Variation In Suicide Rates Research Articles

Predicting state level suicide fatalities in the united states with realtime data and machine learning

Digital trace data and machine learning techniques are increasingly being adopted to predict suicide-related outcomes at the individual level; however, there is also considerable public health need for timely data about suicide trends at the population level. Although significant geographic variation in suicide rates exist by state within the United States, national systems for reporting state suicide trends typically lag by one or more years. We developed and validated a deep learning based approach to utilize real-time, state-level online (Mental Health America web-based depression screenings; Google and YouTube Search Trends), social media (Twitter), and health administrative data (National Syndromic Surveillance Program emergency department visits) to estimate weekly suicide counts in four participating states. Specifically, per state, we built a long short-term memory (LSTM) neural network model to combine signals from the real-time data sources and compared predicted values of suicide deaths from our model to observed values in the same state. Our LSTM model produced accurate estimates of state-specific suicide rates in all four states (percentage error in suicide rate of −2.768% for Utah, −2.823% for Louisiana, −3.449% for New York, and −5.323% for Colorado). Furthermore, our deep learning based approach outperformed current gold-standard baseline autoregressive models that use historical death data alone. We demonstrate an approach to incorporate signals from multiple proxy real-time data sources that can potentially provide more timely estimates of suicide trends at the state level. Timely suicide data at the state level has the potential to improve suicide prevention planning and response tailored to the needs of specific geographic communities.

Suicide Rates and Subgroups With Elevated Suicide Risk Among Patients With Psychiatric Disorders: A Nationwide Cohort Study in Korea.

Despite the distinctly high risk of suicide among patients with psychiatric disorders, little is known regarding the nationwide rates and risk factors for suicide among individual subgroups of patients with psychiatric disorders. This study aimed to assess differences in suicide rates and identify risk factors for suicide across multiple psychiatric diseases using data from a nationally representative cohort in Korea. Six groups of incident patients with psychiatric disorders, namely those with drug use disorder (DUD), alcohol use disorder (AUD), schizophrenia (SCZ), bipolar disorder (BD), depressive disorder (DD), or other affective disorders (OADs), were extracted from the National Health Information Database and followed up. Suicide rates and risk factors were then determined for each disease group. Patients with psychiatric disorders had higher suicide rates than did the general population, with standardized mortality ratios (SMRs) ranging from 2.5 to 16.6. In particular, patients with DUD showed markedly higher suicide rate (584.0 per 100,000 person-years [PYs]; SMR, 16.6) than did patients with affective disorders, including DD (119.8 per 100,000 PYs; SMR, 3.1). AUD, DUD, SCZ, and BD showed lower male/female suicide rate ratios (1.1-1.4) than did depressive and OADs (2.2-2.4). Old age increased the risk for suicide among those with DUD and OADs, while medical aid recipients exhibited the lowest suicide risk among those with the AUD and SCZ. Male sex and the presence of multiple psychiatric comorbidities were consistently identified as suicide risk factors across mental illness subgroups. The current study observed substantial variations in suicide rates and risk factors across psychiatric disorders and patient characteristics, which have significant implications for suicide prevention strategies.

A Critical Review of ‘Regional Variation in Suicide Rates in Sri Lanka Between 1955 and 2011: A Spatial and Temporal Analysis’

This paper hopes to review the article written by D.W. Knipe and et all (Knipe, Padmana than, Muthuwatta, Metcalfe & Gunnell, 2017) on ‘Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis’ which discusses about the fluctuations in suicide rates in Sri Lanka between the years of 1955-2011. The article is written using both qualitative and quantitative methods and it puts emphasis on the co-relationship between the ease of access to pesticides and suicide rates. It uses secondary data to analyze and evaluate the suicide rates of the country with the intent of finding out the relationship between the ease of access to pesticides and its effects on the suicide rate in the country. The 1960s and 1970s showed a dramatic increase in the suicide rates and academics and health advocates at the time pointed to the introduction of highly hazardous pesticides as the culprit. Since all of the data that they have used stems from secondary and which are gathered from and up to the year 2011 one may not be able to have an understanding on impact of the civil conflict that the country faced for three decades on the suicides rates. Suicide rates in Sri Lanka are often calculated by using the Department of Police data, as it is collected nationally and many deaths by suicide occur in the community rather than in hospitals. The quality of the suicide data in Sri Lanka is unlikely to have changed over time, and there have been no research studies which have explicitly investigated whether there are cases of under-reporting in the police statistics. The most problematic issue regarding the article is that, from the outset the authors have not put any or much emphasis on why people commit suicide by using pesticides. It is in any even unsafe or unorthodox to assume that, just because of people having access to pesticides itself is a direct contributory factor for the fluctuations in suicide rates where one can never be blindfolded on other relative issues such as economical, sociological, political, cultural, ethnic and religious factors.

