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Suicides by country of birth groupings in England and Wales: age-associated trends and standardised mortality ratios

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Abstract

Introduction

Suicide rates in England and Wales have declined in recent years. A better understanding of age-associated trends in different ethnic groups may inform strategies to sustain this decline.

Materials and methods

This study examines suicide rates and age-associated trends in England and Wales by country of birth (used as a proxy for ethnicity) using the latest available national mortality data.

Results

The main findings were (a) suicide rates were generally higher in males than females in all age bands in all country of birth groups except the China group, where suicides rates were higher in females than males in the older age bands; (b) male suicide rates increased with ageing in the Indian sub-continent group and female suicide rates increased with ageing in the Africa and China groups; (c) male standardised mortality ratios (SMRs) were generally higher in the younger age bands in the Eastern Europe and Caribbean groups and generally lower in the Australasian, Middle East and Western Europe groups; (d) male SMRs were generally higher in the older age bands in Eastern Europe, Caribbean, Australasian and Western Europe groups and lower in all age bands in the Indian sub-continent group, and (e) female SMRs were generally higher in the older age bands in the China, Africa and Caribbean groups.

Conclusion

There is a need for epidemiological data on suicides in BME groups, including age-associated trends, trends over time, risk and protective factors and methods of suicide to inform suicide prevention strategies.

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References

  1. Shah AK, De T (1998) Suicide and the elderly. Int J Psychiatry Clin Practice 2:3–17

    Article  Google Scholar 

  2. Diekstra RFW (1989) Suicide and attempted suicide: an international perspective. Acta Psychiatr Scand 80(Suppl 354):1–24

    Article  Google Scholar 

  3. Kiemo K (2004) Towards a socio-economic and demographic theory of elderly suicides: a comparison of 49 countries at various stages of development. http://www.soc.ou.se/publications/fulltext/diss2003-3.pdf (Viewed 2 February 2007)

  4. Sartorius N (1995) Recent changes in suicide rates in selected eastern European and other European countries. Int Psychogeriatr 7:301–308

    Article  CAS  PubMed  Google Scholar 

  5. Shah AK, Bhat R, MacKenzie S, Koen C (2007) Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands. Med Sci Law 47:244–252

    Article  PubMed  Google Scholar 

  6. Shah AK (2007) The relationship between suicide rates and age: an analysis of multinational data from the World Health Organisation. Int Psychogeriatr 19(6):1141–1152

    PubMed  Google Scholar 

  7. Neeleman J, Mak V, Wessely S (1997) Suicide by age, ethnic group, coroner’s verdict and country of birth. A three-year survey in inner London. Brit J Psychiatry 181:463–467

    Article  Google Scholar 

  8. Raleigh VS (1996) Suicide patterns and trends in people of Indian sub-continent and Caribbean origin in England and Wales. Ethn Health 1:55–63

    Article  CAS  PubMed  Google Scholar 

  9. Raleigh VS, Balarajan R (1992) Suicide levels and trends among immigrants in England and Wales. Health Trends 24:91–94

    Google Scholar 

  10. Raleigh VS, Balarajan R (1992) Suicide and self burning among Indians and West Indians in England and Wales. Br J Psychiatry 161:365–368

    Article  Google Scholar 

  11. Raleigh VS, Bulusu L, Balarajan R (1990) Suicides among immigrants from the Indian subcontinent. Br J Psychiatry 156:46–50

    Article  Google Scholar 

  12. Office of Population Censuses and Surveys (1983) 1981 Census: country of birth. Great Britain, HMSO, London

    Google Scholar 

  13. Office of Population Censuses and Surveys (1993) 1991 census: ethnic group and country of birth Great Britain. Office of Population Censuses and Surveys, London

    Google Scholar 

  14. Shah AK, Lindesay J, Nnatu I (2005) Cross-cultural issues in the assessment of cognitive impairment. In: O’Brien J, Ames D, Burns A (eds) Dementia. Arnold Hodder, London, pp 147–164

    Google Scholar 

  15. Shah AK (2007) The influence of exclusion criteria on the relationship between suicide rates and age in cross-national studies. Int Psychogeriatr 19:989–992

    Article  PubMed  Google Scholar 

  16. Brock A, Griffiths C (2003) Trends in suicide by method in England and Wales, 1979 to 2001. Health Stat Q 20:7–18

    Google Scholar 

  17. Dennis M, Read S, Andrews H, Wakefield P, Zafar R, Kavi S (2001) Suicide in a single health district: epidemiology and audit of the involvement of psychiatric services. J Mental Health 6:673–682

