Suicide among urban South African adolescents.

UNLABELLED

Knowledge of suicide epidemiology in low- and middle-income settings is important for both well-tailored policies and an increased global understanding of suicide macro-determinants. Adolescents are an important target group in that respect, and those from South Africa are a particular concern, given the additional challenges associated with dramatic political, economic, and health transition.

OBJECTIVE

This study presents a profile of adolescent suicide occurrence and sex, race, and city differences.

STUDY GROUP

Adolescents aged 10-19 years in post-apartheid urban South Africa.

METHODS

Sex-, race- and city-specific suicide rates were calculated for two age groups (10-14, 15-19 years). Using logistic regression, odds ratios were compiled, first adjusting for age, then additionally for sex, race, and city. Female subjects, those classified as 'coloured' (denoting mixed racial origin), and those living in Tshwane were used as reference groups. Proportions (with 95% confidence intervals) of leading suicide methods were compared.

RESULTS

Suicide rates were considerably higher among older adolescents and varied by sex, race, and city. Males had more than twice the odds of committing suicide compared with females. In the fully adjusted model, differences between races were not significant, but city-level differences remained. The leading suicide method was hanging for males and both hanging and poisoning for females.

CONCLUSIONS

In contemporary urban South Africa, male sex, and city of residence, but not race, were associated with the commission of adolescent suicide, which tends to occur by quite specific methods. The findings warrant research into the possible underlying contextual, demographic, and individual mechanisms.