Suicide in Digestive System Cancers: A Scoping Review

Digestive system cancers are important causes of morbidity and mortality worldwide. Cancer patients are more likely to commit suicide. The objective of this scoping review is to provide a comprehensive and updated summary of the existing literature on suicide among patients with digestive system cancers to identify the incidence and risk factors relevant to suicide in these populations. The PRISMA-Scr (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension protocol for scoping reviews) protocol was used. The review was based on relevant articles published prior to January 2022 in databases of Web of Science and PubMed. The authors identified 21 records that met the criteria for inclusion. Among the 21 articles, 18 (n = 85.7%) reported suicide risk factors, 21 (n = 100%) evaluated the incidence of suicide and 16 (n = 76.2%) involved the variation in suicide rates. Only one study comprehensively reported that the suicide rate for this population was 32.8 per 100,000 years and the standardized mortality ratio (SMR) was 1.91. Most suicides occurred in patients with pancreatic, esophageal, and gastric cancers. The factors associated with suicide in digestive system cancers included male gender, older age, the white race, single status, advanced stage of disease, and cancer metastasis. The most critical time for suicide was in the early post-diagnostic period. It is indispensable to identify suicide in these cancer patients, especially those with high-risk factors. In the future, more prospective research may be needed to provide more reliable support and care to prevent suicide.

Decrease and seasonal changes of suicides and suicide attempts in France over the last 10 years

Introduction: The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France, according to the season. Methods: We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009-2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics of the departments, age, gender, and psychiatric disorders. We also collected data on the means of suicide and suicide attempt. Results: The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides are more common among men (75%) and middle-age individuals (45-54 years old), while suicide attempts affected more frequently women (62%) and young adults (15-19 and 40-49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorder, with mood disorders being the most frequent psychiatric disorder. Voluntary drug intoxication was the most common means of suicide attempt (80%), while hanging was the most common means of suicide (54%). Conclusion: The number of suicides and suicide attempts decreased in France over the last 10 years, with large seasonal variations. Further studies are warranted to better understand the underpinning physiological and meteorological factors that may influence these seasonal variations.

The relative importance of macro versus micro geographical scale in explaining suicide variation in Seoul, South Korea 2014-2016.

BackgroundAs ecological factors are getting attention as important determinants of suicide, it is important to identify the unit at which the largest variation exists for more tailed strategy to prevent suicide. We examined the relative importance of two administrative levels for geographic variation in the suicide rate between 2014–2016 in Seoul, the capital city of Korea.MethodsTwo-level linear regression with Dongs (level 1) nested within Gus (level 2) was performed based on suicide death data aggregated at the Dong-level. We performed pooled analyses and then year-stratified analyses. Dong-level socioeconomic status and environmental characteristics were included as control variables.ResultsThe overall age- and sex- standardized suicide rate across all Dongs decreased over time from 24.9 deaths per 100,000 in 2014 to 23.7 deaths in 2016. When Dong and Gu units were simultaneously considered in a multilevel analysis, most of the variation in suicide rate was attributed to within-Gu, between-Dong differences with a contribution of Gu-level being small and decreasing over time in year (Variance partitioning coefficient of Gu = 5.3% in 2014, <0.1% in 2015 and 2016). The number of divorce cases per 100,000 explained a large fraction of variation in suicide rate at the Dong-level.ConclusionsFindings from this study suggest that ecological micro-area unit is more important in reducing the geographic variation in the suicide rate. More diverse ecological-level data needs to be collected for targeted area-based suicide prevention policies in Korea.

Seasonal changes and decrease of suicides and suicide attempts in France over the last 10 years

The objective of this study was to examine the evolution of suicides and suicide attempts over the last 10 years in France. We analyzed the number of deaths by suicide and suicide attempts in metropolitan France (2009–2018) from French national databases, on a daily, weekly or monthly basis. Seasonal variation in suicide rates was modeled using a cosinor function. Based on this model, we determined the association of suicides and suicide attempts with geographic characteristics, age, gender, means used and psychiatric disorders. The number of suicides and suicide attempts decreased over the last ten years in France (mean decrease of 14.49% and 11.69% per year). We observed a significant and recurrent seasonal pattern of suicides and suicide attempts in France, with a peak in spring. The suicide and suicide attempt rates were higher in the northern departments of France. Suicides were more frequent for men (75%) and middle-age individuals (45–54 years old), while suicide attempts were more frequent for women (62%) and young adults and middle-age individual (15–19 and 40–49 years old). Nearly two-thirds of the patients who attempted suicide suffered from comorbid psychiatric disorders. Mood disorders was the most frequent comorbid psychiatric disorder (54%). Voluntary drug intoxication was the most common means of suicide attempt (80%), and hanging was the most common means of suicide (54%). The number of suicides and suicide attempts decreased in France over the last 10 years, with large and recurrent seasonal variations. These findings could be used to alert and adjust prevention policies, as well as developing preventive strategies such as chronotherapeutics.

