Area-level socioeconomic deprivation and suicide by restrictable method of death: Trends in Japan, 1995-2022.

BACKGROUND

To establish an effective and equitable suicide prevention strategy, it is critical that we understand the distribution, according to area-level socioeconomic deprivation, of deaths by methods of suicide that are restrictable. We aimed to reveal this distribution and associated trends in Japan.

METHODS

This serial cross-sectional study used vital statistics in Japan from 1995 to 2022. Area-level socioeconomic deprivation at municipality level was estimated by the Area Deprivation Index in Japan. Suicide by four restrictable methods-pesticide ingestion, jumping from a high place, intentional collision, and medication overdose-were identified based on vital statistics according to area-level socioeconomic deprivation.

RESULTS

From 1995 to 2022, 738,810 suicides were observed, with 108,628 suicides by the four restrictable methods. Suicide rates by pesticide ingestion, jumping from a height, and medication overdose were higher in deprived areas than in non-deprived areas, while the suicide rate by intentional collision was higher in non-deprived areas than in deprived areas. Both suicide by pesticide ingestion and its inequality between deprived and non-deprived areas have continuously decreased since 2000. Suicide by jumping from a height and medication overdose have decreased since 2010, with widened inequality observed between deprived and non-deprived areas.

CONCLUSION

Area-level socioeconomic deprivation was associated with a higher suicide rate by pesticide ingestion, jumping from a height, and medication overdose while suicide rate by intentional collision was higher in non-deprived areas than in deprived areas. Integrating method restrictions tailored to residential characteristics into suicide prevention strategies may help promote health equity across areas.