Sex differences in death by suicide versus the rest of external causes of death across the lifespan. A population study

Background and Objectives

Men, compared to women, have higher rates of mortality by suicide and the rest of external causes in all age groups. However, it is unclear if the higher tendency of men to die by suicide, it is largely related to men higher propensity to die by external causes in general. As far as we know, only one study (US population) assessed sex differences in suicide versus other external causes of death, finding important differences across the lifespan. Thus, our study aims to assess, in Spanish population, if there are differences between sexes in death by suicide versus the rest of external causes of death and its variation across lifespan.

Methods

Cross-sectional study of all Spanish residents that died from suicide and rest of external causes between 2016 and 2018, and which consisted of 45,389 fatalities. To assess sex differences in deaths by suicide versus the rest of external causes of death, we built logistic regression models stratifying by age groups.

Results

Compared to women who died by external causes, men who died by external causes had OR (95 % CI) of 1.94(1.85–2.03) of dying by suicide. The OR were 0.78 (0.64–0.96), 0.57 (0.49–0.67), 0.73 (0.64–0.84) and 0.75 (0.65–0.85) for those 25–34, 35–44, 45–54 and 55–64 years respectively. For those 65–74, 75–84 and ≥ 85 years the trend changed, and OR were 1.15 (1.01–1.31), 2.38 (2.10–2.72), and 3.81 (3.28–4.44) respectively.

Conclusions

Men, compared to women, are more likely to die by suicide versus the rest of external deaths. Nevertheless, there are important differences across the lifespan.