Suicide and intentional self-harm hospitalisations by socioeconomic areas

Suicide by socioeconomic areas

There is a strong association between socioeconomic status and deaths by suicide. Age-standardised rates and numbers of deaths by suicide tend to be higher for those living in lower socioeconomic areas (more disadvantaged areas). However, it is important to remember that suicide can affect all Australians and each person’s experience is unique; not everyone who lives in these areas will experience suicidal behaviours.

Highest rates of suicide occur in lowest socioeconomic areas

From 2001 to 2023, age-standardised suicide rates were highest for those who lived in the lowest socioeconomic areas (most disadvantaged areas) and generally decreased as the level of disadvantage lessened.

In 2023, the suicide rate for people living in the lowest socioeconomic (most disadvantaged) areas (17.3 deaths per 100,000 population; Quintile 1) was more than twice that of those living in the highest socioeconomic (least disadvantaged) areas (7.4 deaths per 100,000 population; Quintile 5). Similarly, the number of deaths by suicide generally declined as socioeconomic disadvantage decreased.

Suicide rates increased over time in lowest socioeconomic areas

Overall, age-standardised suicide rates increased for those living in the lowest socioeconomic areas (Quintile 1); from 14.0 deaths per 100,000 population in 2001 to 17.3 deaths per 100,000 population in 2023. In contrast, smaller change was observed for those living in the higher socioeconomic areas (Quintiles 4 and 5).

Henley and Harrison (2019) found that over the period 2009–10 to 2015–16, suicide rates increased significantly for those living in the lowest socioeconomic areas (most disadvantaged) by an average 3.5% per year while little change was observed for those in the highest (least disadvantaged) socioeconomic areas (0.2% change per year).

Socioeconomic status classifies individuals according to the socioeconomic characteristics of the area in which they lived prior to their death by suicide. More information is available on the ABS website, ABS Index of Relative Socio-Economic Disadvantage (IRSD). 

Methods of suicide vary by socioeconomic areas

The classification system used to code causes of deaths data, ICD-10, uses the term ‘mechanism’ to refer to the external cause of death. Throughout Suicide & self-harm monitoring website, ‘mechanism’ has been used in data visualisations, while the term ‘method’ has been used in the accompanying text.

Throughout 2001 to 2023, age-standardised suicide rates generally decreased with decreasing socioeconomic disadvantage for hanging (ICD-10 X70). In 2023 the rate of suicide by hanging for those living in the lowest socioeconomic areas (Quintile 1) was 2.6 times that of those living in the highest socioeconomic areas (Quintile 5) (11.4 vs 4.4 deaths per 100,000 population).

There was little difference in suicide rates between socioeconomic areas for poisoning excluding gas (ICD-10 X60–X66, X68–X69), firearms (ICD-10 X72–X75), poisoning by gas (ICD-10 X67), or other methods (ICD-10 X71, X76–X84, Y87.0).

Between 2001 and 2023, the proportion of all deaths by suicide that occurred due to exposure to poisonous substances, excluding gas, or by other methods generally increased with decreasing socioeconomic disadvantage. Whereas the proportion of all deaths by suicide completed by hanging tended to decrease as socioeconomic disadvantage increased.

Intentional self-harm hospitalisations by socioeconomic areas

Socioeconomic area classifies individuals according to the socioeconomic characteristics of the area in which they live. These areas are defined using the ABS Index of Relative Socio-Economic Disadvantage (IRSD), which reflects the average level of socioeconomic disadvantage of the area (see Technical notes for more information). 

Does socioeconomic area affect risk of hospitalisation for intentional self-harm?

Rates of hospitalisations for intentional self-harm tend to be higher for those living in lower socioeconomic (more disadvantaged) areas.  

In 2023–24:

• the rate for the most disadvantaged areas (Quintile 1) was 122 hospitalisations per 100,000 population, which is 1.9 times the rate for the least disadvantaged areas (Quintile 5; 66 per 100,000 population).

This is a similar pattern to suicide rates in 2023.

How have rates of intentional self-harm hospitalisations changed for socioeconomic areas?

From 2012–13 to 2023–24:

• the highest proportion of intentional self-harm hospitalisations was for people living in the lowest socioeconomic (most disadvantaged) areas; this proportion has remained relatively stable over the period, averaging around 24%
• rates for males in the lowest socioeconomic areas, Quintile 1 and 2, increased from 122 and 100 hospitalisations per 100,000 in 2012–13 to 140 and 113 in 2016–17, respectively, before decreasing to 88 and 71 hospitalisations per 100,000 population in 2023–24
• rates for females in the lowest (most disadvantaged) socioeconomic areas (Quintile 1) also increased from 189 in 2012–13 to 223 in 2016–17 and then decreased to 155 in 2023–24.

The highest age-specific rates of hospitalisations were for males and females in the lowest socioeconomic areas (Quintile 1). Rates for females were highest among 25–44 year olds between 2012–13 and 2018–19 and 0–24 year olds from 2019–20 to 2023–24. For males, the highest rates for the whole period were among 25–44 year olds.  

• Age-specific rates for intentional self-harm hospitalisations increased for all socioeconomic areas in females aged 0–24 from 2012–13 to 2020–21 before decreasing.
• Rates for females aged 25–44 in Quintile 1 increased from 256 per 100,000 population in 2012–13 to 294 in 2016–17 before falling to 191 in 2022–23. In 2023–24, the rate of intentional self-harm hospitalisation among females aged 25–44 in the lowest socioeconomic areas was 193 per 100,000 population. 
• Rates for males aged 25–44 in Quintile 1 ranged from 207 in 2012–13 to 230 in 2016–17 then fell to 128 in 2023–24.

An increase in the rate of hospitalisations due to intentional self-harm for all socioeconomic areas was reported in 2016–17, which may be due to increases in hospitalisations in some states. Variation in hospital admission policy and practices between states and territories may have contributed to differences in the reporting of hospitalisation data. For further information, see the data quality statement.

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Supplementary tables

• Deaths due to suicide 2023 – National Mortality Database
• Hospitalisations for intentional self-harm 2023–24 – National Hospital Morbidity Database
  
  

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