The influence of deprivation on suicide mortality in urban and rural Queensland: an ecological analysis.

PURPOSE

A trend of higher suicide rates in rural and remote areas as well as areas with low socioeconomic status has been shown in previous research. Little is known whether the influence of social deprivation on suicide differs between urban and rural areas. This investigation aims to examine how social deprivation influences suicide mortality and to identify which related factors of deprivation have a higher potential to reduce suicide risk in urban and rural Queensland, Australia.

METHODS

Suicide data from 2004 to 2008 were obtained from the Queensland Suicide Register. Age-standardized suicide rates (15+ years) and rate ratios, with a 95% confidence interval, for 38 Statistical Subdivisions (SSDs) in Queensland were calculated. The influence of deprivation-related variables on suicide and their rural-urban difference were modelled by log-linear regression analyses through backward elimination.

RESULTS

Among the 38 SSDs in Queensland, eight had a higher suicide risk while eleven had a lower rate. Working-age males (15-59 years) had the most pronounced geographic variation in suicide rate. In urban areas, suicide rates were positively associated with tenant households in public housing, Aboriginal and Torres Strait Islander people, the unemployment rate and median individual income, but inversely correlated with younger age and households with no internet access. In rural areas, only tenant households in public housing and households with no internet access heightened the risk of suicide, while a negative association was found for younger and older persons, low-skilled workers or labourers, and families with low income and no cars.

CONCLUSIONS

The extent to which social deprivation contributes to suicide mortality varies considerably between rural and urban areas.