    Google Scholar 

  18. Hoxey K, Shah AK (2000) Recent trends in elderly suicide rates and methods in England and Wales. Int J Gertiatr Psychiatry 15:274–279

    Article  CAS  Google Scholar 

  19. O’Donnell I, Farmer R (1995) The limitations of official suicide statistics. Br J Psychiatry 166:458–461

    Article  PubMed  Google Scholar 

  20. Shah AK, Elanchenny N, Collinge T (2001) Trends in age band-specific suicide rates in the elderly. Med Sci Law 41:102–106

    CAS  PubMed  Google Scholar 

  21. Gill PS, Bhopal R, Wild S, Kai J (2005) Limitations and potential of country of birth as proxy for ethnic group. Brit Med J 330:196

    Article  PubMed  Google Scholar 

  22. Office of Population Censuses and Surveys (1993) 1991 census: county reports. Office of Population Censuses and Surveys, London

    Google Scholar 

  23. Wild SH, Fischbacher CM, Brock A, Griffiths C, Bhopal R (2007) Mortality from all causes and circulatory diseases by country of birth in England and Wales, 2001–2003. J Public Health 29:191–198

    Article  CAS  Google Scholar 

  24. Wild SH, Fischbacher CM, Brock A, Griffiths C, Bhopal R (2006) Mortality from all cancers and lung, colorectal, breast and prostrate cancer by country of birth in England and Wales, 2001–2003. Br J Cancer 94:1079–1085

    Article  CAS  PubMed  Google Scholar 

  25. Shah AK (2007) Elderly suicide rates in the United Kingdom: trends from 1979 to 2002. Med Sci Law 47:56–60

    Article  PubMed  Google Scholar 

  26. Rehkopf DH, Buka SL (2006) The association between suicide and the socio-economic characteristics of geographical areas: a systematic review. Psychol Med 36:145–157

    Article  PubMed  Google Scholar 

  27. Pritchard C (1996) Suicide in the People’s Republic of China categorised by age and gender: evidence of the influence of culture on suicide. Acta Psychiatr Scand 93:362–367

    Article  CAS  PubMed  Google Scholar 

  28. Yip PSF (2001) An epidemiological profile of suicides in Beijing, China. Suicide Life Threat Behav 31:62–70

    Article  CAS  PubMed  Google Scholar 

  29. Yip PSF, Liu KY, Hu J, Song XM (2005) Suicide rates in China during a decade of rapid social change. Soc Psychiatry Psychiatr Epidemiol 40:792–798

    Article  PubMed  Google Scholar 

  30. Chiu HFK, Takahashi Y, Suh GH (2003) Elderly suicide prevention in East Asia. Int J Geriatr Psychiatry 18:973–976

    Article  CAS  PubMed  Google Scholar 

  31. Yip PSF, Chi I, Yu KK (1998) An epidemiological profile of elderly suicides in Hong Kong. Int J Geriatr Psychiatry 13:631–637

    Article  CAS  PubMed  Google Scholar 

  32. Yip PSF, Tan RCE (1998) Suicides in Hong Kong and Singapore: a tale of two cities. Int J Soc Psychiatry 44:267–279

    Article  CAS  PubMed  Google Scholar 

  33. Qin P, Mortensen PB (2001) Specific characteristics of suicide in China. Acta Psychiatr Scand 103:117–121

    Article  CAS  PubMed  Google Scholar 

  34. Yip PSF, Callanan C, Yuen HP (2000) Urban/rural and gender differentials in suicide rates: east & west. J Affect Disord 57:99–106

    Article  CAS  PubMed  Google Scholar 

  35. Dennis M, Baillon S, Brugha T, Lindesay J, Stewart R, Meltzer H (2007) The spectrum of suicidal ideation in Great Britain: comparisons across a 16–74 age range. Psychol Med 37:795–805

    Article  PubMed  Google Scholar 

  36. Lindesay J, Baillon S, Brugha T, Dennis M, Stewart R, Araya R, Meltzer H (2006) Worry content across the lifespan: an analysis of 16–74 year old participants in the British National Survey of Psychiatric Morbidity 2000. Psychol Med 36:1625–1634

