An analysis of suicide trends in Scotland 1950-2014: comparison with England & Wales

Citation

Dougall N, Stark C, Agnew T, Henderson R, Maxwell M & Lambert P (2017) An analysis of suicide trends in Scotland 1950-2014: comparison with England & Wales. BMC Public Health, 17 (1), Art. No.: 970. https://doi.org/10.1186/s12889-017-4956-6

Abstract
Background Scotland has disproportionately high rates of suicide compared with England. An analysis of trends may help reveal whether rates appear driven more by birth cohort, period or age. A ‘birth cohort effect’ for England & Wales has been previously reported by Gunnell et al. (B J Psych 182:164-70, 2003). This study replicates this analysis for Scotland, makes comparisons between the countries, and provides information on ‘vulnerable’ cohorts. Methods Suicide and corresponding general population data were obtained from the National Records of Scotland, 1950 to 2014. Age and gender specific mortality rates were estimated. Age, period and cohort patterns were explored graphically by trend analysis. Results A pattern was found whereby successive male birth cohorts born after 1940 experienced higher suicide rates, in increasingly younger age groups, echoing findings reported for England & Wales. Young men (aged 20-39) were found to have a marked and statistically significant increase in suicide between those in the 1960 and 1965 birth cohorts. The 1965 cohort peaked in suicide rate aged 35-39, and the subsequent 1970 cohort peaked even younger, aged 25-29; it is possible that these 1965 and 1970 cohorts are at greater mass vulnerability to suicide than earlier cohorts. This was reflected in data for England & Wales, but to a lesser extent. Suicide rates associated with male birth cohorts subsequent to 1975 were less severe, and not statistically significantly different from earlier cohorts, suggestive of an amelioration of any possible influential ‘cohort’ effect. Scottish female suicide rates for all age groups converged and stabilised over time. Women have not been as affected as men, with less variation in patterns by different birth cohorts and with a much less convincing corresponding pattern suggestive of a ‘cohort’ effect. Conclusions Trend analysis is useful in identifying ‘vulnerable’ cohorts, providing opportunities to develop suicide prevention strategies addressing these cohorts as they age.

Keywords
Scotland; England; Wales; UK; Suicide; Age period cohort analysis; Epidemiology; Deaths of undetermined intent; Deaths of intentional self-harm

Journal
BMC Public Health: Volume 17, Issue 1