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Suicide is amongst the three leading causes of death in 15–44-year-olds worldwide. A detailed assessment of secular trends in its incidence in England and Wales over the last 145 years has not previously been conducted; such an assessment may shed light on the potentially preventable factors and provide pointers concerning likely trends in suicide in the world’s emerging economies.
To investigate age-, sex- and method-specific trends in suicide from 1861 to 2005.
Suicide and population data were obtained from the ONS. Overall age-standardised rates using the European Standard Population and age-, sex- and method-specific suicide rates were calculated for ages 15 and over.
Rates in males (M) were consistently higher than females (F) throughout the 19th and 20th centuries, although the sex ratio fluctuated from 11M:2F in the 1880s to 8M:5F in the 1960s. The highest male rates (28 per 100 000) were recorded in the 1890s. Female rates peaked in the 1930s and 1960s (10 per 100 000). In both sexes the lowest recorded rates were in the 21st century. Suicide rates increased in all age groups in the 1930s, coinciding with the Great Depression. Over the period studied, rates fell by 87% in men aged 65+, by 66% in women ages 65+, but rose in younger men (aged 15–44). There was a rapid rise in the use of domestic gas as a method of suicide in both sexes following its introduction at the end of the 19th century. By the 1950s it had become the most commonly used method of suicide, before its use declined after the 1960s. Self poisoning also increased in popularity from the 1860s (5% of suicides, mainly ingestion of hydrochloric, oxalic and carbolic acid) to the 1990s (22% of suicides: mainly analgesics and antidepressants). The sex ratio was consistently lowest for suicides by poisoning and highest for suicides by hanging for most of the time period.
The rapid rise in gas suicide deaths in the 1920s highlights how quickly a new method of suicide can be established in a population when it is easily available. The increase in suicides during the Great Depression has implications in relation to the current economic crisis. The striking changes in suicide rates over time remain largely unexplained. Differences in the acceptability of various suicide methods are likely to account for the differences in sex ratios seen for hanging and poisoning.
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