    Article  PubMed  Google Scholar 

  37. Adityanjee DR (1986) Suicide attempts and suicide in India: cross-cultural aspects. Int J Soc Psychiatry 32:64–73

    Article  CAS  PubMed  Google Scholar 

  38. Bhatia SC, Kahn MH, Medirrata RP (1987) High risk suicide factors across cultures. Int J Soc Psychiatry 33:226–236

    Article  CAS  PubMed  Google Scholar 

  39. Handy S, Chithiramohan BallardCG, Silveira WR (1991) Ethnic differences in adolescent self-poisoning: a comparison of Asian and Caucasian groups. J Adolesc 14:157–162

    Article  CAS  PubMed  Google Scholar 

  40. Kingsbury S (1994) The psychological and social characteristics of adolescent overdose. J Adolesc 17:131–135

    Article  Google Scholar 

  41. Merrill J, Owen J, Wynne S, Whittington R (1990) Asian suicides. Br J Psychiatry 156:748–749

    Article  CAS  PubMed  Google Scholar 

  42. Biswas S (1990) Ethnic differences in self poisoning: a comparative study of an Asian and a white adolescent group. J Adolesc 13:189–193

    Google Scholar 

  43. Hicks MH, Bhugra D (2003) Percevied causes of suicide attempts by UK South Asian women. Am J Orthopsychiatry 73:455–462

    Google Scholar 

  44. Burke AW (1976) Socio-cultural determinants of attempted suicide among West Indians in Birmingham: ethnic origin and immigrant status. Br J Psychiatry 129:261–266

    Article  CAS  PubMed  Google Scholar 

  45. Merrill J, Owen J (1987) Ethnic differences in self-poisoning. A comparison of West Indian and white groups. Br J Psychiatry 150:765–768

    Article  CAS  PubMed  Google Scholar 

  46. Lockhart SP, Baron JH (1987) Changing ethnic and social characteristics of patients admitted for self-poisoning in west London during 1971/2 and 1983/4. J R Soc Med 80:145–148

    CAS  PubMed  Google Scholar 

  47. Blanchflower D, Saleheen J, Shadforth C (2007) The impact of the recent migration from Eastern Europe on the UK economy. http://www.bankofengland.co.uk/publications (Viewed 11/06/2008)

  48. Bhatnagar KS, Frank J (1997) Psychiatric disorders in elderly from the Indian subcontinent living in Bradford. Int J Geriatr Psychiatry 12:907–912

    Article  CAS  PubMed  Google Scholar 

  49. Livingston G, Leavey G, Kitchen G et al (2001) Mental health of migrant elders—the Islington study. Br J Psychiatry 179:361–366

    Article  CAS  PubMed  Google Scholar 

  50. McCracken CFM, Boneham MA, Copeland JRM et al (1997) Prevalence of dementia and depression among elderly people in black and ethnic groups. Br J Psychiatry 171:269–273

    Article  CAS  PubMed  Google Scholar 

  51. Jagger C (1998) Asian elders. An under studied and growing population. Old Age Psychiatr 10:8

    Google Scholar 

  52. Lindesay J, Jagger C, Hibbert MJ et al (1997) Knowledge, uptake and availability of health and social services among Asian Gujarati and white elders. Ethn Health 2:59–69

    Article  CAS  PubMed  Google Scholar 

  53. Rait G, Burns A (1997) Appreciating background and culture: the south Asian elderly and Mental Health. Int J Geriatr Psychiatry 12:973–977

    Article  CAS  PubMed  Google Scholar 

  54. Shah AK, Dighe-Deo D (1998) Elderly Gujaratis and psychogeriatrics in a London psychogeriatric service. Bull Int Psychogeriatr Assoc 14:12–13

    Google Scholar 

  55. Neeleman J, Wessely S (1999) Ethnic minority suicide: a small area geographical study in south London. Psychol Med 29:429–436

    Article  CAS  PubMed  Google Scholar 

  56. Neeleman J, Wilson-Jones C, Wesseley S (2001) Ethnic density and deliberate self-harm; a small area study in south east London. J Epidemiol Community Health 55:85–90

    Article  CAS  PubMed  Google Scholar 

  57. Shah AK, Bhat R, MacKenzie S, Koen C (2008) A cross-national study of the relationship between elderly suicide rates and life expectancy and markers of socio-economic status and healthcare status. Int Psychogeriatr 20:347–360

