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Regional and Time-Series Studies ofSuicide in Nations of the WorldDavid Lester & Bijou YangPublished online: 01 Sep 2006.

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Regional and Time-SeriesStudies of Suicide inNations of the World

David Lester and Bijou Yang

This article reviews simple epidemiological data on completedsuicide rates in different nations of the world, the results oftime-series studies of suicide in nations, and the results ofregional correlates of suicide rates within nations. It is arguedthat it is important to conduct comparable sociologicalstudies in samples of nations so that the general trends anddeviations from these trends can be observed and effortsmade to explain these phenomena.

Keywords suicide, cross-cultural studies, time-series, ecological studies

The first step in examining suiciderates across nations is to look at sim-ple epidemiological data which arenow available from the World HealthOrganization online at www.who.int.Suicide rates for 1990 are shown inTable 1, with a breakdown by sexand age for a more recent year(1995) shown in Table 2. In general,European nations have the highestsuicide rates in the world, whileCentral and South American nationshave the lowest suicide rates. Itappears that countries in the MiddleEast have very low suicide rates.However, their rates have notbeen published by the WHO in recentyears.

It is noteworthy that, since theWHO switched to placing cause ofdeath statistics online (rather thanpublishing the data in book form),the number of nations with availablemortality rates has declined and the

data are not updated regularly. Thesedeficiencies are going to impede satis-factory cross-national research intosuicide.

Several scholars have presentedmore detailed analysis of how suiciderates are related to sex and age(Canetto & Lester, 1995; Fuse, 1980;Girard, 1993; Lester, 1982). One typi-cal pattern is shown by Argentinianmales, whose suicide rates rise mono-tonically with age. In contrast, NewZealand male suicide rates peakfor those aged 15–24 and decline inmiddle age, with a lesser rise intoold age. For females, suicide ratestend either to rise with age (as inBulgaria) or peak in middle age (as inthe United States).

Changes in youth and elderly sui-cide rates from 1980 to 1990, topicsof special interest for public healthprofessionals, are shown in Table 3.It can be seen that Spain, Ireland

Archives of Suicide Research, 9:123–133, 2005Copyright # International Academy for Suicide ResearchISSN: 1381-1118 print/1543-6136 onlineDOI: 10.1080/13811110590903972

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TABLE 1. Suicide Rates Around the World (from the World Health Organization and fromLester [1996]) (Placed in Order of Rates in 1990)

1969–1971 1971–1981 1990 1995

Hungary 34.7 45.0 39.9 32.9

Sri Lanka 19.0 29.0 38.1 �Finland 22.1 24.7 30.3 27.2

Slovenia � � 27.6 28.4

Estonia � � 27.1 40.1

Russian Federation � � 26.5 41.5

Lithuania � � 26.1 45.6

Latvia � � 26.0 40.7

Denmark 22.4 29.1 24.1 17.6

Croatia � � 23.9 19.5

Austria 23.1 26.0 23.6 22.2

Switzerland 18.2 24.7 21.9 20.2

Ukraine � � 20.7 �Belarus � � 20.3 31.2

France 15.5 19.2 20.1 20.3

Czech Republic � � 19.3 16.8

Kazakhstan � � 19.1 28.6

Belgium 15.7 21.5 19.0 21.1

Luxembourg 14.6 16.5 17.8 15.4

Germany � � 17.5 15.8

Sweden 21.5 19.1 17.2 15.3

Japan 15.1 17.5 16.4 17.2

Iceland 7.5 10.2 15.7 10.1

Norway 8.2 12.4 15.5 12.6

Yugoslavia 13.9 14.8 15.3 �Moldova � � 14.8 18.5

Bulgaria 11.8 13.9 14.7 17.0

Mauritius 2.3 3.9 14.2 13.5

Trinidad & Tobago 5.2 5.2 13.7 �New Zealand 9.3 10.2 13.5 14.9

Singapore 9.7 9.8 13.1 13.4

Poland 11.4 12.7 13.0 14.3

Australia 12.7 11.3 12.9 12.0

Canada 11.4 14.1 12.7 13.4

Krygyzstan � � 12.5 13.5

USA 11.4 12.0 12.4 11.9

Hong Kong 10.6 12.4 11.7 11.8

El Salvador 7.6 9.7 11.6 �Puerto Rico 9.7 8.5 10.5 �

(Continued)

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and Northern Ireland witnessedlarge increases in youth suicide rates,but a large increase also occurredfor the elderly and for the popula-tion as a whole, suggesting that thechange was a result of more accuratecertification of death. On the otherhand, the increase in male youthsuicide rates in New Zealand maybe a phenomenon unique to male

youth. During the same period,however, countries such as CostaRica and Hong Kong witnessed adecrease in their male youth suiciderates.

