title: Geography of suicide in Taiwan: spatial patterning and socioeconomic correlates.
abstract: In industrialised Western nations suicide rates tend to be high in inner city areas and socially fragmented neighbourhoods. Few studies have investigated spatial variations in suicide in non-Western settings. We estimated smoothed standardised mortality ratios (1999-2007) for suicide for each of the 358 Taiwanese districts (median population aged 15+: 27,000) and investigated their associations with area characteristics using Bayesian hierarchical models. The geographic distribution of suicide was similar in men and women; young people showed the greatest spatial variation in rates. Rates were highest in East Taiwan, a mostly mountainous rural area. There was no evidence of above average rates in large cities. Spatial patterns of method-specific suicide rates varied markedly, with solids/liquids poisonings showing the greatest geographic variation and hangings the least. Factors most strongly associated with area suicide rates were median household income, population density and lone-parent households. Spatial patterning of suicide in Taiwan differed from that observed in Western nations. Suicide prevention strategies should take into account unique local patterns.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK. shusen@ms25.hinet.net
authors.forename: Shu-Sen
authors.initials: SS
authors.lastname: Chang
authors.forename: Jonathan A C
authors.initials: JA
authors.lastname: Sterne
authors.forename: Benedict W
authors.initials: BW
authors.lastname: Wheeler
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Lu
authors.forename: Jin-Jia
authors.initials: JJ
authors.lastname: Lin
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001499:Bayes Theorem; D002423:Cause of Death; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology