title: Alcohol consumption, alcoholics anonymous membership, and suicide mortality rates, Ontario, 1968-1991.
abstract: OBJECTIVE
  The goal of this study is to identify alcohol-related factors that influence mortality rates from suicide. Specifically, we examine the impact of per capita consumption of total alcohol, distilled spirits, and beer and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total and male and female suicide mortality rates in Ontario between 1968 and 1991.
  
  
  METHODS
  We studied the impact of alcohol consumption levels, AA membership rates, and unemployment rates on suicide mortality rates in Ontario from 1968 to 1991. Time series analyses with Auto Regressive Integrated Moving Average (ARIMA) modeling were applied to total and male and female suicide rates. The analyses performed included total alcohol consumption, distilled spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines.
  
  
  RESULTS
  Total alcohol consumption and consumption of each of beer, distilled spirits, and wine were significantly and positively related to total and female suicide mortality rates. AA membership rates were negatively related to total and female suicide rates. Although data for males did not reach significance (except for the relationship between wine consumption and suicide rate), the direction of effects was consistent with that observed for female and total suicide rates. Unemployment rates were positively related to male and total suicide rates in some models.
  
  
  CONCLUSIONS
  These data confirm the important relationships between per capita consumption measures and suicide mortality rates seen by previous investigators. Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership and treatment for misuse of alcohol can exert beneficial effects observable at the population level.
authors.affiliation: Social, Prevention and Health Policy Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1, Canada. robert_mann@camh.net
authors.forename: Robert E
authors.initials: RE
authors.lastname: Mann
authors.forename: Rosely Flam
authors.initials: RF
authors.lastname: Zalcman
authors.forename: Reginald G
authors.initials: RG
authors.lastname: Smart
authors.forename: Brian R
authors.initials: BR
authors.lastname: Rush
authors.forename: Helen
authors.initials: H
authors.lastname: Suurvali
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000628:therapy*; D000436:Alcoholics Anonymous; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010358:Patient Participation / Q000706:statistics & numerical data*; D015995:Prevalence; D013405:Suicide / Q000706:statistics & numerical data*; D014478:Unemployment / Q000706:statistics & numerical data