The wide range of suicide ratesfrom nation to nation is striking andnot easily understood. Among thenations with very high suicide ratesin 1990 are Hungary, Sri Lanka, and

TABLE 1. (Continued )

1969–1971 1971–1981 1990 1995

Uruguay 10.1 � 10.3 �Netherlands 7.9 10.2 9.7 9.8

Ireland 2.1 6.2 9.5 11.2

Romania � � 9.0 12.3

Portugal 8.0 8.3 8.8 8.2

Turkmenistan � � 8.1 �United Kingdom 8.1 8.6 8.1 7.4

Italy 5.7 7.1 7.6 8.0

Spain 4.3 4.4 7.5 8.1

Zimbabwe 6.0 6.1 7.4 �Uzbekistan � � 7.2 �Liechtenstein 5.0 9.0 6.7 �Argentina 10.0 7.2 6.7 6.4

Taiwan 13.2 9.9 6.7 �Surinam � � 6.7 �Israel 6.6 6.0 6.5 6.5

Barbados 1.9 1.5 6.2 �Chile 6.2 5.5 5.6 �Costa Rica 2.8 4.4 5.2 5.9

Venezuela 6.8 4.7 5.0 �Tajikistan � � 4.4 �Ecuador 2.3 2.8 4.4 �Georgia � � 3.6 �Greece 3.3 3.2 3.5 3.5

Armenia � � 2.8 3.5

Colombia 2.7 3.5 2.7 �Nicaragua 1.4 � 2.4 �Malta 0.8 0.0 2.3 4.6

Mexico 0.8 1.7 2.3 3.2

Azerbaijan � � 1.6 0.7

D. Lester and B. Yang

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TABLE 2. Suicide Rates in 1995 by Sex and Age

