase of the suicide rate for individuals aged over 45. Therefore, intervention designed to reduce suicidal behaviors should emphasize periods of economic recession more than periods of economic expansion for those of middle age and beyond.

Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983-2012.

BackgroundPrevious studies suggested that the racial differences in U.S. suicide rates are decreasing, particularly for African Americans, but the cause behind the temporal variations has yet to be determined. This study aims to investigate the long-term trends in suicide mortality in the U.S. between 1983 and 2012 and to examine age-, period-, and cohort-specific effects by gender and race.MethodSuicide mortality data were collected from the Web-based Injury Statistics Query and Reporting System (WISQARS) and analyzed with the Joinpoint regression and age-period-cohort (APC) analysis.ResultsWe found that although age-standardized rate of suicide in white males, white females, black males, and black females all changed at different degrees, the overall situation almost has not changed since these changes offset each other. By APC analysis, while the age effect on suicide demonstrate an obvious difference between white males and females (with the peak at 75 to 79 for white males and 45 to 54 for white females), young black people are predominantly susceptible to suicide (risk peaks in early 20s for black males and late 20s for black females). Cohort effects all showed a descending trend, except that in white males and females which showed an obvious increase peaked in around cohort 1960. There was a similar period effect trend between different genders in the same race group, but between the races, differences were found in the period before 1990 and after 2000.ConclusionWe confirmed that the distinction in age-specific suicide rate patterns does exist by gender and by race after controlling for period and cohort effects, which suggested that minorities’ age patterns of suicide may have been masked up by the white people in the whole population. The differences of period effects and cohort effects between white and black Americans were likely to be mainly explained by the difference in race susceptibility to economic depression.

Railway suicide in England and Wales 2000-2013: a time-trends analysis.

BackgroundIn 2010, the “Tackling Suicide on the Railways” programme was launched as a joint initiative among Network Rail, the Samaritans and other key organisations such as the British Transport Police and train operators to achieve a 20 % reduction in railway suicides from 2010 to 2015 in Great Britain. We report the most recent age and sex specific trends in railway suicide in England and Wales from 2000 to 2013 and examine whether the initiative’s target reduction in railway suicides is likely to be achieved.MethodsPopulation data and suicide mortality data (all methods combined and railway) for England and Wales were obtained from the Office for National Statistics (ONS) and used to calculate age and gender specific rates for deaths registered from 2000 to 2013. Data on railway suicides were also obtained from the Rail Safety and Standards Board (RSSB) and compared with ONS data. We used joinpoint regression to identify changes in suicide trends across the study period.ResultsThe railway was used in 4.1 % of all suicides in England and Wales (RSSB data were similar to ONS data for most years). Suicides in all persons from all causes decreased from 2000 to 2007, with small increases from 2008 until 2013; this rise was entirely due to an increase in male suicides. Railway suicide rates increased over the entire study period; the proportion of railway suicides in all persons increased from 3.5 to 4.9 % during the study period. This trend was also mainly driven by increases in male suicides as female railway suicide rates remained steady over time. The highest age specific railway suicide rates were observed in middle aged men and women. Although there was no conclusive evidence of an increase in ONS railway suicides, RSSB data showed a statistically significant increase in railway suicides in males from 2009 onwards.ConclusionThe continued rise in male railway suicide in England and Wales is concerning, particularly due to the high economic costs and psychological trauma associated with these deaths. The initiative’s target of a 20 % reduction in railway suicide is unlikely to be achieved.