Inequalities of Suicide Mortality across Urban and Rural Areas: A Literature Review.

Suicide mortality is a major contributor to premature death, with geographic variation in suicide rates. Why suicide rates differ across urban and rural areas has not yet been fully established. We conducted a literature review describing the urban–rural disparities in suicide mortality. Articles were searched in five databases (EMBASE, PubMed, PsychINFO, Scopus, and Web of Science) from inception till 26 May 2021. Eligible studies were narratively analyzed in terms of the urban–rural disparities in suicides, different suicide methods, and suicide trends over time. In total, 24 articles were included in our review. Most studies were ecological and cross-sectional evidence tentatively suggests higher suicide rates in rural than in urban areas. Men were more at risk by rurality than women, but suicide is in general more prevalent among men. No obvious urban–rural pattern emerged regarding suicide means or urban–rural changes over time. Potential suicidogenic explanations include social isolation, easier access to lethal means, stigmatization toward people with mental health problems, and reduced supply of mental health services. For research progress, we urge, first, individual-level cohort and case-control studies in different sociocultural settings. Second, both rurality and urbanicity are multifaceted concepts that are inadequately captured by oversimplified typologies and require detailed assessments of the sociophysical residential environment.

The Need for Collective Awareness of Attempted Suicide Rates in a Warming Climate.

Background: Climate factors may offer a stronger explanation of the variations in suicide rates compared with economic variables, even in the case of patients admitted involuntarily. Aims: We assessed the role of temperature as a determinant of the increased prevalence of suicide attempts (SA). Method: The sample comprised all cases of hospitalization for SA at the Psychiatric Clinic of the IRCCS Ospedale Policlinico San Martino between August 2013 and July 2018. For ambient temperature, data were provided by the Meteorological Observatory of the University of Genoa. Results: We noted a peak in suicides that was typically found in late spring and early summer due to global warming. Limitations: Other environmental/psychological factors contributing to the onset of an acute clinical event were not considered. The cross-sectional design of the study is another limitation. Conclusion: Further studies are needed to clarify the impact of climatic factors on suicide behavior and implement early intervention and preventive strategies for mental health.

Regional Variation of Suicide Mortality in South Korea.

South Korea’s suicide rate is the highest among the members of the Organization for Economic Cooperation and Development. This study seeks to verify regional variation in suicide rates in South Korea and to identify correlating factors. We used age-adjusted suicide rates for 252 administrative districts, and a Community Health Survey, national representative data, and other national representative data such as censuses were used to obtain information on socioeconomic, health related and social integration variables according to each administrative district. Regional variation in suicide rates was analyzed by using Extremal Quotient (EQ), and multiple linear regression analyses were used to investigate associations between variation in suicide rates and regional socioeconomic, public service factors and health related factors. The average suicide rate from 252 regions was 142.7 per 100,000 people. The highest region was Hongchun-gun (217.8) and the lowest was Gwachen-si (75.5). The EQ was 2.89, meaning that there is significant regional variation in suicide rates. Financial independence (β = −0.662, p < 0.001), social welfare budget (β = −0.754, p < 0.001) and divorce rates (β = 17.743, p < 0.001) were significant, along with other adjusted variables. This study suggests considering these factors in order to reduce suicide rates in South Korea.

The Macro and Micro Point of View of Farmer Suicides in India

Agricultural researches, development of innovations, their dissemination and Government funding behind the whole process all come to a grinding halt when the ultimate beneficiaries of the process are left to their fate, are left to die. Yes, the most sensitive yet controversial phenomenon of farmer suicide in India is being indicated. In 2015, 12,602 farmers committed suicide in India (NCRB in Accidental deaths and suicides in India, Ministry of Home Affairs, New Delhi, 2015). Agriculture and farmers ensure the food and nutritional security of the nation; hence, any danger to the well being of farmers is a cause of national concern. Therefore, it necessitates an understanding of the possible reasons which compel farmers to end their lives. Hence, this article attempts to study farmer suicides over the years and state-wise variations in suicide rates. The normalised farmer suicide rate across the states has been calculated as per the latest available suicide data of 2015. An attempt has been made to identify the correlates of farmer suicides with state-level variables related to agriculture and socio-economic development. The results establish the Durkheimian theory; farmer suicide is an individual phenomenon. A compilation of micro-level studies is presented to support the argument.

