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Are neighbourhood social fragmentation and suicide associated in New Zealand? A national multilevel cohort study
  1. Sunny C Collings1,
  2. Vivienne Ivory2,
  3. Tony Blakely2,
  4. June Atkinson2
  1. 1 Social Psychiatry & Population Mental Health Research Unit, University of Otago Wellington, New Zealand;
  2. 2 Health Inequalities Research Programme, University of Otago Wellington, New Zealand
  1. E-mail: sunny.collings{at}otago.ac.nz

Abstract

Background: Studies of the association between neighbourhood fragmentation and suicide have yielded varied results, and none have simultaneously adjusted for neighbourhood fragmentation, neighbourhood deprivation and individual level factors.

Method: We did a multilevel analysis of a 3-year cohort study using probabilistic linkage of census and mortality records, and two measures of neighbourhood fragmentation. 2.8 million respondents to the 1996 New Zealand census were followed up for three years for mortality (1101 suicide deaths in the analysis), aged from 20 to 74 at follow-up.

Results: No consistent association was observed between either measure of neighbourhood social fragmentation and suicide, after controlling for individual level confounders and neighbourhood deprivation. There was some evidence of a U shaped relationship neighbourhood fragmentation and suicide, especially for the Congdon(NZ) index. There was no evidence of an association for a nine variable index that captured family type variables as well as the usual attachment type variables. Neighbourhood deprivation remained as an important predictor of suicide rates.

Conclusion: This paper highlights the importance of understanding both the measure and the wider national context when considering neighbourhood effects on suicide.

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