Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-26T09:18:40.180Z Has data issue: false hasContentIssue false

Death by suicide at the Ward level in Northern Ireland

Published online by Cambridge University Press:  17 October 2017

B. Bunting*
Affiliation:
Bamford Centre, Psychology Research Institute, Ulster University
C. Corry
Affiliation:
National Suicide Research Foundation, University College Cork
S. O'Neill
Affiliation:
Bamford Centre, Psychology Research Institute, Ulster University
A. Moore
Affiliation:
Environmental Sciences Research Institute, Ulster University
*
Author for correspondence: B. Bunting, E-mail: [email protected]

Abstract

Background

Deaths from suicide, as recorded within the Northern Ireland Coroner's Office for the years 2005–2011 inclusive, were analysed in terms of standardised mortality ratios (SMRs), within Wards and Local Government Districts (LGDs). The aim of the study is to examine factors relating to the ecological context of the area within which the person resided at time of death. Area deprivation, religious composition and age structure are examined in terms of SMRs, while controlling for the number of individuals living within a designated area.

Methods

Random-intercept Poisson regression models were used in conjunction with empirical Bayes prediction to examine area effects.

Results

Considerable variation occurs between the numbers of recorded deaths within each area. A strong association is shown between deprivation and the number of deaths by suicide within an area. There was considerable variation at the LGD level in terms of the number of deaths, but once the nested nature of Wards was taken into account and adjusted for level of deprivation, the variation between LGD was no longer statistically significant. When adjusted for the number of individuals within each age group, the number of deaths in the younger and middle-aged groups did not show a statistical difference (0.05 level), nor did the religious composition of the area in terms of the number of recorded deaths.

Conclusions

Based on SMRs, using empirical Bayes prediction, area effects were shown to be substantial, especially in urban locations where there are high rates of deprivation.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boyle, P, Exeter, D, Feng, Z, Flowerdew, R (2005) Suicide gap among young adults in Scotland: population study. British Medical Journal 330, 175176.Google Scholar
Chaix, B, Billaudeau, N, Thomas, F, Havard, S, Evans, D, Kestens, Y, Bean, K (2011) Neighborhood effects on health correcting bias from neighborhood effects on participation. Epidemiology 22, 1826.Google Scholar
Clayton, D, Kaldor, J (1987) Empirical Bayes estimates of age-standardized relative risks for use in disease mapping. Biometric 43, 671681.Google Scholar
Congdon, P (1996) Suicide and parasuicide in London: a small-area study. Urban Studies 33, 137158.Google Scholar
Congdon, P (2013) Assessing the impact of socioeconomic variables on small area variations in suicide outcomes in England. International Journal of Environmental Research and Public Health 10, 158177.Google Scholar
Durkheim, E (1897) [1951]. Suicide: A Study in Sociology. Translation of 1897 by Spaulding, J.A. and Simpson, G. and edited with Introduction by Simpson, G., New York, The Free Press.Google Scholar
Gunnell, D, Wheeler, B, Chang, S, Thomas, B, Sterne, J, Dorling, D (2011) Changes in the geography of suicide in young men: England and Wales 1981–2005. Journal Epidemiology. Community Health 66, 536543.Google Scholar
Jenkins, R, Bhugra, D, Bebbington, P, Brugha, T, Farrell, M, Coid, J, Fryers, T, Weich, S, Singleton, N, Meltzer, H (2008) Debt, income and mental disorder in the general population. Psychological Medicine 10, 19.Google Scholar
Jones, K, Duncan, C (1995) Individuals and their ecologies: analysing the geography of chronic illness within a multilevel modelling framework. Health & Place 1, 2740.Google Scholar
Maimon, D, Kuhl, DC (2008) Social control and youth suicidality: situation Durkheim's ideas in a multilevel framework. American Sociological Review 73, 921943.Google Scholar
Meltzer, H, Bebbington, P, Brugha, T, Jenkins, R, McManus, S, Dennis, MS (2011) Personal debt and suicidal ideation. Psychological Medicine 41, 771778.Google Scholar
Neeleman, J, Wessely, S (1999) Ethnic minority suicide: a small area geographical study in south London. Psychological Medicine 29, 429436.Google Scholar
Nock, MK, Borges, G, Bromet, EJ, Alonso, J, Angermeyer, M, Beautrais, A, Bruffaerts, R, Chiu, WT, de Girolamo, G, Gluzman, S, de Graaf, R, Gureje, O, Haro, JM, Huang, Y, Karam, E, Kessler, RC, Lepine, JP, Levinson, D, Medina-Mora, ME, Ono, Y, Posada-Villa, J, Williams, DR (2008) Cross-national prevalence and risk factors for suicidal ideation, plans, and attempts. British Journal of Psychiatry 192, 98105.Google Scholar
Northern Ireland Multiple Deprivation Measure (2010) Retrieved from (http://www.nisra.gov.uk/deprivation/super_output_areas.htm).Google Scholar
O'Reilly, D, Rosato, M, Connolly, S, Cardwell, C (2008) Area factors and suicide: 5-year follow-up of the Northern Ireland population. The British Journal of Psychiatry 192, 106111.Google Scholar
Pearl, M, Braveman, P, Abrams, B (2001) The relationship of neighborhood socioeconomic characteristics to birthweight among five ethnic groups in California. American Journal of Public Health 91, 18081824.Google Scholar
Pescosolido, B, Georgianna, S (1989) Durkheim, suicide and religion: toward a network theory of suicide. American Sociological Review 54, 3348.Google Scholar
Platt, S, Hawton, K (2000) Suicidal behaviour and the labour market. In The International Handbook of Suicide and Attempted Suicide (ed. Hawton, K. and van Heeringen, K.), pp. 309384. John Wiley & Sons: Chichester.Google Scholar
Rabe-Hesketh, S, Skrondal, A, Pickles, A (2004) Generalized multilevel structural equation modelling. Psychometrika 69, 167190.Google Scholar
Rauh, VA, Andrews, HF, Garfinkel, R (2001) The contribution of maternal age to racial disparities in birthweight: a multilevel perspective. American Journal Public Health 91, 18151824.Google Scholar
Scowcroft, E (2017) Suicide statistics report. London: Samaritans.Google Scholar
Skrondal, A, Rabe-Hesketh, S (2004) Generalized Latent Variable Modeling: Multilevel, Longitudinal and Structural Equation Models. Chapman & Hall/CRC Press: Boca Raton, FL.Google Scholar
Subramanian, SV, Jones, K, Duncan, C (2003) Multilevel methods for public health research. In Neighborhoods and Health (ed. Kawachi, I. and Berkman, L. F.). Oxford University Press, pp. 65111.Google Scholar
Tomlinson, MW (2012) War, peace and suicide: the case of Northern Ireland. International Sociology 27, 464482.Google Scholar
Whitley, E, Gunnell, D, Dorling, D, Davey Smith, G (1999) Ecological study of social fragmentation, poverty, and suicide. British Medical Journal 319, 10341037.Google Scholar
Supplementary material: File

Bunting et al. supplementary material

Bunting et al. supplementary material 1

Download Bunting et al. supplementary material(File)
File 12.8 KB