SOCIOECONOMIC-FACTORS ASSOCIATED WITH SUICIDE IN ELDERLY POPULATIONS IN BRITISH-COLUMBIA - AN 11-YEAR REVIEW

Objective: The effects of socioeconomic factors on suicide rates in th e general population are widely documented. Few of these reports have specifically studied the effects of socioeconomic variables on suicide rates in the elderly population. Elderly persons have the highest sui cide rates of any age-group. This group is different from the rest of the population insofar as suicide is concerned. For example, since mos t elderly persons are no longer in the labour force, it would be expec ted that they would be affected differently by economic factors such a s unemployment. We report the findings of an ecological study of old-a ge suicide in British Columbia over an 11-year period. Methods: We obt ained information on all suicide counts (International Classification of Diseases [ICD-9] codes E590-959) recorded in the 21 health units of British Columbia over the 11-year period from October 1, 1981, to Sep tember 30 1991, from the Division of Vital Statistics of the Province of British Columbia and Statistics Canada. Social, economic, and demog raphic information for the health units was obtained from census data and included the number of persons per household, proportion of the po pulation that lived in I-person households, immigration and migration rates for each region, proportion ion of the population with less than grade 9 education, proportion with less than grade 12 certification, marital status rates, unemployment rates by gender, average household income, average census family inco,ne, and labour-force participation rate by gender. We calculated overall and gender-specific suicide rate s for elderly persons (65 years and older) and younger populations. Us ing Poisson regression analyses, we determined the cross-sectional and longitudinal relative risks associated with the socioeconomic variabl es for the units. and we also examined trends in suicide rates. Result s: There were 4630 suicides in the 11-year period. The mean suicide ra te (per 100 000 population) for those over age 9 years was 18.6 (betwe en health unit SD 5.2, 95% confidence interval [CI] = 17.0-20.2). The elderly have a higher suicide rate in every region. The male suicide r ates (mean = 26.9, SD 6.4, 95% CI = 24.0-30.0) are higher than female rates (mean = 7.5, SD 1.7, 95% CI = 6.8-8.3) in every, region. The fac tors influencing suicides were different for elderly males and elderly females. In all analyses, suicide rates in elderly females remained e ssentially stable across age-groups and units and over the years. Elde rly male suicide rates varied across units and age-groups and over the years. Conclusions: Suicide rates are highest in males over age 74 ye ars. There are regional differences in elderly suicide rates and the f actors that influence them. Longitudinal and cross-sectional risk fact ors differ and there are gender differences in the risk factors. For b oth elderly males and females, suicide rates appear to be influenced b y social factors in the population as a whole, not just in the elderly population. Male and female employment patterns are associated with e lderly male suicide rates, el en though the latter are nor in the labo ur force. For suicide in elderly women the important factors are popul ation education, income, and migration levels.