Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 9/2018

01-09-2018 | Original Paper

Widening socioeconomic inequalities in Australian suicide, despite recent declines in suicide rates

Authors: Lay San Too, Phillip C. F. Law, Matthew J. Spittal, Andrew Page, Allison Milner

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 9/2018

Login to get access

Abstract

Purpose

This study aims to investigate trends in socioeconomic inequalities of suicide from 1979 to 2013 for Australian males and females aged 15–34 years and 35–64 years.

Methods

Data on suicides and population were obtained from national registries. An area-based measure of socioeconomic status (SES) was used, and categorized into low, middle, and high SES areas. Suicide rates for each SES groups were estimated using a negative binomial regression model, adjusted for confounders. Socioeconomic inequalities in suicide were assessed using absolute and relative risk of low-to-high SES areas. Secular changes in socioeconomic inequalities were assessed using trend tests for relative risk.

Results

For young males, there was an increase in socioeconomic inequality driven by a significant decrease in suicide rates in high SES areas. For older males, inequality in suicide increased by 29%, which was related to a marked increase in suicide rates in low SES areas. Inequalities in both young and older female suicides also increased. These increases occurred when corresponding suicide rates in high SES areas decreased.

Conclusions

Recent widening socioeconomic inequalities in Australian suicide have been primarily associated with declines in suicide rates in high SES areas. However, an increasing inequality in older male suicide is linked with low SES. Efforts targeting people from poor areas, especially older males, should be considered when developing suicide prevention strategy.
Appendix
Available only for authorised users
Literature
1.
Page A, Morrell S, Hobbs C, Carter G, Dudley M, Duflou J, Taylor R (2014) Suicide in young adults: Psychiatric and socio-economic factors from a case-control study. BMC Psychiatry 14:68CrossRefPubMedPubMedCentral
2.
Kim MH, Jung-Choi K, Jun HJ, Kawachi I (2010) Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Soc Sci Med 70:1254–1261CrossRefPubMed
3.
Agerbo E, Nordentoft M, Mortensen PB (2002) Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study. BMJ 325:74CrossRefPubMedPubMedCentral
4.
Rehkopf DH, Buka SL (2006) The association between suicide and the socio-economic characteristics of geographical areas: a systematic review. Psychol Med 36:145–157CrossRefPubMed
5.
Barth A, Sogner L, Gnambs T, Kundi M, Reiner A, Winker R (2011) Socioeconomic factors and suicide: an analysis of 18 industrialized countries for the years 1983 through 2007. J Occup Environ Med 53:313–317CrossRefPubMed
6.
Lorant V, Kunst AE, Huisman M, Costa G, Mackenbach J, E.U. working group (2005) Socio-economic inequalities in suicide: a European comparative study. Br J Psychiatry 187:49–54CrossRefPubMed
7.
Milner A, McClure R, De Leo D (2012) Socio-economic determinants of suicide: an ecological analysis of 35 countries. Soc Psychiatry Psychiatr Epidemiol 47:19–27CrossRefPubMed
8.
Platt S, Boyle P, Crombie I, Feng Z, Exeter D (2007) The epidemiology of suicide in Scotland 1989–2004: an examination of temporal trends and risk factors at national and local levels. Scottish Executive Social Research, Edinburgh
9.
Agerbo E, Sterne JA, Gunnell DJ (2007) Combining individual and ecological data to determine compositional and contextual socio-economic risk factors for suicide. Soc Sci Med 64:451–461CrossRefPubMed
10.
Andres AR, Collings S, Qin P (2010) Sex-specific impact of socio-economic factors on suicide risk: a population-based case-control study in Denmark. Eur J Public Health 20:265–270CrossRefPubMed
11.
Page A, Morrell S, Taylor R (2002) Suicide differentials in Australian males and females by various measures of socio-economic status, 1994–98. Aust N Z J Public Health 26:318–324CrossRefPubMed
12.
Kolves K, Potts B, De Leo D (2015) Ten years of suicide mortality in Australia: socio-economic and psychiatric factors in Queensland. J Forensic Leg Med 36:136–143CrossRefPubMed
13.
Qin P, Agerbo E, Mortensen PB (2003) Suicide risk in relation to socioeconomic, demographic, psychiatric, and familial factors: a national register-based study of all suicides in Denmark, 1981–1997. Am J Psychiatry 160:765–772CrossRefPubMed
14.
Turrell G, Mathers C (2001) Socioeconomic inequalities in all cause and specific-cause mortality in Australia: 1985–1987 and 1995–1997. Int J Epidemiol 30:231–239CrossRefPubMed
15.
Burrows S, Auger N, Roy M, Alix C (2010) Socio-economic inequalities in suicide attempts and suicide mortality in Quebec, Canada, 1990–2005. Public Health 124:78–85CrossRefPubMed
16.
Page A, Morrell S, Taylor R, Carter G, Dudley M (2006) Divergent trends in suicide by socio-economic status in Australia. Soc Psychiatry Psychiatr Epidemiol 41:911–917CrossRefPubMed
