Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T18:03:07.609Z Has data issue: false hasContentIssue false
  • English
  • Français

Suicide mortality trends in Galicia, Spain and their relationship with economic indicators

Published online by Cambridge University Press:  02 September 2015

P. Fernández-Navarro ,
M. L. Barrigón ,
J. Lopez-Castroman ,
M. Sanchez-Alonso ,
M. Páramo ,
M. Serrano ,
M. Arrojo  and
E. Baca-García
P. Fernández-Navarro
Affiliation:
Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública – CIBERESP), Spain
M. L. Barrigón
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain
J. Lopez-Castroman
Affiliation:
Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier and INSERM U1061, Montpellier, France
M. Sanchez-Alonso
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain
M. Páramo
Affiliation:
Servicio de Psiquiatría, EOXI de Santiago, Servicio Gallego de Salud, Spain
M. Serrano
Affiliation:
Servicio de Psiquiatría, EOXI de Coruña, Servicio Gallego de Salud, Spain
M. Arrojo
Affiliation:
Servicio de Salud Mental y Asistencia a Drogodependencias, Dirección General de Asistencia Sanitaria, Servicio Gallego de Salud, Spain
E. Baca-García*
Affiliation:
Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
*
*Address for correspondence: E. Baca-García, Department of Psychiatry, IIS-Jimenez Diaz Foundation, Autonoma University, CIBERSAM, Madrid, Spain. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Recent research has shown an association between unemployment and suicide, but the mediating factors in this relationship are still unknown. In this study, we investigated the effect of unemployment and economic recession on suicide rates in the Spanish region of Galicia between 1975 and 2012

Method.

We analysed age-standardised suicide rates in men and women and in four age groups: less than 25 years, 25–45 years, 45–65 years and more than 65 years and performed a joinpoint analysis to determine trend changes throughout 1975–2012 period. Also we analysed the association between suicide, recession and unemployment by means of a temporal trend model with a Generalised Additive Model.

Results.

Suicide rates increased from 145 suicides in 1975 to a high in 1993, with 377 deaths by suicide, representing 1.38% of all causes of death, and thereafter they tend to decrease to 335 suicides in 2012. Joinpoint analyses revealed that suicide rates changed differently across sex and age groups. For men, the annual percentage of change (APC) between 1975 and 1988 (CI 95% 1986–1994) was 5.45 (CI 95% = 3.5, −7.2) but from 1988 the APC became negative [−0.66 (CI 95% = −1.3, −0.1)]. For women, APC between 1974 and 1990 (CI 95% 1986–1992) was 4.86 (CI 95% = 3.2, −6.4) and −1.46 subsequently (CI 95% = −2.2, −0.5). Women aged 24 years or less showed stable suicide rates while men from 45–65 years showed two incidence peaks. When we studied the independent correlation between unemployment, recession and suicide, we found a significant association between unemployment and suicide, but not between recession and suicide for both sexes together and for men while for women there was no significant correlation between suicide and unemployment or recession. Finally, when we studied the effect of the interaction between unemployment and recession on suicide we found economic recession and unemployment interacted with regards to suicide rates (F = 5.902; df = 4.167; p = 0.00098) and after adjusting by sex, the effect was confirmed among men (F = 4.827; df = 2.823; p = 0.0087), but not among women (F = 0.001; df = 1.000; p = 0.979).

Conclusions.

Although suicide rates in Galicia are gradually decreasing in the last decades, there are important sex and age differences. Unemployment was related with suicide during economic recession periods according to our results.

Keywords

Economic recessionjoinpoint analysessuicideunemployment
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 5 , October 2016 , pp. 475 - 484
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

