NEEDS: Dynamic Urban Environmental Exposures on Depression and Suicide

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Is suicide mortality associated with neighbourhood social fragmentation and deprivation? A Dutch register-based case-control study using individualized neighbourhoods.

In a study forthcoming in Journal of Epidemiology and Community Health we examined whether suicide mortality is associated with neighbourhood social fragmentation and socioeconomic deprivation using individualized neighbourhoods.

Using longitudinal Dutch register data, we applied a nested case-control design matching all suicides among persons aged 18-64 years between 2007 and 2016 to 10 random controls in the Dutch population. We measured neighbourhood social fragmentation and deprivation using annually calculated indices for 300, 600 and 1,000 metre circular buffers around each subject’s residential address.

We observed higher suicide mortality in neighbourhoods with high deprivation and social fragmentation. After accounting for individual (socioeconomic) characteristics these associations were largely attenuated. However, suicide mortality among women remained significantly higher in highly fragmented neighbourhoods, especially for women in the older age group (40-64 years). Among men, on the other hand, suicide mortality was lower in highly fragmented neighbourhoods for 18-39-year-olds, as well as in deprived neighbourhoods for 40-64-year-olds. Associations between neighbourhood characteristics and suicide mortality were comparable across buffer sizes.

Overall, these findings suggest that next to individual characteristics, the social and economic context within which people live may both enhance and buffer the risk of suicide.