Urbanicity and methods of suicide: a nationwide population-based study.

Despite urban-rural disparities in suicide rates having been reported in prior studies, there is scant information on the impact of urbanicity on suicide methods. This study investigates violent and nonviolent suicide methods in Taiwan and their association with urbanicity. We use a Taiwanese nationwide mortality database covering the period January 1997 to December 2003. A multilevel logistic regression analysis was performed to examine the relationship between urbanicity and violent/nonviolent suicide methods after adjusting for the age, gender, marital status and employment status of the victims, and the seasons during which the deaths occurred to account for possible dependence within cities/towns. Of the total of 17,849 suicide deaths examined, those residing in more urbanized areas tended to commit suicide by violent methods, an association that remains after controlling for the age, gender, marital and employment status of the victims, and the season during which the deaths occurred. We concluded that a significant association is noted between urbanicity and suicide methods. Thus, effective strategies for suicide prevention should also consider urbanicity.