Trends and Patterns in Suicide in England and Wales

Background. Suicides among young men have been rising since the early 1970s while at the same time the rates for women of all ages and for men over age 44 have been falling. By 1992 the highest risk group was men aged 25–44. In all age groups female rates have declined relative to those for men. Methods. A case-control analysis was undertaken comparing suicide deaths with deaths from natural causes for the years 1990–1992, based on data collected on the death certificate, and 1991 census data relating to the ward of residence of the person who died. Data for men and women aged 16–64 were analysed separately, with allowance for the fact that the effects of the factors analysed could be different above and below age 45. Results. For men, different models were necessary for the two age groups, but for women a single model sufficed. For men and women occupations with access to effective methods of suicide, such as veterinarians, medical practitioners, nurses and pharmacists had much higher risks than other professions. Being widowed/divorced or marital status not stated was also an important risk factor, as was being single for men aged 45 and over and women of all ages. Country of birth was also significantly related to suicide risk. For older men, living in a ward with unemployment rates below 5% was a risk factor, as was living in a ward with high owner occupancy rates. Younger men living in wards with owner occupancy rates below 55% were at reduced risk. For women owner occupancy and unemployment rates had little association with suicide rates. Older men and women of all ages living in areas of high mobility were at higher relative risk of suicide. Living in a ward where a high proportion of the population aged 16–64 were living alone was a strong risk factor for women, but not for men. Living in a ward that was completely rural was a risk factor for men and women alike, but the effect was greatest for older men.