15–24 25–34 35–44 45–54 55–64 65–74 75+

Males

Argentina 8.9 9.1 10.9 15.1 19.9 28.0 43.8

Armenia 3.2 7.3 6.8 10.8 13.3 9.8 7.1

Australia 23.1 31.0 24.8 21.7 21.3 18.5 26.8

Austria 25.8 32.4 38.5 41.3 44.8 54.6 121.4

Azerbaijan 1.4 0.8 3.0 1.9 1.2 4.2 5.5

Belarus 28.6 63.9 81.8 118.3 94.9 73.5 70.3

Bulgaria 13.9 18.0 23.7 31.0 35.3 46.4 104.8

Canada 24.7 29.9 30.0 28.3 22.9 19.8 26.6

Costa Rica 11.8 14.7 18.6 14.7 16.0 9.5 8.4

Croatia 21.9 25.0 32.2 37.0 42.4 69.9 104.8

Cuba 14.6 24.8 25.9 32.5 47.9 61.7 124.4

Czech 18.4 25.9 34.1 36.4 33.6 34.0 87.5

Denmark 13.2 26.1 27.6 26.0 41.0 38.8 63.7

Estonia 28.0 62.1 107.5 138.9 108.7 88.0 110.5

Finland 36.6 51.8 67.8 57.4 55.2 50.4 54.9

France 15.2 32.2 41.2 39.8 35.1 47.5 97.0

Germany 13.3 20.0 27.5 30.1 30.2 35.4 83.3

Greece 4.4 7.4 6.5 7.2 6.3 7.9 17.4

Hong Kong 9.0 13.8 12.9 16.8 21.5 40.5 64.4

Hungary 19.2 37.2 72.9 84.2 68.9 88.0 168.9

Ireland 23.8 26.5 29.7 19.7 16.0 22.7 21.2

Israel 9.8 9.7 11.0 13.1 19.9 20.2 37.2

Italy 7.3 10.5 12.0 13.6 15.4 22.6 43.3

Japan 11.3 20.1 24.1 36.0 39.2 30.4 53.2

Kazakhstan 42.7 67.6 79.7 94.8 90.7 75.5 88.0

Kyrgyzstan 20.2 29.5 41.8 59.7 46.6 44.3 45.7

Latvia 37.8 79.7 100.4 119.1 125.1 103.9 106.1

Lithuania 48.6 76.1 128.1 160.2 125.2 106.3 135.1

Mauritius 15.8 33.4 37.6 35.2 26.9 24.8 27.8

Mexico 7.6 9.2 7.3 7.2 9.2 9.7 18.8

Moldova 11.9 35.7 48.6 62.5 59.1 51.0 61.7

Netherlands 9.2 14.5 19.5 15.8 18.0 18.2 25.7

New Zealand 44.1 33.9 25.1 26.1 19.7 29.7 29.5

Norway 22.6 22.1 21.9 23.5 22.0 31.8 24.4

Poland 16.5 26.4 38.6 43.7 37.6 32.2 32.4

Portugal 5.8 10.7 8.6 15.5 17.3 30.1 51.6

Romania 11.6 20.1 31.1 41.6 31.5 23.8 31.6

Russia 53.7 91.5 107.5 121.7 104.7 89.8 93.9

Singapore 12.2 13.9 20.7 22.8 23.3 36.4 107.1

(Continued)

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TABLE 2. (Continued )

15–24 25–34 35–44 45–54 55–64 65–74 75+

Slovakia 12.6 24.6 34.7 42.9 34.1 45.9 54.5

Slovenia 33.7 36.5 50.5 72.9 77.0 75.0 104.7

South Korea 11.5 16.4 18.8 25.4 26.6 33.8 47.5

Spain 8.7 12.5 11.6 13.1 15.8 25.3 45.1

Sweden 13.4 20.9 28.3 31.8 29.4 29.3 42.9

Switzerland 24.2 24.9 30.1 40.1 40.2 49.7 88.2

UK 11.0 17.9 18.0 14.3 11.9 11.3 15.7

USA 22.5 25.6 24.1 22.8 22.0 28.7 48.3

Females

Argentina 3.3 2.6 3.0 4.1 4.3 6.1 6.6

Armenia 1.0 3.5 2.0 1.3 5.6 0.8 3.9

Australia 6.1 6.4 7.0 7.7 6.0 5.0 5.2

Austria 3.8 8.5 11.2 14.4 14.1 19.0 29.0

Azerbaijan 0.0 0.4 0.6 0.0 0.0 0.0 1.1

Belarus 4.5 6.7 10.5 17.5 15.3 17.1 16.1

Bulgaria 4.0 6.7 6.8 6.8 11.7 25.4 35.6

Canada 4.9 5.8 8.3 8.6 7.4 5.6 3.7

Costa Rica 4.0 2.4 3.6 2.2 4.5 0.0 0.0

Croatia 5.3 6.0 10.0 10.0 17.1 19.8 26.4

Cuba 17.9 14.8 16.1 20.4 21.2 27.3 30.9

Czech 4.2 3.7 9.2 9.3 12.9 15.5 30.6

Denmark 2.3 4.6 12.9 16.3 18.2 22.1 27.0

Estonia 6.8 8.8 18.9 21.1 31.7 25.4 35.1

Finland 8.4 13.4 19.3 17.2 16.6 12.7 9.7

France 4.6 8.6 12.6 15.8 16.3 18.1 21.6

Germany 3.9 5.1 7.8 10.4 12.0 14.4 23.9

Greece 0.8 1.4 0.8 1.4 2.3 2.1 1.6

Hong Kong 5.6 7.6 9.2 8.8 13.3 23.8 38.9

Hungary 3.8 8.6 16.8 21.7 24.8 29.9 60.0

Ireland 3.6 7.7 7.3 8.1 6.9 2.3 2.8

Israel 4.2 1.0 3.3 3.8 6.5 8.4 22.2

Italy 1.6 2.6 3.6 4.6 5.8 7.4 8.2

Japan 5.5 8.2 8.6 13.1 15.7 19.5 34.4

Kazakhstan 10.3 10.2 9.3 14.8 15.6 19.6 32.1

Kyrgyzstan 9.9 6.3 6.0 15.0 10.0 17.1 11.6

Latvia 6.0 6.7 21.8 25.1 19.2 19.2 38.5

Lithuania 7.5 11.4 21.6 24.8 23.3 26.6 33.0

Mauritius 11.2 4.2 6.1 6.8 9.1 12.1 7.8

Mexico 2.0 1.2 0.9 1.3 0.8 1.2 1.0

(Continued)