17.
Cingano F (2014) “Trends in Income Inequality and its Impact on Economic Growth”, OECD Social, Employment and Migration Working Papers, no. 163. OECD Publishing
18.
OECD.Stat (2017) OECD Income Distribution Database (IDD)
19.
Driscoll T, Henley G, Harrison J (2003) The National Coroners Information System as an information tool for injury surveillance. Catalogue no. INJCAT 60. Australian Institute of Health and Welfare, Canberra
20.
Elnour AA, Harrison J (2009) Suicide decline in Australia: where did the cases go? Aust N Z J Public Health 33:67–69CrossRefPubMed
21.
Australian Bureau of Statistics (2016) 3303.0—causes of death, Australia. Australian Bureau of Statistics, Canberra
22.
Taylor R, Page A, Morrell S, Harrison J, Carter G (2005) Social and psychiatric influences on urban-rural differentials in Australian suicide. Suicide Life Threat Behav 35:277–290CrossRefPubMed
23.
Taylor R, Page A, Morrell S, Harrison J, Carter G (2005) Mental health and socio-economic variations in Australian suicide. Soc Sci Med 61:1551–1559CrossRefPubMed
24.
Morrell S, Page A, Taylor R (2007) The decline in Australian young male suicide. Soc Sci Med 3:747–754CrossRef
25.
Page A, Taylor R, Martin G (2010) Recent declines in Australian male suicide are real, not artefactual. Aust N Z J Psychiatry 44:358–363CrossRefPubMed
26.
Australian Institute of Family Studies (2000) Valuing young lives: Summative evaluation of the national youth suicide prevention strategy. Volume 2: Research report. Australian Institute of Family Studies, Melbourne
27.
Department of Health and Ageing (2012) National Suicide Prevention Strategy. Department of Health and Ageing, Canberra
28.
Department of Health and Ageing (2013) Programs: Taking Action to Tackle Suicide package. Department of Health and Ageing, Canberra
29.
Page A, Taylor R, Gunnell D, Carter G, Morrell S, Martin G (2011) Effectiveness of Australian youth suicide prevention initiatives. Br J Psychiatry 199:423–429CrossRefPubMed
30.
Spittal MJ, Pirkis J, Miller M, Studdert DM (2012) Declines in the lethality of suicide attempts explain the decline in suicide deaths in Australia. PLoS One 7:e44565CrossRefPubMedPubMedCentral
31.
Benach J, Malmusi D, Yasui Y, Martinez JM, Muntaner C (2011) Beyond Rose’s strategies: a typology of scenarios of policy impact on population health and health inequalities. Int J Health Serv 41:1–9CrossRefPubMed
32.
Page A, Milner A, Morrell S, Taylor R (2013) The role of under-employment and unemployment in recent birth cohort effects in Australian suicide. Soc Sci Med 93:155–162CrossRefPubMed
33.
Hsu CY, Chang SS, Lee ES, Yip PS (2015) Geography of suicide in Hong Kong: spatial patterning, and socioeconomic correlates and inequalities. Soc Sci Med 130:190–203CrossRefPubMed
34.
Milner A, Page A, LaMontagne AD (2014) Cause and effect in studies on unemployment, mental health and suicide: A meta-analytic and conceptual review. Psychol Med 44:909–917CrossRefPubMed
35.
Taylor R, Page A, Morrell S, Carter G, Harrison J (2004) Socio-economic differentials in mental disorders and suicide attempts in Australia. Br J Psychiatry 185:486–493CrossRefPubMed
36.
De Leo D, Dudley MJ, Aebersold CJ, Mendoza JA, Barnes MA, Harrison JE, Ranson DL (2010) Achieving standardised reporting of suicide in Australia: rationale and program for change. Med J Aust 192:452–456PubMed
37.
38.
Geronimus AT, Bound J (1998) Use of census-based aggregate variables to proxy for socioeconomic group: evidence from national samples. Am J Epidemiol 148:475–486CrossRefPubMed
39.
Carr-Hill R, Rice N (1995) Is enumeration district level an improvement on ward level analysis in studies of deprivation and health? J Epidemiol Community Health 49(suppl 2):S28–S29CrossRefPubMedPubMedCentral
Metadata
Title
Widening socioeconomic inequalities in Australian suicide, despite recent declines in suicide rates
Authors
Lay San Too
Phillip C. F. Law
Matthew J. Spittal
Andrew Page
Allison Milner
Publication date
01-09-2018
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 9/2018
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-018-1527-9

Other articles of this Issue 9/2018

Social Psychiatry and Psychiatric Epidemiology 9/2018 Go to the issue

Original Paper

Traumatic exposure, acculturative stress and cultural orientation: the influence on PTSD, depressive and anxiety symptoms among refugees

Original Paper

School poverty and the risk of attempted suicide among adolescents

Original Paper

Do trauma type, stressful life events, and social support explain women veterans’ high prevalence of PTSD?

Original Paper

The association of depression and posttraumatic stress disorder with the metabolic syndrome in a multi-ethnic cohort: the HELIUS study

Original Paper

Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis

Correction

Correction to: Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study