Data-informed targets for suicide prevention: a small-area analysis of high-risk suicide regions in Australia
To investigate small-area variation in risks associated with suicide deaths across four regional communities in New South Wales, Australia, and to determine whether these areas have unique demographic and socioeconomic risk profiles that could inform targeted means restriction suicide prevention efforts.
Archival data on suicide mortality for all deaths in New South Wales, Australia, over the period 2006–2015 were geospatially attributed to four high-risk priority regions. Deaths in the four regions were compared to each other, and to NSW, on demographic factors, indicators of economic deprivation, and suicide means.
Priority means restriction targets were identified for all sites. In Murrumbidgee, suicide deaths were significantly more likely to involve firearms and older males (p < 0.001). The Central Coast had a greater proportion of overdose deaths (p < 0.001), which were associated with being female and unemployed. Suicide deaths in Newcastle were associated with being younger (p = 0.001) and involving ‘jumping from a height’ (p < 0.001), while economic deprivation was a major risk for suicide death in Illawarra Shoalhaven (p < 0.001).
Local regions were significantly differentiated from each other, and from the State, in terms of priority populations and means of suicide, demonstrating the need for locally based, targeted interventions. There were, however, also some risk constancies across all sites (males, hanging, economic deprivation), suggesting that prevention initiatives should, optimally, be delivered within multilevel models that target risk commonalities and provide tailored initiatives that address risk specific to a region.
KeywordsSuicide Prevention Epidemiology
This study is funded by a grant from the Paul Ramsay Foundation. We would also like to thank the National Coronial Information System for the provision of data, and the data team at Black Dog Institute who were instrumental in cleaning and managing the data (Alex Burnett, Emily Li).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the Hunter New England Local Health District Human Research Ethics Committee (HREC/16/HNE/399; SSA/16/HNE/400) and the National Coronial Information System Justice Human Research Ethics Committee (M0381).
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