Suicide rate under COVID-19's shadow: Spatiotemporal dynamics and environmental associations in Hong Kong

As public health crises like COVID-19 exacerbate urban suicide risks, understanding their spatial and temporal dynamics and environment association mechanisms is increasingly critical in high-density metropolis. While existing research often examines isolated pandemic periods or limited environment factors, integrated spatiotemporal perspectives on suicide rates (SuR), particularly across full pandemic cycles, remain underexplored. This study addresses this gap by developing a multiscale framework to assess dynamics patterns of SuR during the pandemic and their associations with multidimensional urban environment factors in Hong Kong. Our approach integrates dynamic time warping (DTW) to detect temporal synchronization with confirmed cases, Getis-Ord Gi* for hotspot evolution, and geographically and temporally weighted regression to quantify varying associations across social, micro built, and macro built environment factors. Analysis reveals phased temporal patterns: synchronization in the first and fifth waves, driven by initial shock, mid-term social cohesion buffering, and late rebounds from cumulative stressors. Spatially, persistent hotspots in Kowloon contrasted with after-pandemic reconfiguration and emerging peripheral risks. Regression models highlighted dynamic heterogeneity, with micro built environment factors showing peak period sensitivity and functional reversal, protective global factors like residential density and POI diversity fostering buffering, and macro built environment factors related with functional zoning providing structural stability diluted by full cycle adaptation. These findings illuminate specific reshaping of environment-SuR linkages, providing planning insights for phased suicide prevention: early psychological support and transparency, midterm community cohesion and employment linked stability, and post peak enhancements in socioeconomic relief, mixed use accessibility, and restorative environments to enhance suicide prevention resilience of citizens during public health crisis. • Spatial and temporal dynamics of SuR in Hong Kong are analyzed in relation to CAL across full pandemic periods. • Multi-dimensional framework integrates social, built, and cyber factors associated with SuR during the pandemic. • SuR declined in early phases then rebounded, with spatially disturbed distribution correlated with environmental factors. • Findings offer insights for urban suicide prevention management and public health strategies in post-crisis recovery.