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Urban/rural inequalities in suicide in Scotland, 1981-1999

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  • Levin, Kate A.
  • Leyland, Alastair H.

Abstract

Although suicide accounts for a small percentage of deaths in Scotland (1.4% in 1999), it has been steadily increasing over the last two decades. In the US, Australia, England and Wales the greatest rises in suicide for this time period, occurred in rural areas. This study describes the pattern and magnitude of urban/rural variation in suicide in Scotland, examines methods of suicide within differing geographies and looks at trends in suicides over time. Scotland is split into four rurality types. Suicide data for all areas of Scotland (apart from Grampian which underwent changes in postcode sector boundaries in 1996) are investigated using Standardised Mortality Ratios (SMRs) and multilevel Poisson modelling, adjusting for age, sex and deprivation. SMRs for 1981-85, 1989-93 and 1995-99 are created across the four geographies, using the populations of Scotland in 1983, 1991 and 1997 as the standard populations (SMR=100). The highest rates in 1995-99 are seen in "remote rural" areas, SMR=125 (95% confidence interval 107-146). Models adjusted for age and deprivation show significantly greater risk of male suicide in remote rural areas relative to urban areas and significantly lower risk of female suicide in accessible rural areas. The method of suicide varies across ruralities for both males and females. The study considers how the relationship between suicides and rurality varies over time and how methods of suicide vary across different ruralities. The steepest rises in suicide amongst men, adjusting for age and deprivation, were seen to occur in accessible rural areas, however highest rates remain in remote rural areas.

Suggested Citation

  • Levin, Kate A. & Leyland, Alastair H., 2005. "Urban/rural inequalities in suicide in Scotland, 1981-1999," Social Science & Medicine, Elsevier, vol. 60(12), pages 2877-2890, June.
    • Handle: RePEc:eee:socmed:v:60:y:2005:i:12:p:2877-2890
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    Cited by:

    1. Page, Andrew & Morrell, Stephen & Taylor, Richard & Dudley, Michael & Carter, Greg, 2007. "Further increases in rural suicide in young Australian adults: Secular trends, 1979-2003," Social Science & Medicine, Elsevier, vol. 65(3), pages 442-453, August.
    2. Boyle, Paul J. & Norman, Paul & Popham, Frank, 2009. "Social mobility: Evidence that it can widen health inequalities," Social Science & Medicine, Elsevier, vol. 68(10), pages 1835-1842, May.
    3. Hempstead, Katherine, 2006. "The geography of self-injury: Spatial patterns in attempted and completed suicide," Social Science & Medicine, Elsevier, vol. 62(12), pages 3186-3196, June.
    4. Harriss, Louise & Hawton, Keith, 2011. "Deliberate self-harm in rural and urban regions: A comparative study of prevalence and patient characteristics," Social Science & Medicine, Elsevier, vol. 73(2), pages 274-281, July.
    5. Riva, Mylene & Curtis, Sarah & Gauvin, Lise & Fagg, James, 2009. "Unravelling the extent of inequalities in health across urban and rural areas: Evidence from a national sample in England," Social Science & Medicine, Elsevier, vol. 68(4), pages 654-663, February.
    6. Levin, K.A. & Dundas, R. & Miller, M. & McCartney, G., 2014. "Socioeconomic and geographic inequalities in adolescent smoking: A multilevel cross-sectional study of 15 year olds in Scotland," Social Science & Medicine, Elsevier, vol. 107(C), pages 162-170.
    7. Curtis, Sarah & Cunningham, Niall & Pearce, Jamie & Congdon, Peter & Cherrie, Mark & Atkinson, Sarah, 2021. "Trajectories in mental health and socio-spatial conditions in a time of economic recovery and austerity: A longitudinal study in England 2011–17," Social Science & Medicine, Elsevier, vol. 270(C).
    8. Pearce, Jamie & Barnett, Ross & Jones, Irfon, 2007. "Have urban/rural inequalities in suicide in New Zealand grown during the period 1980-2001?," Social Science & Medicine, Elsevier, vol. 65(8), pages 1807-1819, October.
    9. Levin, Kate A. & Davies, Carolyn A. & Douglas, Gail V.A. & Pitts, Nigel B., 2010. "Urban-rural differences in dental caries of 5-year old children in Scotland," Social Science & Medicine, Elsevier, vol. 71(11), pages 2020-2027, December.
    10. Gartner, Andrea & Farewell, Daniel & Roach, Paul & Dunstan, Frank, 2011. "Rural/urban mortality differences in England and Wales and the effect of deprivation adjustment," Social Science & Medicine, Elsevier, vol. 72(10), pages 1685-1694, May.
    11. Kim, Myoung-Hee & Jung-Choi, Kyunghee & Jun, Hee-Jin & Kawachi, Ichiro, 2010. "Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea," Social Science & Medicine, Elsevier, vol. 70(8), pages 1254-1261, April.
    12. Levin, Kate A. & Leyland, Alastair H., 2006. "A comparison of health inequalities in urban and rural Scotland," Social Science & Medicine, Elsevier, vol. 62(6), pages 1457-1464, March.
    13. Cheung, Yee Tak Derek & Spittal, Matthew J. & Pirkis, Jane & Yip, Paul Siu Fai, 2012. "Spatial analysis of suicide mortality in Australia: Investigation of metropolitan-rural-remote differentials of suicide risk across states/territories," Social Science & Medicine, Elsevier, vol. 75(8), pages 1460-1468.
    14. Matteo Migheli, 2017. "Size of Town, Level of Education and Life Satisfaction in Western Europe," Tijdschrift voor Economische en Sociale Geografie, Royal Dutch Geographical Society KNAG, vol. 108(2), pages 190-204, April.
    15. Riva, Mylène & Curtis, Sarah & Norman, Paul, 2011. "Residential mobility within England and urban–rural inequalities in mortality," Social Science & Medicine, Elsevier, vol. 73(12), pages 1698-1706.

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