Inequalities in suicide rates associated with deprivation in England from 2004 to 2019

Although addressing inequality has been a public and political priority for decades, inequalities in health, wealth, and other societal domains persist in England. In Ireland, rates of suicide are twice as high in the most deprived decile of society compared with the least deprived. Trends in the association between deprivation and suicide in England are unclear.

To describe the relationship between deprivation and suicide in England in 2019 and analyse trends in this relationship over time.

Data on rate of suicide and Index of Multiple Deprivation (IMD) for each local authority in England for 2018 and 2004 were obtained from the Office for National Statistics' publicly available databases. The mean suicide rate for each quintile of deprivation was calculated, and means compared using ANOVA. The correlation coefficients between IMD and suicide rate were calculated for both 2004 and 2019. Steiger's test was used to compare coefficients over time.

In 2019, the suicide rate in the least deprived quintile was 8.7 per 100 000 person-years, compared with 8.3 in 2004. This increased across each quintile to 11.1 suicides per 100 000 person-years in the most deprived quintile in 2019 (ANOVA: P<0.001), and to 11.7 in 2004 (ANOVA: P<0.001). The correlation coefficient between IMD and suicide rate in 2004 was 0.43, compared with 0.33 in 2019. Steiger's test demonstrated no significant difference between coefficients over time (P = 0.16).

Suicide is associated with deprivation in England. Despite significant research and policy effort, there has been no improvement in this association between 2004 and 2019.