Analysis of suicide monitoring data at smaller specified units of geography and time, and considering possible associations with other causes of death, has the potential to provide important information upon which to design prevention and intervention initiatives. We constructed and analysed a subset of the National Mortality database which included Australian wide deaths occurring and registered between 2001 and 2020. Deaths data are aggregated to 2016 Australian Statistical Geography Standard (2016 ASGS) Statistical Area Level 2 (SA2) spatial areas, single month time units, sex, and broad age group. Using primary cause, deaths were grouped according to whether the individual died by suicide, another ‘death of despair’ (alcoholic liver disease and cirrhosis, or accidental poisonings), or any other cause of death. Our study aimed to: 1) describe suicide and other ‘deaths of despair’; 2) analyse factors associated with suicide and ‘deaths of despair’, including socioeconomic status and remoteness; 3) identify spatiotemporal clusters of suicide deaths; and 4) explore whether clusters of suicide deaths are associated with clustering of other ‘deaths of despair.’
We find that when we control for population size, there was not a large increase or decrease in suicide over the last twenty-years in Australia, though there is still some year-on-year fluctuation. We find some monthly variability in suicide deaths, with the lowest rate of suicide occurring in mid-late Spring and early Winter. We find similar age and sex patterns to the national level data, but show that remoteness, rather than socioeconomic status is the more consistent predictor of suicide deaths. We show that although some of the spatiotemporal determinants of other deaths of despair (deaths due to alcohol or poisoning) are different than those for suicide, a high rate of other deaths of despair in an area is associated with a high rate of suicide, even when spatiotemporal factors are controlled for. We do show, however, that deaths from all other causes are a better predictor of deaths due to suicide, giving some support to the view that in Australia at least the three categories of deaths of despair do not correlate with each other in a particularly strong way.