Have Urban/Rural Suicide Inequalities Grown in New Zealand from 1980-2001?
Previous studies have noted that rates of suicide have increased in a number of OECD countries over the last 20 years. In many of these countries there has been a disproportionate increase in rural suicide, contributing to greater urban/rural health inequalities. This research evaluates whether urban/rural inequalities in suicide have grown for males and females during the 1980s and 1990s, a period of rapid social and economic change to New Zealand society. Using consistent geographical areas, we calculate age standardised suicide rates for urban and rural areas. To assess whether socioeconomic factors underlie any urban/rural inequality in suicide, we investigate whether urban/rural status had an effect upon rates of suicide independently of socioeconomic deprivation for the time periods 1990-92 and 1999-2001.
We find that overall suicide rates have increased among those aged under 45 but decreased for those aged over 45. Female suicide rates are consistently higher in urban than in rural areas. Male urban suicide rates are higher than their rural counterparts for all time periods other than the late 1990s. While female rates of suicide remained consistent in urban and rural areas, there were fluctuations in male urban/rural suicide inequalities. Initially, male suicide rates increased steadily until 1984-88 when there was a sharp rise in urban suicide. Male suicide in rural areas displayed sharp rises in 1989-91 and 1995-98. Increases were most marked among young males. By the end of the 1990s, rates of male suicide in urban and rural areas were very similar. These results are supported by Poisson regression analyses which demonstrate significant urban/rural differences in the early 1990s which had disappeared by the late 1990s. These effects are independent of the possible confounding effect of deprivation. Potential explanations are offered for fluctuating urban/rural inequalities including major economic structural changes from 1984 onwards, changing levels of social integration and selective migration.
Figure 1 . Three-year averaged age-standardised rates of suicide for males and females by binary urban/rural location.
Staff Involved
Dr Jamie Pearce
Irfon Jones
Assoc Prof Ross Barnett
Dr Paul White
Peter Day
Publications
- Pearce J, Barnett R, Jones I, 2007, Have urban/rural inequalities in suicide in New Zealand grown during the period 1980-2001? Social Science and Medicine, In Press.
- Pearce J, Barnett J R , Collings S and Jones I . 2007, Did geographical inequalities in suicide among males aged 15-44 in New Zealand increase during the period 1981-2001? Australian and New Zealand Journal of Psychiatry, Vol 41, pp 359-365.