Suicide mortality in Spain and its relationship with economic indicators in a region with high suicide rates.

Introduction Spatial patterns of mortality could help us to focus research to achieve prevention. On the other hand, recent research has shown an association between unemployment and suicide, but the mediating factors in this relationship are still unknown. Objectives We investigated the provincial spatial patterns of suicide mortality in Spain, and the effect of unemployment and economic recession on suicide mortality rates in the Spanish region of Galicia that has high suicide rates. Method To describe regional suicide mortality in Spain and to assess its association with recession and unemployment in Galicia, we calculated age-standardized suicide rates in men and women throughout 1975–2012 by region and performed a time-trend Generalized Additive Model using mortality data provided by National Statistics Institute and employment data collected from Statistics Institute of Galicia. Results In Spain, during the study period, there were 105,134 suicides with an age-adjusted rate of 10.2 and 3.02 per 100,000 population in men and women, respectively. There is a high variability in mortality rates across Spanish provinces. Madrid had the lower rates and Asturias and Galicia the higher ones. In Galicia, suicide rates were 13.7 in men and 4.3 in women per 100,000 and we found that economic recession and unemployment interacted with regards to suicide rates ( P = 9.80E-4) and after stratifying by sex, the effect was confirmed only among men ( P = 8.70E-3). Conclusions In Spain, suicide mortality varies greatly by region and in Galicia that is one of Spanish regions with higher suicide rates, unemployment was related with suicide during economic recession periods. [ABSTRACT FROM AUTHOR]