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Finland, and it is difficult to pin-pointsimilarities between the nations. Twomultivariate studies which haveattempted to discover correlates ofnational suicide rates have appeared.Lester (1996) identified six inde-pendent factors of social variablesfor 72 nations in his sample, butonly one factor, that measuring theeconomic and social developmentof the nations, was associated withsuicide rates. The more develo-ped nations had higher suiciderates. Simpson and Conklin (1989)identified two factors which corre-lated with suicide rates, economicdevelopment and Islam, with suiciderates higher in the more developednations and lower in Islamic nations.Thus, the more developed nations,with a higher quality of life (Lester,1989), appear to have higher suiciderates.

Time-Series Studies

There have been many time-series studies of suicide rates withina nation, for example by Stack(1989). However, even when oneinvestigator studies two or morenations (usually in separate papers),the studies use different time peri-ods and different social variables aspredictors of the time-series suiciderate. For example, Stack (1990) stud-ied suicide rates in Denmark for theperiod 1951–1980 using divorce andunemployment rates as the predic-tors; Stack (1992) studied suiciderates in Finland for the period1952–1978 using divorce, unemploy-ment, religiosity, and individualismas the predictors.

It is not always easy (or even poss-ible) to obtain comparable data setsfor the same period for nations of the

TABLE 2. (Continued )

15–24 25–34 35–44 45–54 55–64 65–74 75+

Moldova 4.1 6.5 10.9 13.6 14.1 18.2 28.0

Netherlands 4.4 6.6 8.7 9.5 7.9 10.6 9.9

New Zealand 12.3 6.7 6.6 8.4 5.4 5.3 8.2

Norway 5.5 5.2 10.1 9.9 7.4 9.5 5.4

Poland 3.0 3.5 7.2 7.7 7.9 8.0 6.4

Portugal 3.0 2.8 3.9 5.5 7.2 6.5 13.1

Romania 2.6 4.2 5.9 7.4 7.5 8.5 6.7

Russia 9.8 11.4 15.0 18.4 17.9 23.0 34.8

Singapore 11.6 9.2 12.0 12.2 8.5 28.7 53.8

Slovakia 2.0 4.8 5.8 7.4 7.1 9.1 6.3

Slovenia 4.2 10.7 15.4 15.2 23.6 19.8 27.3

South Korea 7.3 8.5 7.3 7.7 7.6 13.4 18.9

Spain 2.1 2.2 3.6 3.9 6.3 7.0 10.3

Sweden 5.2 6.4 13.5 13.9 12.7 11.0 17.2

Switzerland 6.7 7.7 10.7 15.5 18.2 23.8 18.0

UK 2.2 3.1 4.7 4.2 4.0 4.3 5.7

USA 3.7 5.2 6.5 6.7 5.3 5.4 5.5

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world. Many nations do not publishannual rates of social and health vari-ables consistently. However, Lester

and Yang (1998) obtained time-series data for 29 nations for theperiod 1950–1985 and used the same

TABLE 3. Percentage Change in Youth and Elderly Suicide Rates from 1980 to 1990

Percentage Change

Males Females

Total (%) Youth (%) Elderly (%) Total (%) Youth (%) Elderly (%)

Australia þ26 þ51 �2 �7 þ4 �13Austria �8 �13 þ26 �10 �18 þ5

Bulgaria þ8 þ25 �11 þ7 �43 þ22

Canada �4 �1 �15 �24 �7 �29Costa Rica �45 �6 þ14 þ14 �65 þinfinity

Czechoslovakia �10 �38 �5 �10 �4 �10#

Denmark �12 �13 �6 �27 �87 þ2

England=Wales þ 10 þ83 �10 �45 �33 �44Finland þ19 þ36 þ50 þ16 þ21 þ5

France þ6 �10 þ6 0 �19 þ5

Greece þ17 þ73 þ5 �21 þ83 �61Hong Kong �12 �10 þ6 �14 �12 �29Hungary �7 �36 �3 �19 þ2 �17Ireland þ73 þ154 þ289 þ9 þ21 �47Israel þ17 �38 �1 �5 þ175 �47Italy þ13 þ11 þ34 �11 �17 �8Japan �8 �45 �14 �5 �43 �19Netherlands �4 �1 �17 �3 �3 þ24