    PubMed  Google Scholar 

  58. Shah AK, Padayatchi M, Das K (2008) The relationship between elderly suicide rates and elderly dependency ratios: a cross-national study using data from the WHO data bank. Int Psychogeriatr 20:594–604

    Google Scholar 

  59. Fukuda Y, Nakamura K, Takano T (2005) Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973–1977 and 1993–1998: increased importance of injury and suicide in inequality for ages under 75. Int J Epidemiol 34:100–109

    Article  PubMed  Google Scholar 

  60. Kennedy HG, Iveson RC, Hill O (1999) Violence, homicide and suicide: strong correlation and wide variation across districts. Br J Psychiatry 175:462–466

    Article  CAS  PubMed  Google Scholar 

  61. Kowalski GS, Faupel CE, Starr PD (1987) Urbanisation and suicides: a study of American Counties. Social Forces 66:85–101

    Article  Google Scholar 

  62. Rezaeian M, Dunn G, St Leger S, Appleby L (2005) The ecological association between suicide rates and indices of deprivation in English local authorities. Soc Psychiatry Psychiatr Epidemiol 40:785–791

    Article  PubMed  Google Scholar 

  63. Shah R, Uren Z, Baker A, Majeed A (2002) Trends in suicide from drug overdose in the elderly in England and Wales, 1993–1999. Int J Geriatr Psychiatry 17:416–421

    Article  PubMed  Google Scholar 

  64. Whitley E, Gunnell D, Dorling D, Smith GD (1999) Ecological study of social fragmentation, poverty, and suicide. Brit Med J 319:1034–1037

    CAS  PubMed  Google Scholar 

  65. Berk M, Dodd S, Henry M (2006) The effect of macroeconomic variables on suicide. Psychol Med 36:181–189

    Article  PubMed  Google Scholar 

  66. Cutright P, Fernquist RM (2000) Effects of social integration, period, region, and culture of suicide on male age-specific suicide rates: 20 developed countries, 1955–1898. Soc Sci Res 29:148–172

    Article  CAS  PubMed  Google Scholar 

  67. Lorant V, Kunst AE, Huisman M, Costa G, Mackenbach J (2005) Socio-economic inequalities in suicide: a European comparative study. Br J Psychiatry 187:49–54

    Article  PubMed  Google Scholar 

  68. Zhang J (1998) Suicide in the world: toward a population increase theory of suicide. Death Stud 22:525–539

    Article  CAS  PubMed  Google Scholar 

  69. Barker J (1984) Research perspectives on ageing: Black and Asian old people in Britain, 1st edn. Age Concern Research Unit, London

    Google Scholar 

  70. Shah AK, Oommen G, Wuntakal B (2005) Cultural aspects of dementia. Psychiatry 4:103–106

    Article  CAS  Google Scholar 

  71. Silveira E, Ebrahim S (1995) Mental health and health status of elderly Bengalis and Somalis in London. Age Ageing 24:474–480

    Article  CAS  PubMed  Google Scholar 

  72. Boneham M (1989) Ageing and ethnicity in Britain: the case of elderly Sikh women in a midlands town. New Community 15:447–459

    Google Scholar 

  73. Kua EH, Ko SM, Ng TP (2003) Recent trends in elderly suicide rates in a multi-ethnic Asian city. Int J Geriatr Psychiatry 18:533–536

    Article  PubMed  Google Scholar 

  74. Burr J (2002) Cultural stereotypes of women from south Asian communities: mental healthcare professionals’ explanations for patterns of suicide and depression. Soc Sci Med 55:835–845

    Article  CAS  PubMed  Google Scholar 

  75. Department of Health (1999) Saving lives: our healthier nation (Cm 4386). Stationery Office, London

    Google Scholar 

  76. National Statistics Online (2008) Suicides. http://www.statistics.gov.uk (Viewed 02/06/2008)

  77. UK Immigration (2006) UK immigration statistics for the past two years. http://www.ukimmigration.com (Viewed 04/06/2008)

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Shah, A., Lindesay, J. & Dennis, M. Suicides by country of birth groupings in England and Wales: age-associated trends and standardised mortality ratios. Soc Psychiatry Psychiatr Epidemiol 46, 197–206 (2011). https://doi.org/10.1007/s00127-010-0188-0

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  • DOI: https://doi.org/10.1007/s00127-010-0188-0

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