Time trend by region of suicides and suicidal thoughts among Greenland Inuit

Abstract

BackgroundSuicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys.ObjectiveTo analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland.DesignData included the Greenland registry of causes of death for 1970–2011 and 2 cross-sectional health surveys carried out in 1993–1994 and 2005–2010 with 1,580 and 3,102 Inuit participants, respectively.ResultsSuicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group.ConclusionSuicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.

A scoping review

“…H. Karsberg, Lasgaard, & Elklit, 2012;Omma, Jacobsson, & Petersen, 2012;Omma et al, 2013). In Greenland suicide rates were found to be higher among men than women while the prevalence of suicidal thoughts was higher among women (Bjerregaard & Larsen, 2015). The highest suicide rate is found among young men aged 20-24.…”

“…Gender differences in suicide rates and risk factors have been identified by multiple studies Bania, Lydersen, & Kvernmo, 2016;Bjerregaard & Larsen, 2015;Fraser, Geoffroy, Chachamovich, & Kirmayer, 2015;S. H. Karsberg, Lasgaard, & Elklit, 2012;Omma, Jacobsson, & Petersen, 2012;Omma et al, 2013).…”

“…Furthermore, it is necessary to study the social and cultural changes occurring in Inuit and Sami societies and more specifically the gender differences in socialisation (Bals, Turi, Vitterso, et al, 2011;Bjerregaard & Larsen, 2015;Fraser et al, 2015;Lehti et al, 2009;Omma et al, 2012;Rasmus et al, 2014). Studying the details of socio-cultural changes will help in identifying the causes of mental problems in general (Lehti et al, 2009;Omma et al, 2012).…”

“…One of the main findings in the report 'Sharing Hope', a comprehensive report that documented and evaluated best practices in mental wellness-related interventions in circumpolar regions, was the fact that "suicide prevention requires culturally-grounded solutions that are community-based and community-driven" (SDWG, 2015). When looking at the regional differences of suicide rates over time, as done in Greenland, it becomes clear that strategies for prevention need to consider the different temporal patterns, disparities in living conditions and local context (Bjerregaard & Larsen, 2015 Broad community-based approaches for prevention can entail clinicians and frontline workers screening for risk factors in indigenous communities with attention to gender differences MIO, 2017aMIO, , 2017bMIO, , 2017dMota et al, 2012;Redvers et al, 2015;Reigstad & Kvernmo, 2017), enhancing teachers' ability to detect symptoms and problems as well as providing low threshold health services from primary school onwards Chachamovich et al, 2015;MIO, 2017aMIO, , 2017bMIO, , 2017d, and/or fostering parenting skills in young families Chachamovich et al, 2015;Kral et al, 2011;MIO, 2017aMIO, , 2017bMIO, , 2017d. The latter approach has shown to provide promising results such as decreasing rates of maladaptive behaviours and long-term mental health outcomes (Chachamovich et al, 2015).…”

“…A great amount of the selected literature pointed out the importance of developing culturally and locally relevant interventions (Bals et al, 2010;Bjerregaard & Larsen, 2015;DeCou et al, 2013;Fraser et al, 2015;Redvers et al, 2015), for example to strengthen Inuit and Sami populations' traditional ways with the aim to prevent suicide (DeCou et al, 2013). One of the main findings in the report 'Sharing Hope', a comprehensive report that documented and evaluated best practices in mental wellness-related interventions in circumpolar regions, was the fact that "suicide prevention requires culturally-grounded solutions that are community-based and community-driven" (SDWG, 2015).…”