title: Suicide mortality in South Africa: a city-level comparison across socio-demographic groups.
abstract: BACKGROUND
  South Africa offers a valuable study environment to assess the impact of political and social changes on health. Increasing urbanisation has led to a focus on city development and its effect on its residents. The study assesses whether sex- and race-specific suicide rates differ across six of South Africa's major cities. Regional differences may reflect varying contextual and individual underlying mechanisms. Those need to be understood for appropriately targeted prevention efforts.
  
  
  METHODS
  Suicide mortality data (n=4,946) for the six cities between 2001 and 2003 were used to assess whether there are differences in rates for age-standardised race and sex groups across cities and whether these differences are constant across cities. The overall age-standardised rates for the six cities was 25.3/100,000 for men and 5.6/100,000 for women.
  
  
  RESULTS
  Suicide rates are most often highest among whites and men, but both the magnitude and distribution of suicide vary considerably for different race and sex groups within and across cities. There is a strong association between the method of suicide used and the city.
  
  
  CONCLUSIONS
  Despite some common trends in the suicide profile across South African cities, city does matter for the magnitude and distribution of suicide mortality across race and sex groups and for the method of suicide used. The need for locally based suicide research investigating possible reasons for these differences is highlighted.
authors.affiliation: Karolinska Institutet, Dept. of Public Health Sciences, Division of Social Medicine, 171 76, Stockholm, Sweden. stephanie.burrows@phs.ki.se
authors.forename: Stephanie
authors.initials: S
authors.lastname: Burrows
authors.forename: Lucie
authors.initials: L
authors.lastname: Laflamme
mesh_terms: D000328:Adult; D003710:Demography; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012424:Rural Population / Q000706:statistics & numerical data*; D013019:South Africa / Q000453:epidemiology; D013405:Suicide / Q000208:ethnology / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*