New Zealand þ51 þ95 þ8 �24 �17 �65N. Ireland þ107 þ87 þ20 þ56 þ213 þ61

Norway þ27 þ8 þ29 þ21 þ91 þ68

Portugal þ21 þ42 þ8 þ15 �24 þ45

Puerto Rico þ24 �19 þ39 �25 �24 �100Scotland þ30 þ72 �7 �37 �42 �60Singapore þ19 þ48 �26 þ15 �34 þ14

Spain þ67 þ65 þ81 þ86 þ55 þ102

Sweden �13 �13 þ13 �8 �9 þ31

Switzerland �14 �27 þ8 �16 �49 þ1

USA þ10 þ9 þ33 �11 �9 þ11

USSR �24 �24 þ6 �16 þ5 þ6

West Germany �21 �21 �1 �32 �20 �8Yugoslavia þ4 �5 þ22 þ6 �36 þ28

#The data for Czechoslovakia are for 1981 to 1990 since 1980 data were not published by theWorld Health Organization.

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TABLE 4. Results of the Multiple Time-Series Regressions of the Suicide Rate for 29 Nations

ConstantMarriage

RateBirthRate

DivorceRate R2

Durbin-WatsonStatistic

Australia 8.928 0.004 0.189 �0.181 0.69 1.78

Austria 11.787�� �0.150 0.219 6.967��� 0.81 2.03

Belgium 19.050 �0.869 �0.076 5.476� 0.95 1.89

Canada 10.796��� 0.130 �0.192��� 1.961��� 0.98 1.56

Costa Rica 4.312�� 0.050 �0.047� 1.495� 0.63 2.03

Czechoslov. 28.449��� 0.382 �0.327 �2.649 0.79 2.36

Denmark 23.383 �0.251 �0.363 3.410 0.84 2.01

England=Wales 8.434�� �0.653� 0.390�� �0.043 0.95 1.30

Finland 19.639�� �0.137 �0.075 3.487� 0.86 2.16

France 12.078�� �1.068�� 0.437� 4.872��� 0.95 2.28

Hungary 49.455�� �0.550 �0.213 3.204 0.96 2.45

Iceland 27.981 �0.355 �0.469 �2.904 0.20 1.71

Japan 3.126 0.590 �0.249 10.292� 0.86 1.11

Luxembourg# 21.666�� �1.113 �0.284 3.651 0.69 1.90

Mauritius 1.060 0.033 �0.014 16.033� 0.45 2.03

Mexico 1.418 �0.084 0.018 �0.121 0.27 2.01

Netherlands 5.286 0.036 �0.021 2.712��� 0.96 1.62

New Zealand 11.322��� �0.282 �0.010 0.632 0.49 1.97

N. Ireland �1.602 �0.352 0.373� 4.721��� 0.65 2.13

Norway 0.242 �0.738�� 0.462 6.323��� 0.96 1.93

Portugal## 8.424��� �0.217 0.100 1.134 0.34 2.02

Puerto Rico 2.104 �0.078 0.273� 0.407 0.65 2.06

Scotland 6.653 �0.051 0.083 1.008 0.83 1.98

Sweden 12.078� �1.076 0.968� 0.337 0.58 2.03

Switzerland 15.412 0.924 �0.488 5.357 0.90 2.06

Taiwan 2.040 0.205 0.266� 2.649 0.80 2.10

USA 16.310��� �0.368�� �0.151��� 0.430��� 0.92 2.08

West Germany 26.757��� �0.754� �0.038 �0.359 0.80 1.87

Yugoslavia 32.110��� �1.175��� �0.242��� �3.701��� 0.93 1.28

positive 9 12 22

negative 20 17 7

significant & positive 0 6 12

significant & negative 6 4 1

# Interpolation used for one year of missing suicide rates.## Interpolation used for three years of missing suicide rates.���p < .001.��p < .01.�p < .05.