Suicide, sentiment and crisis

A lack of clarity surrounds the precise nature of the transmission mechanism by which an economic crisis actually affects suicide. This study posits the hypothesis that this influence broadly translates as emotional reaction, ‘gut feelings’ and as such explicitly considers the use of subjective factors of economic performance to better explain variations in suicide rates. Alongside traditional economic indicators we use a ‘consumer sentiment’ measure, a sense of how economic factors are perceived to be impacting on individuals, to explain suicide rates. Furthermore, we explicitly consider the impact of the global financial crisis and test the impact of state public and health expenditures. Results show that consumer sentiment is found to offer a significantly greater explanatory role in exploring variations in the suicide rate compared to traditional economic indicators. Moreover, the effect of consumer sentiment is greater for females than for males, with some nuances in explaining this result. State public and health expenditures do not seem to have any significant influence on suicide rates.

Geographical and Temporal Variation of Suicide in India, 2006-2015: An Investigation of Factors Associated with Suicide Risk Difference across States/Union Territories.

Background:In India, about 130,000 people died by suicide in the year 2015. It is important to understand the variation of suicide across different parts of India and the trend of suicide rates over the years. The objectives of this study were to determine whether suicide rates in India showed temporal variation in the last decade and to determine whether suicide rates in India showed geographical variation across different states and union territories (UTs).Methods:Data on suicide rates for the years 2006–2015 were collected from the official publication of the National Crime Records Bureau. This study looked for time trend in suicide rates over the years. Further, the variation in suicide rates across different states/UTs in India and the factors associated with the variation were also analyzed.Results:The average suicide rate in India for the years 2006–2015 was 10.9/100,000 population. Overall, there was no significant variation in the suicide rate over time in the years studied. The average suicide rate varied widely across the states and UTs, between 0.91 and 43.92 per 100,000 population. The analysis revealed a positive association between suicide rates and accident rates for the above years. In addition, for the year 2011, a positive association between suicide rate and per capita state domestic product was noted.Conclusion:There was no variation in the suicide rate in India over time. However, there were significant regional differences. Reporting differences and economic factors could partially explain the differences.

Suicide in India: a complex public health tragedy in need of a plan

Suicide in India: a complex public health tragedy in need of a plan

Ten-year evolution of suicide rates and economic indicators in large Brazilian urban centers.

This was a retrospective ecological study to examine the relationship between suicide rates and economic indicators in large Brazilian urban centers. Data on macroeconomic indicators (GDP and unemployment rates) and suicide rates of the largest Brazilian cities were collected from January 2006 to December 2015. Six cities were included in the study: Porto Alegre in the South, Recife and Salvador in the Northeast, and Belo Horizonte, São Paulo and Rio de Janeiro in the Southeast region. We observed a 4% increase in the age-adjusted suicide rate in these large Brazilian urban centers from 2006 to 2015, which is less pronounced than the 9% increase in the national rates of suicide observed in the same period. The effect of economic indicators was heterogeneous among the centers, but, overall, the variation in suicide rates was inversely related to unemployment and did not show a significant relationship with GDP. These findings indicate a more complex link between economics and suicide whenever looking at local regional indicators. Further research should focus on possible intervening factors, what may inform better preventive interventions.

Suicide Trends Among and Within Urbanization Levels by Sex, Race/Ethnicity, Age Group, and Mechanism of Death - United States, 2001-2015.

