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Individual and community factors for railway suicide: a matched case–control study in Victoria, Australia

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Abstract

Purpose

This study aims to simultaneously examine individual- and community-level factors associated with railway suicide.

Methods

We performed a case–control study in Victoria, Australia between 2001 and 2012. Data on cases of railway suicide were obtained from the National Coronial Information System (a database of coronial investigations). Controls were living individuals randomly selected from the Household, Income and Labour Dynamics in Australia study, matching to cases on age groups, sex and year of exposures. A conditional logistic regression model was used to assess the individual-level and community-level influences on individual odds of railway suicide, controlling for socioeconomic status.

Results

Individual-level diagnosed mental illness increased railway suicide odds by six times [95 % confidence interval (CI) 4.5, 9.2]. Community-level factors such as living in an area with a presence of railway tracks [odds ratio (OR) 1.8, 95 % CI 1.2, 2.8], within a city (OR 3.2, 95 % CI 1.9, 5.4), and with a higher overall suicide rate (OR 1.02, 95 % CI 1.01, 1.04) were independently associated with greater individual odds of railway suicide compared to living in an area without a presence of railway tracks, outside a city, and with a relatively lower overall suicide rate.

Conclusions

The effects of mental illness and high incidence of overall suicides are prominent, but not specific on railway suicide. The effects of presence of railway tracks and city residence suggest the importance of accessibility to the railways for individual risk of railway suicide. Prevention efforts should focus on vulnerable people live in areas with easy access to the railways.

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Acknowledgments

The authors acknowledge the Department of Justice and Regulation for granting access to the National Coronial Information System, the Coroners Court of Victoria for providing us railway suicide data for cross-referencing, and Ms Nadia Polikarpowski (NCIS Coder at the Coroners Court of Victoria) for her assistance in data collection. We also thank the Victorian railway regulators and operators (from the Department of Transport, Planning and Local Infrastructure, Public Transport Victoria, Victrack, Metro trains, V/Line, Australian Rail Track Corporation and Transport Safety Victoria), HILDA, the Australian Bureau of Statistic, Victorian Commission for Gambling and Liquor Regulation and the Victoria Police for providing data. This study used unit record data from the HILDA Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either FaHCSIA or the Melbourne Institute.

Author information

Authors and Affiliations

  1. Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia

    Lay San Too & Matthew J. Spittal

  2. Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3006, Australia

    Lyndal Bugeja

  3. Harvard Injury Control Research Center, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Roderick McClure

  4. Deakin Population Health SRC, School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia

    Allison Milner

  5. Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia

    Allison Milner

Authors
  1. Lay San Too
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  2. Matthew J. Spittal
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  3. Lyndal Bugeja
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  4. Roderick McClure
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  5. Allison Milner
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Corresponding author

Correspondence to Lay San Too.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was approved by the Health Sciences Human Ethics Committee (the University of Melbourne) and the Justice Human Research Ethics Committee (State Government Victoria) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Too, L.S., Spittal, M.J., Bugeja, L. et al. Individual and community factors for railway suicide: a matched case–control study in Victoria, Australia. Soc Psychiatry Psychiatr Epidemiol 51, 849–856 (2016). https://doi.org/10.1007/s00127-016-1212-9

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  • DOI: https://doi.org/10.1007/s00127-016-1212-9

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