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Rurality as a Risk Factor for Attempted Suicide and Death by Suicide in Ontario, Canada

Authors :
Claire de Oliveira
Peter Gozdyra
Paul Kurdyak
Simon Chen
Jürgen Rehm
Rebecca Barry
Source :
The Canadian Journal of Psychiatry. 67:679-689
Publication Year :
2021
Publisher :
SAGE Publications, 2021.

Abstract

Objective This study aims to examine rural and urban differences in attempted suicide and death by suicide in Ontario, Canada. Method This is a population-based nested case-control study. Data were obtained from administrative databases held at ICES, which capture all hospital and emergency department visits across Ontario between 2007 and 2017. All adults living in Ontario who attempted suicide or died by suicide are included in the study, and controls were matched by sex and age. Suicides were captured using vital statistics. Suicide attempts were determined using emergency department service codes. Results Rurality is a risk factor for attempted suicide and death by suicide. Rural males are more likely to die by suicide compared with urban males (adjusted odds ratio(AOR) = 1.70, 95% confidence interval (CI), 1.49 to 1.95), and the odds of death by suicide increase with increasing levels of rurality. Rural males and females have an increased risk of attempted suicide compared with their urban counterparts (males: AOR = 1.37, 95% CI, 1.24 to 1.50) (females: AOR = 1.26, 95% CI, 1.14 to 1.39), with a pattern of increasing risk of suicide attempts with increasing rurality. Rural females are not at increased risk of suicide compared with urban females (AOR = 1.08, 95% CI, 0.80 to 1.45). Sensitivity analyses corroborated the results. Conclusions Rural males are almost two times more likely to die by suicide compared with urban males, and both rural males and females have an elevated risk of suicide attempts compared with urban residents. Future research should examine potential mediators of the relationship between rurality and suicide.

Details

ISSN :
14970015 and 07067437
Volume :
67
Database :
OpenAIRE
Journal :
The Canadian Journal of Psychiatry
Accession number :
edsair.doi.dedup.....4b2027443ad2061946d68831540dfda8