Social Psychiatry and Psychiatric Epidemiology

, Volume 40, Issue 8, pp 601–604

Changing patterns of suicide in a poor, rural county over the 20th century

A comparison with national trends
  • Simon A. Hill
  • Colin Pritchard
  • Richard Laugharne
  • David Gunnell
Original Paper


Rural suicide rates have been shown to be disproportionately high in several countries. This study compares suicide rates in Cornwall with the rest of England and Wales over a 90-year period (1911–2001). Age and sex standardised mortality ratios were calculated for suicide and undetermined death for Cornwall standardised to England and Wales. From 1911 until the start of the Second World War, suicide rates were lower in Cornwall than England and Wales. Since the 1960s suicide rates in Cornwall have risen significantly above England and Wales. We have shown that the suicide rate in a poor, rural area has increased disproportionately compared to England and Wales over the last 35 years. This change has occurred in both sexes. Prior to this period the suicide rate was lower or about the same as that in England and Wales.


suicide rate rural deprivation income inequality standardised mortality ratio 


  1. 1.
    Bunting J, Kelly S (1998) Geographic variations in suicide mortality, 1982–1996. Popul Trends 93:7–18PubMedGoogle Scholar
  2. 2.
    Dudley MJ, Kelk NJ, Florio TM et al (1997) Suicide among young Australians 1964–1993: a comparison with metropolitan trends. Soc Psychiatry Psychiatr Epidemiol 32:251–260CrossRefPubMedGoogle Scholar
  3. 3.
    Gunnell D, Martin RM (2004) Patterns of general practitioner consultation for mental illness by young people in rural areas. A cross-sectional study. Health Stat Q 21:30–33PubMedGoogle Scholar
  4. 4.
    Gunnell D, Peters T, Kammerling M et al (1995) The relation between parasuicide, suicide, psychiatric admissions and socio-economic deprivation. Br Med J 311:226–230Google Scholar
  5. 5.
    Kawachi I, Kennedy BP (1997) Health and social cohesion: why are about income inequality? Br Med J 314:1037–1040Google Scholar
  6. 6.
    Kelly S, Charlton J, Jenkins R (1995) Suicide deaths in England and Wales, 1982–92: the contribution of occupation and geography. Popul Trends 80:16–25PubMedGoogle Scholar
  7. 7.
    Linsley KR, Schapira K, Kelly TP (2001) Open verdict v. suicide—importance to research. Br J Psychiatry 178:465–468CrossRefPubMedGoogle Scholar
  8. 8.
    Mehlum L, Hutten K, Gjerston F (1999) Epidemiological trends of youth suicide in Norway. Arch Suicide Res 5:193–205CrossRefGoogle Scholar
  9. 9.
    Middleton N, Gunnell D, Frankel S et al (2003) Urban–rural differences in suicide trends in young adults: England and Wales 1981–1998. Soc Sci Med 57(7):1183–1194CrossRefPubMedGoogle Scholar
  10. 10.
    Murray J (1947) Devon and Cornwall: a preliminary survey. Wheaton, ExeterGoogle Scholar
  11. 11.
    Morselli E (1903) Suicide. Appleton & Co, New YorkGoogle Scholar
  12. 12.
    Paykel ES, Abbott R, Jenkins R, Brugha TS et al (2000) Urban–rural mental health differences in Great Britain: findings from the National Morbidity Survey. Psychol Med 269–280Google Scholar
  13. 13.
    Payton P (1993) The making of modern Cornwall: historical experience and the persistence of ‘difference’. University of Exeter Press, RedruthGoogle Scholar
  14. 14.
    Phillips MR, Li X, Zhang Y (2002) Suicide rates in China, 1995–1999. Lancet 359:835–840CrossRefPubMedGoogle Scholar
  15. 15.
    Singh GK, Siahpush M (2002) Increasing rural–urban gradients in US suicide mortality, 1970–1997. Am J Public Health 92(7):1161–1167PubMedGoogle Scholar
  16. 16.
    Wills P (1998) Cornish regional development: evaluation, Europe and evolution. In: Payton P (ed) Cornish studies 6. Exeter University Press, Exeter, pp 143–162Google Scholar
  17. 17.
    Zacharakis CA, Madianos MG, Papadimitriou GN (1998) Suicide in Greece 1980–1995: patterns and social factors. Soc Psychiatry Psychiatr Epidemiol 33:471–476CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Simon A. Hill
    • 1
  • Colin Pritchard
    • 2
  • Richard Laugharne
    • 3
  • David Gunnell
    • 4
  1. 1.Langdon HospitalDevonUK
  2. 2.Research and Development Support UnitRoyal Cornwall Hospital TrustTruroUK
  3. 3.Peninsular Medical School Mental Health Research GroupWonford House HospitalExeterUK
  4. 4.Dept. of Social MedicineUniversity of BristolBristolUK

Personalised recommendations