Spatial analysis of suicide mortality in Québec: spatial clustering and area factor correlates

Understanding the spatial distribution of suicide can inform the planning, implementation and evaluation of suicide prevention actions. No previous study has assessed spatial clustering of the different methods of suicide in Quebec. The aim of this study was to assess spatial clustering of suicide in Quebec between 2004 and 2007 and neighborhood level predictors of the clusters. Scan statistics was applied to detect clusters of suicides by method and by sex. Smoothed standardized mortality ratios (SMRs) for suicide for each neighborhood were also estimated and their association with neighborhood characteristics was investigated using the Bayesian hierarchical spatial model. The pattern of suicide rate was different among men and women; men showed higher standardized mortality rates. The most likely clusters of suicide were found in remote rural areas. However, some neighborhoods in urban areas also had noticeable suicide clusters. Firearms suicide was most likely found in remote rural areas while poisoning and hanging suicide methods clustered in urban areas. These findings suggest that it is important to take geographical variations into account in national policy and health services planning.