Aims: To describe the epidemiology of Suicide in Tuscany according to the triad of time, place and person.
Methods: The 4,764 cases of suicide, defined according to categories E950-E959 of ICD-9 in Tuscany over the period 1988-2002, were obtained from the Tuscan Mortality Register. Mortality indicators were calculated and analyzed. The spatial analysis was carried out by deriving Empirical Bayes Estimates for the 287 municipalities.
Results: The crude mortality rate in the 2000-2002 is 7.8 per 100000 population (male: 12.4; female: 3.5). The age-standardized rate in the 2000-2002 is 5.8 per 100,000 population (male: 9.6; female: 2.6). The highest risk for suicide, especially in the case of males, are concentrated in the southern hinterland Tuscany, in a cluster of rural municipalities that represent the old mining district of Tuscany. The SMRs according to residential municipality (population per square kilometre), confirm a greater risk of suicide for males residing in rural communities.
Conclusions: The cluster of excessive mortality from suicide in Southern Tuscany could be the consequence of social determinants, related to the urban and social crisis following agriculture decline and mine closure.