The influence of socio-economic factors on geographic and temporal variations in suicide.
The majority of research on suicide has focused on the role of direct risk factors in the
development of suicidal intent, including personal characteristics and psychiatric illness.
While research on the wider influence of socio-economic circumstances is not uncommon,
most research has considered single risk factors, and often limits the scope of the research to
small groups or small areas. This research attempted to provide a unified and comprehensive
analysis, and used mainly aggregate data to consider the extent to which socio-economic
factors explain geographic and temporal variations in suicide.
Variations in suicide over the local authority districts of England and Wales were found to be
significantly associated with several ecological predictors, including male unemployment,
lone households, low social class and divorce. The importance of the predictors varied
according to age and sex, and the results corresponded well to those from individual level
studies. The research also considered the geographical differences between suicide and
undetermined death verdicts, and found that the latter have a significant urban bias. These
cross- 3ectional results were used as the basis for a study of the changes that took place in
suicide rates during the 1980s, to determine the extent to which changes in the area
characteristics that were significant at a given point in time accounted for changes in suicide
rates over time. Particular attention was given to the dramatic rise in rates among younger
males (aged 15-44). Little evidence was found at the ecological level to support the
hypothesis that changes in unemployment and/or deprivation, the proportion of people living
alone, or the divorce rate might have been responsible for the increase in suicide among
younger men, while the rates for all other groups declined.
Individual data for Norfolk were also used, and the predictors of geographic variation were
found to be very similar for Norfolk and England and Wales. Furthermore, although the sexand
age-specific changes in rates during the 1980s were also similar, the ecological variable~
again failed to adequately predict the changes. Analysis did not support the hypothesis tha1
suicide rates increased solely because of the increased availability of motor vehicle exhaus1
fumes as a suicide method, though there was some suggestion that this may have contributec
to the trends. Further analysis of individual deaths found strong evidence to suggest the urbar
bias of undetennined death to be an artifact of the reporting of suicide, whereby mon
equivocal methods, more likely to lead to an undetermined death verdict, tend to be use(
more often in urban areas.
Two main conclusions are reached. First, the extent of the urban-rural variation between tbl
verdicts was such that studies using different definitions of suicide over the same study are;
could possibly derive diifering conclusions. Combining the verdicts is therefore encouragec
Second, while the geography of suicide may be explained in tenns of socio-economic facton
changes in suicide rates appear to have little or no geographic and socio-economi
manifestation. Detennining the role of cultural change, presently the only theory t
adequately account for the divergence in rates, requires more psychologically and socially