Elsevier

Social Science & Medicine

Volume 49, Issue 10, November 1999, Pages 1419-1423
Social Science & Medicine

Short report
Increasing rates of suicide in young men in England during the 1980s: the importance of social context

https://doi.org/10.1016/S0277-9536(99)00213-0Get rights and content

Abstract

Attempts to explain rising rates of suicide among young men in Britain and elsewhere during the 1980's have identified the characteristics of those people who kill themselves. Little, however, is known about the impact that changes in social context may have had on changing rates of suicide during this time. Changes in aggregate levels of unemployment, poverty, marriage and the proportion of adults living alone during the 1980s were derived from data collected in the UK National Census of 1981 and 1991. In an ecological analysis these changes were compared with changes in age-adjusted rates of suicide in men aged 15 to 44, in 364 county districts of England between the beginning and end of the 1980s. Areas experiencing the lowest increase in rates of suicide were those that experienced the smallest rise in the proportion of people living alone, the greatest increase in unemployment and highest levels of social deprivation. In addition to investigating the effect that characteristics of people have in determining the risk of suicide in individuals who kill themselves, further attention needs to be paid to the impact that social context may have on mediating these risks.

Introduction

Concern has been expressed about the steady increase in the rate of suicide that took place among young men in Europe and North America during the course of the 1980s. In Britain during this period the national rate of suicide fell but the rate in young men (aged 15 to 45) rose by 30% (Charlton et al., 1992). Similar changes were observed in other countries (Barraclough, 1988), but reasons for these trends are unclear (Hawton, 1992). While the study of the characteristics of individuals who have killed themselves has contributed greatly to our knowledge of risk factors for suicide in young men (e.g. Lesage et al., 1994), there is an increasing awareness that a persons health is affected not only by individual risks but by exposure to factors in the environment that effect all those who share this environment (McIntyre et al., 1993). Assessing the impact that factors in shared environment have on health requires the use of aggregate data (Susser, 1994). Studies using aggregate data have demonstrated important ecological associations between unemployment (Pritchard, 1992), poverty (Gunnel et al., 1995), divorce (Stack, 1990) and household composition (Ashford and Lawrence, 1976) and rates of suicide. Additional valuable information has emerged from studying the relationship between changing rates of suicide and changes in social variables over time (Sainsbury et al., 1980). However, there has been little attempt to explore rising rates of suicide in young men using this method. McLoone demonstrated that areas of Scotland that experienced the greatest increases in the rate of suicide in young men in Scotland during the 1980s were those judged to be most deprived at the time of the 1981 Census (McLoone, 1996) The relationship between rates of suicide in young men and unemployment is less clear (Charlton et al., 1994).

This study set out to assess ecological associations between changes in social factors and changes in the rate of suicide in young men in England during the 1980s. Specifically longitudinal associations between the proportion of households occupied by only one adult, the proportion who were married, levels of access to a car and unemployment and change in the rates of suicide in men aged 15–44 in the 364 county districts of England were examined.

Section snippets

Method

We obtained socio-demographic data on the county districts and metropolitan boroughs from the National Censuses of 1981 and 1991. There are 366 county districts in England with a mean population of men aged 15–44 of 28,000. Two districts, the Isles of Scilly and the City of London are markedly dissimilar from the remaining 364 districts, the population of these two areas is almost eight times smaller than the next largest district. We therefore excluded them from further analysis. We then

Results

The distribution of the change in age standardised rate of suicide in county districts over this period was normally distributed (mean=19.5 per 100,000. Standard deviation (S.D.)=27). Changes in explanatory variables between 1991 and 1981 were also normally distributed. Over this ten year period the proportion of people who had no access to a car fell by 5.7% (inter-quartile range=−7.0 to −4.7). The proportion of economically active men who were unemployed rose by 0.9% (inter-quartile

Discussion

This study is the first to explore the role of changing social factors on the rate of suicide in young men in Britain, using an ecological design. County districts that experienced the greatest increase in the rate of suicide in young men during the 1980s were those which also experienced the largest fall in the rate of male unemployment and largest rise in car ownership and largest rise in the proportion of people living alone.

Acknowledgements

M.J.C. was funded by a Maudsley/Bethlem NHS Trust Training Fellowship.

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