Suicide in urban and rural regions of Belarus, 1990-2005.
OBJECTIVE
To examine the occurrence of suicide in urban and rural regions of Belarus in the post-Soviet period.


METHODS
Unlinked cross-sectional study using data drawn from four time points.


METHODS
Age- and gender-specific suicide data for urban and rural regions of Belarus were obtained from the Belarus Ministry of Statistics for the years 1990, 1995, 2000 and 2005. The data were recalculated into seven age categories and then directly standardized. Poisson regression models were used to assess changes in urban-rural suicide rate ratios across the four time points.


RESULTS
Between 1990 and 2000, the suicide rate rose sharply in Belarus. It started to reduce after 2000, but in 2005 it was still much higher than its initial level. The same was true for urban and rural suicide rates and for male suicide rates in all regions combined. However, after 1995, there was a divergence between gender-specific rates in urban and rural areas. A small reduction in urban suicide rates for both genders contrasted with a sharp increase in suicide rates among men and women in rural areas. By 2005, although suicide rates had fallen from their 2000 level for both genders in urban and rural locations, the decrease was much smaller in rural areas. These changes resulted in a deteriorating rural-urban suicide ratio across the period 1990-2005, with suicide rates among nearly every rural male age group remaining extreme after 1995. Although it is probable that a deteriorating social and economic situation has underpinned increasing suicide rates in all regions, there may be factors that are specific to rural locations, such as increasing social isolation and poor provision of medical services, that account for the extreme suicide rates now being recorded there.


CONCLUSIONS
By 2005, Belarus had one of the highest suicide rates in the world. This now requires urgent intervention by the necessary authorities to ameliorate this situation in urban and, especially, rural locations.
Razvodovsky
Y
Y
Grodno State Medical University, Grodno 230015, Belarus.
Stickley
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D002094:Republic of Belarus / Q000453:epidemiology; D012424:Rural Population; D013405:Suicide / Q000639:trends*; D014505:Urban Population; D055815:Young Adult