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Urban-rural differences in suicide trends in young adults: England and Wales, 1981-1998

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  • Middleton, Nicos
  • Gunnell, David
  • Frankel, Stephen
  • Whitley, Elise
  • Dorling, Daniel

Abstract

Suicide rates amongst young people, particularly males, have increased in many industrialised countries since the 1960s. There is evidence from some countries that the steepest rises have occurred in rural areas. We have investigated whether similar geographical differences in trends in suicide exist in England and Wales by examining patterns of suicide between 1981 and 1998 in relation to rurality. We used two complementary population-based indices of rurality: (1) population density and (2) population potential (a measure of geographic remoteness from large concentrations of population). We used the electoral ward (n=9264, median population aged 15-44: 1829) as the unit of analysis. To assess whether social and economic factors underlie rural-urban differences in trends we used negative binomial regression models to investigate changes in suicide rates between the years for which detailed national census data were available (1981 and 1991). Over the years studied, the most unfavourable trends in suicide in 15-44-year olds generally occurred in areas remote from the main centres of population; this effect was most marked in 15-24-year-old females. Observed patterns were not explained by changes in age- and sex-specific unemployment, socio-economic deprivation or social fragmentation. The mental health of young adults or other factors influencing suicide risk may have deteriorated more in rural than urban areas in recent years. Explanations for these trends require further investigation.

Suggested Citation

  • Middleton, Nicos & Gunnell, David & Frankel, Stephen & Whitley, Elise & Dorling, Daniel, 2003. "Urban-rural differences in suicide trends in young adults: England and Wales, 1981-1998," Social Science & Medicine, Elsevier, vol. 57(7), pages 1183-1194, October.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:7:p:1183-1194
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    Cited by:

    1. Page, Andrew & Morrell, Stephen & Taylor, Richard & Dudley, Michael & Carter, Greg, 2007. "Further increases in rural suicide in young Australian adults: Secular trends, 1979-2003," Social Science & Medicine, Elsevier, vol. 65(3), pages 442-453, August.
    2. Pearce, Jamie & Barnett, Ross & Jones, Irfon, 2007. "Have urban/rural inequalities in suicide in New Zealand grown during the period 1980-2001?," Social Science & Medicine, Elsevier, vol. 65(8), pages 1807-1819, October.
    3. Ferdi Botha, 2012. "The Economics Of Suicide In South Africa," South African Journal of Economics, Economic Society of South Africa, vol. 80(4), pages 526-552, December.
    4. Cockings, Samantha & Martin, David, 2005. "Zone design for environment and health studies using pre-aggregated data," Social Science & Medicine, Elsevier, vol. 60(12), pages 2729-2742, June.
    5. Antonio Rodríguez & Sunny Collings & Ping Qin, 2008. "Socio-economic differences in suicide risk vary by sex : A population-based case-control study of 18-65 year olds in Denmark," Development Research Working Paper Series 05/2008, Institute for Advanced Development Studies.
    6. Gartner, Andrea & Farewell, Daniel & Roach, Paul & Dunstan, Frank, 2011. "Rural/urban mortality differences in England and Wales and the effect of deprivation adjustment," Social Science & Medicine, Elsevier, vol. 72(10), pages 1685-1694, May.
    7. Markowitz, Sara & Cuellar, Alison, 2007. "Antidepressants and youth: Healing or harmful?," Social Science & Medicine, Elsevier, vol. 64(10), pages 2138-2151, May.

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