Spatio-temporal Distribution of Suicide Risk in Iran: A Bayesian Hierarchical Analysis of Repeated Cross-sectional Data

Abstract

Objectives: We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016.Methods: In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used.Results: The relative risk of suicide mortality was greater than 1 in 43.0% of Iran’s provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran’s provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years.Conclusions: The highest risk of suicide mortality was observed in Iran’s northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

Commentary: Spatiotemporal Patterns of Suicide in Korea from 2009 to 2019 Using Geographic Information Systems

“…My suggestion would be in line with the authors’ to incorporate socio-economic and cultural risk factors in spatiotemporal analysis for suicide. Other similar international studies such as in USA, 9 Brazil, 10 and Iran 11 successfully demonstrated the association of high-risk areas with other risk factors such as opioid use, marital status, race, and gender. Authors of the current study could center their effort in examining the risk factors in new and persistent hotspots of suicide, and thereby adjoin relevant specific suggestions to the policy makers to assist in attenuating the suicidal risk globally, in conjunction with the spatiotemporal patterns of suicide.…”