An atlas of suicide mortality: England and Wales, 1988–1994

N Middleton, J Sterne, DJ Gunnell

Research output: Contribution to journalArticle (Academic Journal)peer-review

48 Citations (Scopus)


The incidence of suicide exhibits marked geographic variability; however, documentation of features in its spatial distribution, or the magnitude of differences, is limited. Standardised mortality ratios, commonly presented in maps, are calculated in each area independently and incorporate no information about heterogeneity or clustering. Bayesian hierarchical models with random effects for between-area and local variability in neighbouring areas were used to map age- and sex-specific estimates of rate ratios of suicide across wards in England and Wales. Differences were greater than expected due to random variation alone. Although the geography of suicide differed across age/sex groups, some common patterns emerged e.g. high rates in (a) central parts of cities and (b) remote and coastal areas. Some features were common to all, while others appeared male specific or specific to the younger age group. Suicide prevention strategies can be informed by an understanding and addressing the geography of suicide.
Translated title of the contributionAn atlas of suicide mortality: England and Wales, 1988–1994
Original languageEnglish
Pages (from-to)492 - 506
Number of pages15
JournalHealth and Place
Volume14 (3)
Publication statusPublished - Sept 2008

Bibliographical note

Publisher: Elsevier


Dive into the research topics of 'An atlas of suicide mortality: England and Wales, 1988–1994'. Together they form a unique fingerprint.

Cite this