ArticleBMC public health2017
Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis.
Article in BMC public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 39 citations in OpenAlex.
- What Women Want: Mental Health in the Context of Violence Against Women in Sri Lanka-A Qualitative Study of Priorities and Capacities for Care.Violence against women · 2025Article
- Article
- The Spatio-Temporal Distribution of Suicide-related Emergency Calls in a European City: Age and Gender Patterns, and Neighborhood Influences.Psychosocial intervention · 2024Article
- Intimate partner violence, suicide and self-harm in Sri Lanka: Analysis of national data.PloS one · 2024Article
- Evaluating the programme and behavior change theories of a community alcohol education intervention in rural Sri Lanka: a study protocol.Global health action · 2023Article
- The effect of the COVID-19 pandemic on the trends and characteristics of natural and unnatural deaths in an urban Sri Lankan cohort viewed through retrospective analysis of forensic death investigations from 2019 to 2022.Osong public health and research perspectives · 2023Article
- Spatiotemporal Patterns of Suicide in Korea From 2009 to 2019 Using Geographic Information Systems.Alpha psychiatry · 2023Article
- Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries.Social psychiatry and psychiatric epidemiology · 2022Article
- Sex education and self-poisoning in Sri Lanka: an explorative analysis.BMC public health · 2022Article
- Hospital presentations for self-poisoning during COVID-19 in Sri Lanka: an interrupted time-series analysis.The lancet. Psychiatry · 2021Article
- Is being a 'left-behind' child associated with an increased risk of self-poisoning in adulthood? Findings from a case-control study in Sri Lanka.BMJ global health · 2021Article
- Addressing Psychosocial Vulnerabilities Through Antenatal Care-Depression, Suicidal Ideation, and Behavior: A Study Among Urban Sri Lankan Women.Frontiers in psychiatry · 2021Article
- Exploration of associations between deliberate self-poisoning and psychiatric disorders in rural Sri Lanka: A case-control study.PloS one · 2021Article
- Regional Variation of Suicide Mortality in South Korea.International journal of environmental research and public health · 2020Article
- A qualitative exploration of rural and semi-urban Sri Lankan men's alcohol consumption.Global public health · 2020Article
- Article
- Childhood adversity and deliberate self-poisoning in Sri Lanka: a protocol for a hospital-based case-control study.BMJ open · 2019Article
- Socio-demographic and economics factors associated with suicide mortality in Iran, 2001-2010: application of a decomposition model.International journal for equity in health · 2018Article
- Attempted suicide in Sri Lanka - An epidemiological study of household and community factors.Journal of affective disorders · 2018Article
- What calls for service tell us about suicide: A 7-year spatio-temporal analysis of neighborhood correlates of suicide-related calls.Scientific reports · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundBetween 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka's 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period.
methodsWe mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka's suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman's rank correlation and negative binomial models.
resultsThe rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = -0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = -0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively.
conclusionsThe findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka's suicide rate, but the impact of other factors cannot be ruled out.
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