Problem/ConditionSuicide is a public health problem and one of the top 10 leading causes of death in the United States. Substantial geographic variations in suicide rates exist, with suicides in rural areas occurring at much higher rates than those occurring in more urban areas. Understanding demographic trends and mechanisms of death among and within urbanization levels is important to developing and targeting future prevention efforts.Reporting Period2001–2015.Description of SystemMortality data from the National Vital Statistics System (NVSS) include demographic, geographic, and cause of death information derived from death certificates filed in the 50 states and the District of Columbia. NVSS was used to identify suicide deaths, defined by International Classification of Diseases, 10th Revision (ICD-10) underlying cause of death codes X60–X84, Y87.0, and U03. This report examines annual county level trends in suicide rates during 2001–2015 among and within urbanization levels by select demographics and mechanisms of death. Counties were collapsed into three urbanization levels using the 2006 National Center for Health Statistics classification scheme. ResultsSuicide rates increased across the three urbanization levels, with higher rates in nonmetropolitan/rural counties than in medium/small or large metropolitan counties. Each urbanization level experienced substantial annual rate changes at different times during the study period. Across urbanization levels, suicide rates were consistently highest for men and non-Hispanic American Indian/Alaska Natives compared with rates for women and other racial/ethnic groups; however, rates were highest for non-Hispanic whites in more metropolitan counties. Trends indicate that suicide rates for non-Hispanic blacks were lowest in nonmetropolitan/rural counties and highest in more urban counties. Increases in suicide rates occurred for all age groups across urbanization levels, with the highest rates for persons aged 35–64 years. For mechanism of death, greater increases in rates of suicide by firearms and hanging/suffocation occurred across all urbanization levels; rates of suicide by firearms in nonmetropolitan/rural counties were almost two times that of rates in larger metropolitan counties. InterpretationSuicide rates in nonmetropolitan/rural counties are consistently higher than suicide rates in metropolitan counties. These trends also are observed by sex, race/ethnicity, age group, and mechanism of death.Public Health ActionInterventions to prevent suicides should be ongoing, particularly in rural areas. Comprehensive suicide prevention efforts might include leveraging protective factors and providing innovative prevention strategies that increase access to health care and mental health care in rural communities. In addition, distribution of socioeconomic factors varies in different communities and needs to be better understood in the context of suicide prevention.

Methodological barriers to studying the association between the economic crisis and suicide in Spain

BackgroundThe hypothetical relationship between economic recession and the increase in suicides in Spain is subject to various arguments. In addition to the inherent complexity of capturing and explaining the underlining mechanisms that could describe this causal link, different points of contention have been be identified. The period of this association and its possible starting points, the socioeconomic determinants that may explain the variation in suicide rate, and the data sources available are the main focus of controversy. The present study aims to identify the phases of association between different periods of economic recession and suicide rates, and compare the effect of different social determinants of health that have been mentioned in previous studies.MethodsWe have used interrupted time series analyses to assess the impact of economic recession on national rates of suicide mortality provided by the Spanish Statistical Office (1980–2014). In an attempt to consider the factors that have affected the study of suicide in Spain, different data sources/periods, predictors, and regions in Spain were analysed.ResultsThe analysis revealed a positive and significant relationship between the Great Recession and suicide rates during the second period of economic recession (2011–2014), while appeared to decrease during the first recession period. However, the first decreasing trend was not statistically significant in the global analysis of the evolution of monthly suicide rates for the entire country. Both unemployment and per capita GDP were positively related to suicide trends. Finally, the regional analysis demonstrates a similar pattern in different Spanish areas.ConclusionAlthough previous studies have mentioned the double-dip in the suicide rate associated with the corresponding period of double recession, our study only identify a positive relationship during the second recession period. These results points out that the major impact of economic problems might have had a delayed effect due to initial protection policies.

Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis

BackgroundBetween 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka’s 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period.MethodsWe mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka’s suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman’s rank correlation and negative binomial models.ResultsThe rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = −0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = −0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively.ConclusionsThe findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka’s suicide rate, but the impact of other factors cannot be ruled out.

Suicides in commuting railway systems: The case of Stockholm county, Sweden

The objective of this study is to understand the spatial and temporal dynamics of suicides in commuting railway environments. Data on suicides in Stockholm commuting railway from 2006 to 2013 was analysed. The study sets out to identify significant clusters in suicides then evaluate whether commuting railway environments affect variations in suicide rates. Fieldwork inspection, spatial cluster techniques (NNHC and Getis-Ord statistics) and regression models underlie the methodology of study. Findings show no seasonality was observed in suicide cases, but winter months concentrate a larger share of events. Suicides do not occur evenly throughout the day but tend to take place more often in weekdays. Modelling findings shows that suicide rates increase with speed trains and decrease where barriers along tracks are installed. Although high speed trains are still a motive of concern for suicide prevention, findings call for a whole railway-approach to safety - one that extends maintenance beyond the platforms and stations' vicinities.

Geographic variation in suicide rates in Australian farmers: Why is the problem more frequent in Queensland than in New South Wales?

ABSTRACTResearch on farmer suicide is limited in explaining the variations in farmers’ demographic characteristics. This study examines farmer suicides in two Australian states: Queensland (QLD) and New South Wales (NSW). Standardized suicide rates over 2000–2009 showed a 2 times higher prevalence of suicide in QLD than NSW (147 vs. 92 cases, respectively). Differences in age and suicide method were observed between states, although they do not appear to account for the sizeable intra- and interstate variations. Suicide prevention initiatives for farmers should account for different age groups and also specific place-based risk factors that may vary between and within jurisdictions.