Evolving sex differences in suicide mortality by age in Spain, 2000-2023: a nationwide trend analysis
AI Summary
Overall age-adjusted suicide rate stable (AAPC -0.4%); male rates declined while female rates remained broadly stable with increases in selected groups.
Suicide mortality rose sharply with age, especially men aged 70+, and male-to-female ratio peaked at 10.74 in the 95+ age group.
Male-to-female ratio narrowed in 15-29, 50-54, 75-79, 80-84 age groups, mainly from falling male rates; midlife female increases need targeted prevention.
J Epidemiol Community Health. 2026 May 22:jech-2025-225558. doi: 10.1136/jech-2025-225558. Online ahead of print.
ABSTRACT
INTRODUCTION: Sex disparities in suicide mortality persist worldwide, with male rates 2-4 times higher than female rates, but age-specific patterns over time remain insufficiently understood.
AIM: To examine long-term trends in suicide mortality in Spain (2000-2023), focusing on sex-specific and age-specific differences and the evolution of the male-to-female suicide rate ratio.
METHODS: We conducted a longitudinal study using national mortality data from the Spanish Statistical Office. Crude and age-adjusted suicide rates were calculated by sex and age group. Joinpoint regression assessed temporal trends and male-to-female rate ratios across 15 age groups.
RESULTS: The overall age-adjusted rate showed no significant change (average annual percent change: -0.4%), with a significant decrease among men (-0.7%) and stable overall rates among women, while increases were observed in selected female age groups. Rates increased with age, particularly among men aged 70+. The male-to-female ratio widened with age, reaching 10.74 in the 95+ group, but narrowed over the study period in four age groups (15-29, 50-54, 75-79, 80-84), mainly due to declining male rates.
CONCLUSION: Despite modest changes over time, marked age-related sex disparities persist. Older men remain the highest-risk group, while increases among women in midlife warrant targeted prevention.
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