Suicide methods among Brazilian women from 1980 to 2019: Influence of age, period, and cohort

To analyze the effect of age, period, and cohort on suicides among women by hanging, strangulation, suffocation, firearms, and autointoxication in different Brazilian regions from 1980 to 2019.

Ecological time-trend study employing estimable functions to estimate APC models, facilitated through the Epi library of the R statistical program, version 4.2.1. Specific rates by age group per 100,00 women and relative risks by period and cohort were estimated using this method.

Between 1980 and 2019, 49,997 suicides among women were reported using the methods under study. Higher suicide rates per 100,000 women were observed in the South using strangulation and suffocation (2.42), while lower firearm suicide rates were observed in the Northeast (0.13). After adjusting the APC model, there was an increase in age-specific rates with advancing age across all regions for suicides by hanging, strangulation, and suffocation. In contrast, suicides by firearms and autointoxication showed a decrease in rates with advancing age. The period effect indicated an increased risk of suicides by hanging, strangulation (RR >1 and p<0.05) in the five-year intervals of the 2000s in the North, Southeast, and South regions. During the same period, there was an increased risk of suicides by autointoxication in the Southeast, South, and Northeast (RR>1, p<0.05). Suicides by firearms exhibited a statistically significant reduction in the risk of death from 2005 to 2019 in the Southeast and South regions, and from 2005 to 2014 in the Northeast and Midwest. The observed increase in the North region was not statistically significant (RR>1, p>0.05). The cohort effect demonstrated an increased risk of suicides by hanging, strangulation in younger cohorts (RR>1, p<0.05), whereas other methods showed an elevated risk in older cohorts relative to the 1950-1954 generation.

The results presented here may suggest changes in suicide method preferences between 1980 and 2019.