Citation

Congdon PD. Int. J. Environ. Res. Public Health 2012; 10(1): 158-177.

Affiliation

School of Geography, Queen Mary University of London, Mile End Rd, London E1 4NS, UK. p.congdon@qmul.ac.uk.

Copyright

(Copyright © 2012, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph10010158

PMID

23271304

Abstract

Ecological studies of suicide and self-harm have established the importance of area variables (e.g., deprivation, social fragmentation) in explaining variations in suicide risk. However, there are likely to be unobserved influences on risk, typically spatially clustered, which can be modeled as random effects. Regression impacts may be biased if no account is taken of spatially structured influences on risk. Furthermore a default assumption of linear effects of area variables may also misstate or understate their impact. This paper considers variations in suicide outcomes for small areas across England, and investigates the impact on them of area socio-economic variables, while also investigating potential nonlinearity in their impact and allowing for spatially clustered unobserved factors. The outcomes are self-harm hospitalisations and suicide mortality over 6,781 Middle Level Super Output Areas.

Language: en