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The possible evidence for an epidemiological transition hypothesis for elderly suicides

Published online by Cambridge University Press:  30 November 2009

A. Shah
A. Shah*
Affiliation:
Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston and West London Mental Health NHS Trust, London, U.K.
*
Correspondence should be addressed to: Professor Ajit Shah, John Connolly Unit, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU, U.K. Phone: +44 (0)208 354 8191; Fax: +44 (0)208 354 8307. Email: ajit.shah@wlmht.nhs.uk.
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Abstract

Background: An epidemiological transition hypothesis has been developed to explain simultaneously wide cross-national variations in elderly suicide rates, trends over time for elderly suicide rates and age-associated trends in suicides rates. This speculative hypothesis suggests that there is a curvilinear (inverted U-shaped curve) relationship between elderly suicide rates and socioeconomic status fitting the quadratic equation y = a + bx − cx2 (where y is the suicide rate, x is the socioeconomic status, and a, b and c are constants).

Methods: The predicted curvilinear relationship between elderly suicide rates and gross national domestic product (GDP), a measure of socioeconomic status, fitting the above quadratic equation was examined with a curve estimation regression model using data from the World Health Organization.

Results: The relationship between suicide rates in both sexes in the age-bands 65–74 and 75+ years and the GDP was curvilinear (inverted U-shaped curve) and fitted the above quadratic equation, and was statistically significant (at least p<0.05) in all four groups.

Conclusions: Caution should be exercised in accepting this model of the epidemiological transition hypothesis for elderly suicide rates because it is generated from cross-sectional data using an ecological design. Ideally, this model requires rigorous testing by following selected countries of low socioeconomic status over time as they develop socioeconomically.

Keywords

suicideselderly suicidessocioeconomic statusepidemiology
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 2 , March 2010 , pp. 219 - 226
Copyright
Copyright © International Psychogeriatric Association 2009

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