BACKGROUND: Few studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis. METHODS: This ecological study of trends was based on three periods, two before the economic crisis (2000-2003, 2004-2008) and one during the crisis (2009-2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model. RESULTS: Among men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24-3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35-0.68) in the third period. CONCLUSIONS: Area socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied.

Agència de Salut Pública de Barcelona Barcelona Spain

CIBER Epidemiología y Salud Pública Madrid Spain

Department of Experimental and Health Sciences Universitat Pompeu Fabra Barcelona Spain

Department of Geography and Tourism Centre of Studies in Geography and Spatial Planning University of Coimbra Coimbra Portugal

Department of Health Psychology Medical Faculty P J Safarik University in Kosice Kosice Slovak Republic

Department of Hygiene Epidemiology and Medical Statistics Medical School National and Kapodistrian University of Athens Medical School Athens Greece

Department of Population Health Sciences and Department of Analytical Environmental and Forensic Sciences School of Population Health and Environmental Sciences King's College London UK

Department of Public Health Sciences Karolinska Institutet Stockholm Sweden

Department of Public Health University of Turin Turin Italy

Department of Social Geography and Regional Development Faculty of Science Charles University Prague Czechia

Department of Sociology Interface Demography Vrije Universiteit Brussel Brussels Belgium

Institut d'Investigació Biomèdica Barcelona Spain

Institute of Health Equity at the Research Department of Epidemiology and Public Health University College London London UK

Olomouc University Social Health Institute Palacky University in Olomouc Olomouc Czech Republic

Service of Environmental Quality and Intervention Agència de Salut Pública de Barcelona Barcelona Spain

Service of Health Information Systems Agència de Salut Pública de Barcelona Barcelona Spain

Service of Prevention and Attention of Drug Use Agència de Salut Pública de Barcelona Barcelona Spain

Unit of Research Training and Communication Agència de Salut Pública de Barcelona Barcelona Spain

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