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Ethnicity and suicide in England and Wales: a national linked cohort study

Duleeka Knipe, Paul Moran, Laura D Howe, Saffron Karlsen, Nav Kapur, Lauren Revie, Ann John Orcid Logo

The Lancet Psychiatry, Volume: 11, Issue: 8, Pages: 611 - 619

Swansea University Author: Ann John Orcid Logo

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DOI (Published version): 10.1016/s2215-0366(24)00184-6

Abstract

Background Our understanding of ethnic disparities in suicide in England and Wales is limited as ethnicity is not recorded on death certificates. Using linked data, we examined variations, by sex, in suicide rates in England and Wales by ethnicity and migrant/descendant status.Methods Using the Offi...

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Published in: The Lancet Psychiatry
ISSN: 2215-0366
Published: Elsevier BV 2024
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>66712</id><entry>2024-06-12</entry><title>Ethnicity and suicide in England and Wales: a national linked cohort study</title><swanseaauthors><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-06-12</date><deptcode>MEDS</deptcode><abstract>Background Our understanding of ethnic disparities in suicide in England and Wales is limited as ethnicity is not recorded on death certificates. Using linked data, we examined variations, by sex, in suicide rates in England and Wales by ethnicity and migrant/descendant status.Methods Using the Office for National Statistics mortality (2012-2019) linked 2011 census data from the Public Health Research Database (PHRD), we calculated the age-standardised suicide rates by sex for each of the 18 self-identified ethnicity groups. We present rates by age, sex, and methods used for suicide by ethnic group. We estimated age and sex adjusted incidence rate ratios using Poisson regression models for each ethnic minority group compared to the majority population. We involved people with lived experience in the research.Findings 31,644 suicide deaths occurred over the study period with 3602 (11%) in people from ethnic minorities. The mean age of death in ethnic minority groups was x (range x-x , standard deviation x). Almost all ethnic minority groups had a lower rate of suicide than the White-British majority, apart from individuals who identified as being from a Mixed heritage background or Gypsy/Irish Travellers. In females who identified as Mixed White/Caribbean or Gypsy/Irish Travellers, the rate of suicide was 79% (IRR 1.79 95% CI 1.45, 2.21) and two times (IRR 2.26 95% CI 1.42, 3.58) higher than the White-British majority, respectively. While rates in males identifying as from these two groups were similar to the White-British majority. Compared to the non-migrant population, migrants had a lower rate of suicide regardless of ethnicity, but in the descendent population Mixed heritage descendants had a higher risk of suicide. Interpretation There are ethnic disparities in suicide mortality in England and Wales, but the reasons for this are unclear. The lower rate of suicide in most ethnic minority groups may reflect a genuinely lower risk or differences in the classification of suicide. The higher rate in previously overlooked ethnic minority groups warrants further attention. For some it may be driven by a greater suicide risk in descendent populations (i.e., potentially ethnic minority British born individuals), rather than migrants and, for those from Mixed heritage background, by experiences of liminality and identity invalidation.</abstract><type>Journal Article</type><journal>The Lancet Psychiatry</journal><volume>11</volume><journalNumber>8</journalNumber><paginationStart>611</paginationStart><paginationEnd>619</paginationEnd><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2215-0366</issnPrint><issnElectronic/><keywords/><publishedDay>1</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-08-01</publishedDate><doi>10.1016/s2215-0366(24)00184-6</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [204813/Z/16/Z] and the Elizabeth Blackwell Institute for Health Research, University of Bristol. 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AJ was supported by MRC DATAMIND [MR/W014386/1]</funders><projectreference>[MR/W014386/1]</projectreference><lastEdited>2024-07-23T15:43:15.5986238</lastEdited><Created>2024-06-12T11:46:41.3526806</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Duleeka</firstname><surname>Knipe</surname><order>1</order></author><author><firstname>Paul</firstname><surname>Moran</surname><order>2</order></author><author><firstname>Laura D</firstname><surname>Howe</surname><order>3</order></author><author><firstname>Saffron</firstname><surname>Karlsen</surname><order>4</order></author><author><firstname>Nav</firstname><surname>Kapur</surname><order>5</order></author><author><firstname>Lauren</firstname><surname>Revie</surname><order>6</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>7</order></author></authors><documents><document><filename>66712__30952__c06ccb48bae54bf098a7578010747d89.pdf</filename><originalFilename>66712.VoR.pdf</originalFilename><uploaded>2024-07-23T15:41:55.4765326</uploaded><type>Output</type><contentLength>386632</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2024 The Author(s). 