Changing patterns of suicide in a poor, rural county over the 20th century: a comparison with national trends.

Rural suicide rates have been shown to be disproportionately high in several countries. This study compares suicide rates in Cornwall with the rest of England and Wales over a 90-year period (1911-2001). Age and sex standardised mortality ratios were calculated for suicide and undetermined death for Cornwall standardised to England and Wales. From 1911 until the start of the Second World War, suicide rates were lower in Cornwall than England and Wales. Since the 1960s suicide rates in Cornwall have risen significantly above England and Wales. We have shown that the suicide rate in a poor, rural area has increased disproportionately compared to England and Wales over the last 35 years. This change has occurred in both sexes. Prior to this period the suicide rate was lower or about the same as that in England and Wales.