Suicide rates in Shandong, China, 1991-2010: rapid decrease in rural rates and steady increase in male-female ratio.
BACKGROUND
China has one of the highest suicide rates in the world; however, the recent trends in suicide have not been adequately studied. This study aimed to examine the potential changes in the rates and characteristics in a Chinese population.


METHODS
Data on suicide deaths in 1991-2010 were extracted from the Shandong Disease Surveillance Point (DSP) mortality dataset based on ICD-10 codes. The temporal trend in age-adjusted suicide rates for each subpopulation was tested using log-linear Poisson regression analysis.


RESULTS
From 1991 to 2010, there was a marked decrease in the overall suicide rate in Shandong, with an average reduction of 8% per year. The decrease trend was stronger in rural than in urban areas and more evident in females than in males. Similar decreases were observed for all age groups. Pesticide ingestion and hanging remained the top two methods for suicide.


CONCLUSIONS
There are likely quality concerns in the morality data, such as underreporting and misclassification, as well as low accuracy in determining the underlying causes of deaths. The representativeness of the DSP system may also be problematic due to the rapid changes in economy and demography.


CONCLUSIONS
Completed suicides in Shandong have sharply declined over the past 20 years. Higher rates in females versus males and in rural versus urban areas, which were previously considered to be distinguishing features of suicide in China, are becoming less pronounced.
School of Public Health, Queensland University of Technology, QLD, Australia.
Jiandong
J
Sun
Xiaolei
X
Guo
Jiyu
J
Zhang
Cunxian
C
Jia
Aiqiang
A
Xu
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult