  Background: Neighbourhood social fragmentation and socioeconomic deprivation
seem to be associated with suicide mortality. However, results are
inconclusive, which might be because dynamics in the social context are not
well-represented by administratively bounded neighbourhoods at baseline. We
used individualized neighbourhoods to examine associations between suicide
mortality, social fragmentation, and deprivation for the total population as
well as by sex and age group. Methods: Using a nested case-control design, all
suicides aged 18-64 years between 2007 and 2016 were selected from longitudinal
Dutch register data and matched with 10 random controls. Indices for social
fragmentation and deprivation were calculated annually for 300, 600, and 1,000
metre circular buffers around each subject's residential address. Results:
Suicide mortality was significantly higher in neighbourhoods with high
deprivation and social fragmentation. Accounting for individual characteristics
largely attenuated these associations. Suicide mortality remained significantly
higher for women living in highly fragmented neighbourhoods in the fully
adjusted model. Age-stratified analyses indicate associations with
neighbourhood fragmentation among women in older age groups (40-64 years) only.
Among men, suicide risk was lower in fragmented neighbourhoods for
18-39-year-olds and for short-term residents. In deprived neighbourhoods, the
suicide risk was lower for 40-64-year-old men and long-term residents.
Associations between neighbourhood characteristics and suicide mortality were
comparable across buffer sizes. Conclusion: Our findings suggest that next to
individual characteristics, the social and economic context within which people
live may both enhance and buffer the risk of suicide.