19 Age Groups – Standard Populations – SEER Datasets. Retrieved 8 July 2015 from http://seer.cancer.gov/stdpopulations/stdpop.19ages.html Google Scholar
Alameda-Palacios, J, Ruiz-Ramos, M, García-Robredo, B (2014). Suicidio, prescripción de antidepresivos y desempleo en Andalucía (Suicide, antidepressant prescription and unemployment in Andalusia (Spain)). Gaceta Sanitaria 28, 309–312.Google Scholar
Álvaro-Meca, A, Kneib, T, Gil-Prieto, R, Gil de Miguel, A (2013). Epidemiology of suicide in Spain, 1981–2008: a spatiotemporal analysis. Public Health 127, 380–385.CrossRefGoogle ScholarPubMed
Ayuso-Mateos, JL, Barros, PP, Gusmão, R (2013). Financial crisis, austerity, and health in Europe. The Lancet 382, 391–392.Google Scholar
Barr, B, Taylor-Robinson, D, Scott-Samuel, A, McKee, M, Stuckler, D (2012). Suicides associated with the 2008–10 economic recession in England: time trend analysis. BMJ 345, e5142–e5142.Google Scholar
Blasco-Fontecilla, H, Perez-Rodriguez, MM, Garcia-Nieto, R, Fernandez-Navarro, P, Galfalvy, H, de Leon, J, Baca-Garcia, E (2012). Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study. BMJ Open 2, e000785.Google Scholar
Chang, S-S, Gunnell, D, Sterne, JAC, Lu, T-H, Cheng, ATA (2009). Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time–trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Social Science & Medicine 68, 1322–1331.Google Scholar
Chang, S-S, Stuckler, D, Yip, P, Gunnell, D (2013). Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ 347, f5239–f5239.Google Scholar
Chishti, P, Stone, DH, Corcoran, P, Williamson, E, Petridou, E, EUROSAVE Working Group (2003). Suicide mortality in the European Union. European Journal of Public Health 13, 108–114.Google Scholar
Coope, C, Gunnell, D, Hollingworth, W, Hawton, K, Kapur, N, Fearn, V, Wells, C, Metcalfe, C (2014). Suicide and the 2008 economic recession: who is most at risk? Trends in suicide rates in England and Wales 2001–2011. Social Science & Medicine (1982) 117, 76–85.Google Scholar
Crespo, V (2009). Desarrollos recientes en salud mental comunitaria en Galicia. Revista do Serviço de Psiquiatria do Hospital Prof. Doutor Fernando Fonseca 6, 77–97.Google Scholar
Dominici, F, McDermott, A, Zeger, SL, Samet, JM (2002). On the use of generalized additive models in time-series studies of air pollution and health. American Journal of Epidemiology 156, 193–203.CrossRefGoogle ScholarPubMed
Gavrilova, NS, Semyonova, VG, Evdokushkina, GN, Gavrilov, LA (2000). The response of violent mortality to economic crisis in Russia. Population Research and Policy Review 19, 397–419.Google Scholar
Grupo de trabajo de la Guía de Práctica Clínica de Prevención y Tratamiento de la Conducta Suicida. I. Evaluación y Tratamiento (2012). Guía de Práctica Clínica de Prevención y Tratamiento de la Conducta Suicida. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad, Política Social e Igualdad. Axencia de Avaliación de Tecnoloxías Sanitarias de Galicia (avalia-t): Madrid, Spain.Google Scholar
Hajat, S, Kovats, R, Atkinson, R, Haines, A (2002). Impact of hot temperatures on death in London: a time series approach. Journal of Epidemiology and Community Health 56, 367–372.Google Scholar
Hastie, T, Tisbhirani, R (1990). Generalized Additive Models. Chapman and Hall: London.Google Scholar
Haw, C, Hawton, K, Gunnell, D, Platt, S (2014). Economic recession and suicidal behaviour: possible mechanisms and ameliorating factors. International Journal of Social Psychiatry, 0020764014536545.Google Scholar
Hintikka, J, Saarinen, PI, Viinamäki, H (1999). Suicide mortality in Finland during an economic cycle, 1985–1995. Scandinavian Journal of Public Health 27, 85–88.CrossRefGoogle ScholarPubMed
IGE – Instituto Galego de Estatística. Retrieved 8 July 2015 from http://www.ige.eu/web/index.jsp?idioma=es.Google Scholar
Iñíguez, C, Pérez-Hoyos, S, Ballester, F, Sáez, M (2003). Comparación de dos métodos en el análisis del efecto a corto plazo de la contaminación atmosférica en la salud (Comparison of two methods in the analysis of the short-term effect of air pollution on health). Gaceta Sanitaria 17, 283–288.Google Scholar
Instituto Nacional de Estadistica. Spanish Statistical Office. Retrieved 8 July 2015 from http://www.ine.es Google Scholar
Karanikolos, M, Mladovsky, P, Cylus, J, Thomson, S, Basu, S, Stuckler, D, Mackenbach, JP, McKee, M (2013). Financial crisis, austerity, and health in Europe. The Lancet 381, 1323–1331.Google Scholar
Kim, H-J, Fay, MP, Feuer, EJ, Midthune, DN (2000). Permutation tests for joinpoint regression with applications to cancer rates. Statistics in Medicine 19, 335–351.Google Scholar