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spelling v2 66712 2024-06-12 Ethnicity and suicide in England and Wales: a national linked cohort study ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2024-06-12 MEDS Background Our understanding of ethnic disparities in suicide in England and Wales is limited as ethnicity is not recorded on death certificates. Using linked data, we examined variations, by sex, in suicide rates in England and Wales by ethnicity and migrant/descendant status.Methods Using the Office for National Statistics mortality (2012-2019) linked 2011 census data from the Public Health Research Database (PHRD), we calculated the age-standardised suicide rates by sex for each of the 18 self-identified ethnicity groups. We present rates by age, sex, and methods used for suicide by ethnic group. We estimated age and sex adjusted incidence rate ratios using Poisson regression models for each ethnic minority group compared to the majority population. We involved people with lived experience in the research.Findings 31,644 suicide deaths occurred over the study period with 3602 (11%) in people from ethnic minorities. The mean age of death in ethnic minority groups was x (range x-x , standard deviation x). Almost all ethnic minority groups had a lower rate of suicide than the White-British majority, apart from individuals who identified as being from a Mixed heritage background or Gypsy/Irish Travellers. In females who identified as Mixed White/Caribbean or Gypsy/Irish Travellers, the rate of suicide was 79% (IRR 1.79 95% CI 1.45, 2.21) and two times (IRR 2.26 95% CI 1.42, 3.58) higher than the White-British majority, respectively. While rates in males identifying as from these two groups were similar to the White-British majority. Compared to the non-migrant population, migrants had a lower rate of suicide regardless of ethnicity, but in the descendent population Mixed heritage descendants had a higher risk of suicide. Interpretation There are ethnic disparities in suicide mortality in England and Wales, but the reasons for this are unclear. The lower rate of suicide in most ethnic minority groups may reflect a genuinely lower risk or differences in the classification of suicide. The higher rate in previously overlooked ethnic minority groups warrants further attention. For some it may be driven by a greater suicide risk in descendent populations (i.e., potentially ethnic minority British born individuals), rather than migrants and, for those from Mixed heritage background, by experiences of liminality and identity invalidation. Journal Article The Lancet Psychiatry 11 8 611 619 Elsevier BV 2215-0366 1 8 2024 2024-08-01 10.1016/s2215-0366(24)00184-6 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [204813/Z/16/Z] and the Elizabeth Blackwell Institute for Health Research, University of Bristol. NK is supported by Mersey Care NHS Foundation Trust and the NIHR Greater Manchester Patient Safety Research Collaboration. AJ was supported by MRC DATAMIND [MR/W014386/1] [MR/W014386/1] 2024-07-23T15:43:15.5986238 2024-06-12T11:46:41.3526806 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Duleeka Knipe 1 Paul Moran 2 Laura D Howe 3 Saffron Karlsen 4 Nav Kapur 5 Lauren Revie 6 Ann John 0000-0002-5657-6995 7 66712__30952__c06ccb48bae54bf098a7578010747d89.pdf 66712.VoR.pdf 2024-07-23T15:41:55.4765326 Output 386632 application/pdf Version of Record true © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. true eng http://creativecommons.org/licenses/by/4.0/
title Ethnicity and suicide in England and Wales: a national linked cohort study
spellingShingle Ethnicity and suicide in England and Wales: a national linked cohort study
Ann John
title_short Ethnicity and suicide in England and Wales: a national linked cohort study
title_full Ethnicity and suicide in England and Wales: a national linked cohort study
title_fullStr Ethnicity and suicide in England and Wales: a national linked cohort study
title_full_unstemmed Ethnicity and suicide in England and Wales: a national linked cohort study
title_sort Ethnicity and suicide in England and Wales: a national linked cohort study
author_id_str_mv ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Ann John
author2 Duleeka Knipe
Paul Moran
Laura D Howe
Saffron Karlsen
Nav Kapur
Lauren Revie
Ann John
format Journal article
container_title The Lancet Psychiatry
container_volume 11
container_issue 8
container_start_page 611
publishDate 2024
institution Swansea University
issn 2215-0366
doi_str_mv 10.1016/s2215-0366(24)00184-6
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
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description Background Our understanding of ethnic disparities in suicide in England and Wales is limited as ethnicity is not recorded on death certificates. Using linked data, we examined variations, by sex, in suicide rates in England and Wales by ethnicity and migrant/descendant status.Methods Using the Office for National Statistics mortality (2012-2019) linked 2011 census data from the Public Health Research Database (PHRD), we calculated the age-standardised suicide rates by sex for each of the 18 self-identified ethnicity groups. We present rates by age, sex, and methods used for suicide by ethnic group. We estimated age and sex adjusted incidence rate ratios using Poisson regression models for each ethnic minority group compared to the majority population. We involved people with lived experience in the research.Findings 31,644 suicide deaths occurred over the study period with 3602 (11%) in people from ethnic minorities. The mean age of death in ethnic minority groups was x (range x-x , standard deviation x). Almost all ethnic minority groups had a lower rate of suicide than the White-British majority, apart from individuals who identified as being from a Mixed heritage background or Gypsy/Irish Travellers. In females who identified as Mixed White/Caribbean or Gypsy/Irish Travellers, the rate of suicide was 79% (IRR 1.79 95% CI 1.45, 2.21) and two times (IRR 2.26 95% CI 1.42, 3.58) higher than the White-British majority, respectively. While rates in males identifying as from these two groups were similar to the White-British majority. Compared to the non-migrant population, migrants had a lower rate of suicide regardless of ethnicity, but in the descendent population Mixed heritage descendants had a higher risk of suicide. Interpretation There are ethnic disparities in suicide mortality in England and Wales, but the reasons for this are unclear. The lower rate of suicide in most ethnic minority groups may reflect a genuinely lower risk or differences in the classification of suicide. The higher rate in previously overlooked ethnic minority groups warrants further attention. For some it may be driven by a greater suicide risk in descendent populations (i.e., potentially ethnic minority British born individuals), rather than migrants and, for those from Mixed heritage background, by experiences of liminality and identity invalidation.
published_date 2024-08-01T15:43:14Z
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