Rates and characteristics of suicide by immigration background in Norway

Abstract

Suicide mortality among immigrant groups is an important health issue, particularly in countries with growing segments of immigrant populations such as Norway. Through linkage of Norwegian national registers we wanted to estimate suicide rates (per 100,000 population) in immigrant groups and to profile characteristics of suicide by immigration background with respect to sex, age, method and seasonality of suicide as well as time since immigrating to Norway. Among all 11,409 suicides during 1992–2012, 1,139 (10%) were individuals with an immigration background. Suicide rate was lower in first-generation immigrants (foreign-born persons to two foreign-born parents) than native Norwegians (9.53 vs 12.22, P < 0.01), with a significant difference confined to male rates only. Foreign-born persons with at least one Norwegian-born parent had significantly higher suicide rates than natives in both sexes (22.42 vs 18.03 in males, 11.67 vs 6.54 in females, P < 0.01). The most frequently used suicide method in all the population groups was hanging; this method accounted for 44.0% of all suicides of first-generation immigrants, 45.2% of all suicides of foreign-born persons with at least one Norwegian-born parent, and 35.4% of all suicides of natives. Suicide by firearms accounted for a much smaller proportion of cases of first-generation immigrants (6.7%) and foreign-born persons with at least one Norwegian-born parent (6.8%) than cases of native Norwegians (20.7%). In terms of monthly distribution, suicides of first-generation immigrants displayed two peaks, in May and in November (P = 0.01). More than 25% of all first-generation immigrant suicides occurred in the first five years after immigration; but differences in time since immigration were observed by sex and country group of origin, in particular among those aged 35 years or less when moving to Norway. In conclusion, there are notable differences in characteristics of suicides by immigration background. Knowledge of immigrant mortality according to suicide method, seasonality of suicide, and time since immigration may be useful when planning suicide preventive measures.

Insights into rates, risks and characteristics of suicide by immigration background in Norway

“…Our studies (Puzo et al, 2017(Puzo et al, , 2018a(Puzo et al, , 2018b have provided rich insights into suicide by immigration background, which are of clear importance from both public health and policy perspectives. The findings underscore the importance of not treating immigrants as a homogeneous group, as the rates, risks, and characteristics of suicide vary according to their immigration background.…”

“…A better understanding of the interplay between suicide and immigration is of fundamental importance as a basis for planning future public policies for immigrant minorities living in the country. This article summarizes core findings from three studies we recently conducted (Puzo, Mehlum, & Qin, 2017, 2018a, 2018b with data from Norwegian national registers addressing suicide risk among various immigrant populations from an epidemiological perspective. In particular, we highlight important findings about suicide rates and risks for people with various immigration backgrounds as compared with native Norwegians, the impact of a range of socio-economic factors on risk of suicide as well as differential characteristics of suicides by immigration background with respect to method of suicide, seasonality of suicide and time to suicide since immigration.…”

“…Access to data for the studies whom this paper refers to (Puzo et al, 2017(Puzo et al, , 2018a(Puzo et al, , 2018b was approved by the Regional Ethical Committee for Medical and Health Research (REK South-East) and owners of the relevant individual registers.…”

Suicidality and suicide prevention in culturally and linguistically diverse (CALD) communities: A systematic review

“…Stigma, which is defined as a mark of disgrace or infamy, or a reproach on one's reputation (Barney, Griffiths, Jorm & Christensen, 2006), was highlighted by five studies as a key barrier to help-seeking for suicidal ideation and behaviour (Chung, 2012;Han & Oliffe, 2015;Heredia Montesinos et al, 2019;Paraschakis et al, 2014;Puzo, Mehlum & Qin, 2018). Stigma most commonly stemmed from cultural norms and shame associated with suicide and mental illness.…”

“…This theme was highlighted in Turkish women (Heredia Montesinos et al, 2019), Asian immigrants (Chung, 2012) and Korean-Canadian immigrants (Han & Oliffe, 2015). Anti-stigma awareness campaigns were cited in two studies as a possible way to help improve help-seeking behaviour (Heredia Montesinos et al, 2019;Puzo, Mehlum & Qin, 2018).…”