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Socioeconomic inequalities in suicide mortality in Barcelona during the economic crisis (2006–2016): a time trend study
  1. Natalia López-Contreras1,2,
  2. Maica Rodríguez-Sanz1,3,4,5,
  3. Ana Novoa2,5,
  4. Carme Borrell1,3,5,6,
  5. Jordi Medallo Muñiz7,
  6. Mercè Gotsens2,3
  1. 1Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
  2. 2Servei de Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, Spain
  3. 3Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  4. 4Àrea de Recerca, Docència i Comunicació, Agència de Salut Pública de Barcelona, Barcelona, Spain
  5. 5Institut d’Investigació Biomèdica (IIB) de Sant Pau, Barcelona, Spain
  6. 6Gerència, Agència de Salut Pública de Barcelona, Barcelona, Spain
  7. 7Clinical Service, Catalonian Institute of Legal Medicine and Forensic Science, Barcelona, Spain
  1. Correspondence to Natalia López-Contreras; ext_nlopez{at}aspb.cat

Abstract

Objectives This study aimed to analyse trends in socioeconomic inequalities in suicide mortality in Barcelona before and after the start of the economic crisis that started at the end of 2008, including both individual factors and contextual factors of the deceased’s neighbourhood of residence.

Design This is a trend study of three time periods: pre-economic crisis (2006–2008), early crisis (2009–2012) and late crisis (2013–2016).

Setting Total Barcelona residents between 2006 and 2016 (≥25 years of age) and death data derived from the Judicial Mortality Registry of Barcelona.

Participants 996 deaths by suicide between 2006 and 2016 were analysed.

Primary and secondary outcome measures The outcomes were age-standardised suicide mortality rates and the associations (relative and absolute risk) between suicide mortality and individual and contextual characteristics for the three time periods.

Results From 2006 to 2008, men with a lower educational level were more likely to commit suicide than better educated men (relative risk (RR)=1.46; 95% CI 1.11 to 1.91). This difference disappeared after the onset of the crisis. We found no differences among women. From 2013 to 2016, suicide risk increased among men living in neighbourhoods with higher unemployment levels (RR=1.57; 95% CI 1.09 to 2.25) and among women living in neighbourhoods with a higher proportion of elderly people living alone (RR=2.13; 95% CI 1.15 to 3.93).

Conclusions We observed risks for suicide among men living in neighbourhoods of Barcelona with higher unemployment levels and among women living in neighbourhoods with a higher proportion of elderly people living alone. Inequalities in suicide mortality according to educational level tended to disappear during the crisis among men. Thus, it is important to continue to monitor suicide determinants especially in times of economic crisis.

  • suicide
  • health inequalities
  • socioeconomic
  • mortality

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors MRS and MG made substantial contributions to the conception and design of this study. NLC, MRS and MG performed data analysis. NLC, MRS, MG, CB and AN contributed to the interpretation of data. NLC was involved in drafting the manuscript, and MRS, MG, CB, AN and JM revised it critically for important intellectual content. All authors gave final approval of the version to be published.

  • Funding statement This research was partially supported by the CIBER Epidemiología y Salud Pública.

  • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.