Hanging, strangulation, and suffocation deaths of undetermined intent: Hidden suicides on the rise in post-pandemic Argentina?

The objective of this study is to identify spatial and spatio-temporal clusters of reported suicides and injury deaths of undetermined intent (DUI) by hanging, strangulation, and suffocation (HAUS); determine whether these clusters coincide geographically; and describe the overlap in their spatiotemporal distributions. Spatial autocorrelation and space-time scan statistics techniques were used to detect spatial and spatiotemporal clusters of HASU-DUI and HASU-suicide in Argentina, during 2015-2023. The spatiotemporal analysis identified distinct geographic clustering of HASU deaths (both suicides and DUI) across Argentina (2015-2023). We observed inverse spatial patterns -low-risk suicide clusters and high-risk DUI clusters expanded-with overlapping areas showing declining suicides and rising DUIs post-2020. Our spatiotemporal analysis suggests potential reclassification patterns between deaths recorded as undetermined intent (DUI) and suicides in post-pandemic Argentina. These findings suggest that combining undetermined deaths by hanging, strangulation and suffocation (Y20) with official suicide data may provide a more complete mortality picture in Argentina.