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predictors for the suicide rate—mar-riage, birth and divorce rates.1 Theresults are shown in Table 4. It can beseen that, in the majority of nations,suicide was negatively associated withbirth and marriage rates and positivelyassociated with the divorce rate.

The importance of these studiesusing a uniform methodology is thatthe research can then move to thesecond stage, namely predicting andexplaining the strength and the sign ofthe association in the sample of nations.For example, Durkheim’s (1897) classicsociological theory of suicide, based onthe levels of social integration andsocial regulation, would predict nega-tive associations between suicide ratesand both marriage and birth rates anda positive associationwith divorce rates.The question now is why, therefore, dothe results from Luxembourg fit thisprediction while the results fromAustralia are diametrically opposite. Atthe present time, such studies havenot been conducted on the variationin the associations reported above.

Lester and Yang (1998) exploredcorrelates of the stability of national sui-cide rates, and their study illustrates themethodology required. They foundthat, in a sample of 36 nations for theperiod 1960–1990, the standard devi-ation of the nation’s suicide rate waspositively associated with the suiciderate. Thus, nations with a higher suiciderate experienced greater variation intheir suicide rates during this 31 yearperiod. This is the type of study thatneeds to be conducted once compara-ble time-series regressions have beencarried out for a large sample of nations.

Regional Studies

Many studies have been conduc-ted on the social correlates of theregional variation of suicide withinnations, for example, Guttierez (1995)in Spain, Kerkhof and Kunst (1994)in the Netherlands and Ferrada-Noli(1997) in Sweden. Lester has conduc-ted such studies in 14 nations of theworld and conducted a meta-analysisof his results (Lester, 1998–1999). Asummary of his results for variablesexamined in six or more nations isshown in Table 5.

1Restricting the predictors to only marriageand birth rates, the sample of nations wasincreased to 36.

TABLE 5. Correlations between Suicide Rates and Social Variables over the Regionsof a Nation

Social Variable Number of Nations Weighted Average Correlation df

Birth rate 12 �0.08 373

Population size 10 �0.19� 265

Population density 9 �0.19� 242

Death rate 9 0.17� 219

Divorce rate 7 0.17� 259

Unemployment rate 7 �0.07 176

Marriage rate 6 0.35� 212

% elderly 6 0.20� 191

Infant mortality 6 �0.10 160

�significant at the .05 level or better.

D. Lester and B. Yang

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It can be seen that suicide rateswere consistently associated withpopulation size and population den-sity (negatively), and with death,marriage and divorce rates and thepercentage of elderly (positively).The correlations between suiciderates and population density wasnegative in 6 nations and positive in3 nations; the association betweensuicide rates and divorce rates waspositive in 4 nations and negative in2 nations. Thus, even where there isa consistent association, not allnations conform to the same pattern.

Clearly, then, not all nations showthe same association between thepopulation density of their differentregions (provinces, states or counties)and suicide rates or between divorcerates and suicide rates. There may bean overall trend, although there seemsto be many exceptions. Once thesetrends and deviations from the trendsare identified, then research can beginto explore what social factors deter-mine the deviations from the trends.

DISCUSSION

We have attempted to show in thisarticle that it is important to conductcomparable sociological studies ofsuicide rates in a large sample ofnations of the world. If this is done,then it is possible to identify whichresults are reliable and which arenot. It is more meaningful to con-clude that the reliable associationssupport (or do not support) someparticular theory of suicide.

Although Lester and Yang havedeveloped identical data sets for thetime-series analysis of suicide rates,the data sets for regional studies withinnations are not uniform. A different setof variables has been examined for

each nation. It is important in futureresearch to establish greater uniform-ity in these regional studies.

AUTHOR NOTE

David Lester, The Richard StocktonCollege of New Jersey, Pomona, NJ,USA.

Bijou Yang, Drexel University,Philadelphia, PA, USA.

Correspondence regarding thisarticle should be addressed to DavidLester, Ph.D., Psychology Program,The Richard Stockton College ofNew Jersey, Pomona, NJ, USA. E-mail:lesterd@stockton.edu

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