Lester, BY (2001). Learnings from Durkheim and beyond: the economy and suicide. Suicide and Life-Threatening Behavior 31, 15–31.Google Scholar
Likhvar, V, Honda, Y, Ono, M (2011a). Relation between temperature and suicide mortality in Japan in the presence of other confounding factors using time-series analysis with a semiparametric approach. Environmental Health and Preventive Medicine 16, 36–43.Google Scholar
Likhvar, V, Honda, Y, Ono, M (2011b). Relation between temperature and suicide mortality in Japan in the presence of other confounding factors using time-series analysis with a semiparametric approach. Environmental Health and Preventive Medicine 16, 36–43.Google Scholar
Lopez Bernal, JAL, Gasparrini, A, Artundo, CM, McKee, M (2013). The effect of the late 2000s financial crisis on suicides in Spain: an interrupted time-series analysis. The European Journal of Public Health 23, 732–736.Google Scholar
Lundin, A, Hemmingsson, T (2009). Unemployment and suicide. The Lancet 374, 270–271.Google Scholar
Morrell, S, Page, AN, Taylor, RJ (2007). The decline in Australian young male suicide. Social Science & Medicine (1982) 64, 747–754.Google Scholar
OECD (2014). Gross domestic product (GDP). 25 June. OECD Publishing. Retrieved 31 July 2015 from https://data.oecd.org/gdp/gross-domestic-product-gdp.htm Google Scholar
Pridemore, WA, Chamlin, MB, Cochran, JK (2007). An interrupted time-series analysis of Durkheim's Social Deregulation thesis: the case of the Russian Federation. Justice Quarterly: JQ/Academy of Criminal Justice Sciences 24, 271.Google Scholar
Rancans, E, Salander Renberg, E, Jacobsson, L (2001). Major demographic, social and economic factors associated to suicide rates in Latvia 1980–98. Acta Psychiatrica Scandinavica 103, 275–281.Google Scholar
Reeves, A, Stuckler, D, McKee, M, Gunnell, D, Chang, S-S, Basu, S (2012). Increase in state suicide rates in the USA during economic recession. The Lancet 380, 1813–1814.Google Scholar
Reeves, A, Stuckler, D, McKee, M, Gunnell, D, Chang, S-S, Basu, S (2013). Suicide, recession, and unemployment – authors’ reply. The Lancet 381, 722.Google Scholar
Reeves, A, McKee, M, Stuckler, D (2014). Economic suicides in the Great Recession in Europe and North America. The British Journal of Psychiatry 205, 246–247.Google Scholar
Rihmer, Z, Kapitany, B, Gonda, X, Dome, P (2013). Suicide, recession, and unemployment. The Lancet 381, 722–723.Google Scholar
Rodríguez-Rieiro, C, Aragonés, N, Pollan, M, López-Abente, G, Pérez-Gómez, B (2009). Evolución de la mortalidad por cáncer de cérvix por regiones en España entre 1975 y 2004 (Temporal trends of cervical cancer mortality rates among regions in Spain: 1975–2004). Medicina Clínica 133, 41–46.Google Scholar
Ruiz-Pérez, I, Olry de Labry-Lima, A (2006). Suicide in Spain today. Gaceta Sanitaria/S.E.S.P.A.S 20(Suppl. 1), 25–31.Google Scholar
Sánchez-Cantalejo Ramírez, E, Ocaña-Riola, R (1997). Actualizaciones en regresión: suavizando las relaciones (An update in regression: smoothing relationships). Gaceta Sanitaria 11, 24–32.Google Scholar
SEER*Stat Software. Retrieved 8 July 2015 from http://www.seer.cancer.gov/seerstat Google Scholar
Stuckler, D, Basu, S, Suhrcke, M, Coutts, A, McKee, M (2009). The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. The Lancet 374, 315–323.CrossRefGoogle ScholarPubMed
Stuckler, D, Basu, S, Suhrcke, M, Coutts, A, McKee, M (2011). Effects of the 2008 recession on health: a first look at European data. The Lancet 378, 124–125.Google Scholar
Suhrcke, M, Stuckler, D (2012). Will the recession be bad for our health? It depends. Social Science & Medicine 74, 647–653.Google Scholar
The R Project for Statistical Computing. Retrieved 8 July 2015 from http://www.r-project.org/ Google Scholar
Värnik, P, Sisask, M, Värnik, A, Arensman, E, Van Audenhove, C, van der Feltz-Cornelis, CM, Hegerl, U (2012). Validity of suicide statistics in Europe in relation to undetermined deaths: developing the 2–20 benchmark. Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention 18, 321–325.Google Scholar
Vidal Lancis, C, Martínez-Sánchez, JM, Mateos Mazón, M, Peris Tuser, M (2010). Breast cancer mortality trend in Spain and its autonomous communities during the period 1980–2005. Revista Española de Salud Pública 84, 53–59.Google Scholar
Wood, SN (2003). Thin plate regression splines. Journal of the Royal Statistical Society: Series B (Statistical Methodology) 65, 95–114.Google Scholar
Supplementary material: File

Fernández-Navarro supplementary material

Tables S1-S3

Download Fernández-Navarro supplementary material(File)
File 29.7 KB