Abstract
PURPOSE: There are notable geographic variations in incidence rates of suicide both in Japan and globally. Previous studies have found that rurality/urbanity shapes intra-regional differences in suicide mortality, and suicide risk associated with rurality can vary significantly by gender and age. This study aimed to examine spatial patterning of and rural-urban differences in suicide mortality by gender and age group across 1887 municipalities in Japan between 2009 and 2017. METHODS: Suicide data were obtained from suicide statistics of the Ministry of Health, Labour and Welfare in Japan. We estimated smoothed standardized mortality ratios for suicide for each of the municipalities and investigated associations with level of rurality/urbanity using Bayesian hierarchical models before and after adjusting for socioeconomic characteristics. RESULTS: The results of the multivariate analyses showed that, for males aged 0-39 and 40-59 years, rural residents tended to have a higher suicide risk compared to urban ones. For males aged 60+ years, a distinct rural-urban gradient in suicide risk was not observed. For females aged 0-39 years, a significant association between suicide risk and rurality was not observed, while for females aged 40-59 years and females aged 60 years or above, the association was a U-shaped curve. CONCLUSION: Our results showed that geographical distribution of and rural-urban differences in suicide mortality in Japan differed substantially by gender and age. These findings suggest that it is important to take demographic factors into consideration when municipalities allocate resources for suicide prevention.
Original language | English |
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Pages (from-to) | 731-746 |
Number of pages | 16 |
Journal | Social Psychiatry and Psychiatric Epidemiology |
Volume | 56 |
Issue number | 5 |
Early online date | 7 Nov 2020 |
DOIs | |
Publication status | Published - 1 May 2021 |
Bibliographical note
AcknowledgementsThis work was supported by a Grant-in-Aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Award Number 18K10080).
Funding
This work was supported by a Grant-in-Aid for scientific research from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Award Number 18K10080).
Keywords
- Suicide
- Geographical variation
- Level of rurality/urbanity
- Spatial analysis
- Bayesian hierarchical model