Are there Regional Disparities in Suicide Rates? Quantifying Suicide Distributions for

AbstractThe study commences with a question that epidemiology would regardas ‘old’ viz. whether suicide rates are higher in rural areas or urban areas,and turns to applying an economic technique of analysis to studying re-gional suicide disparities. Several dispersion measures are applied to timeseries male and female suicide rates, including economic inequality mea-sures and measures from regional studies. Equations are modelled on thesedispersion measurements, establishing the sign on the slope coecients.It is determined whether regional disparities in Queensland lessened, orincreased, in the study period. The interpretations relevant to a regionalstudies literature are discussed. Key words: suicide, regional disparities,measuring dispersion, economic inequality 1 Introduction and Background This study answers two questions about the spatial distribution of suicide ratesusing time-series data for Queensland. Initially we ask, ‘Are suicide rates higherin rural areas in comparison to urban areas? ’ This question addresses a long-standing issue, returning to this topic because various epidemiological mattersare still not settled. However, our main focus is on a second research question:are suicide rates by geographical region converging through time or is there adiverging trend in Queensland? In other words, are regional disparities lessen-ing, or increasing, through time? The test for convergence/divergence here isbased on temporal movement towards/away from the weighted mean for all theregions.We demonstrate that suicide data are amenable to the techniques of descrip-tive analysis of disparities at the regional level. As yet, these data are simplynot analysed with the tools of analysis from the literature. There are also im-portant technical issues in answering this second question empirically, in termsof the literature on measuring inequality and, in particular, the welfare eco-nomics basis of inequality measurement. The answer to the second questionis also in the genre of three Australian studies which are descriptive analysesof disparities. Those studies are concerned with regional labour market vari-ables (DIXON, SHEPHERD and THOMPSON, 2001; DIXON, 2006; DIXONand MAHMOOD, 2006), following MARTIN’s (1997) application of absolutedispersion and relative dispersion measures to regional unemployment data forthe United Kingdom.This topic could be regarded as misplaced in the present literature, belongingrather to the literatures of epidemiology, psychology or psychiatry, mental healthservices research, suicide prevention services research etc. However, this studywould be misplaced in those literatures. Apart from the relevance of the techni-cal emphases herein, the Discussion section below proposes a case that a study ofsuicide can belong with disciplines such as regional studies, economics etc. thatare concerned with population-level issues. The e ectiveness of health/welfareservices can be constrained by economic factors underlying spatial inequalitiesin access. The interpretation of the disparities reported here is also informedby a phenomenon in suicide, described as psychache by SHNEIDMAN (1993). 2