The Unequal Global Geographic Distribution of Suicide: Spatial Patterns and Its Relationship with Alcohol

Objective To demonstrate inequalities in the distribution of the global suicide rate, a key component of deaths of despair, using spatial autocorrelation, and to evaluate, using spatial analyses, the association of suicide with sociodemographic variables, particularly alcohol consumption. Methods Using suicide data from the 2017–2021 period, five-year average age-standardized suicide rates were calculated, and their spatial autocorrelation was examined. In addition, the relationship between suicide and alcohol consumption was evaluated using Bivariate Moran’s I, while other potential predictors related to suicide were analyzed using spatial regression models. Furthermore, Lorenz curves were used to demonstrate the unequal distribution of suicide rates and the other variables, and Gini coefficients were calculated. Results The spatial autocorrelation of suicide rates was high, and clusters were evident. Regions where suicide rates clustered at high levels were Eastern Europe and South Africa, while low-rate clusters were observed particularly in the Middle East. However, the clusters showed some differences by sex. In spatial regression models, unemployment, economic freedom, and population density were found to be factors affecting suicide. Conclusion The fact that suicide rates show a marked spatial autocorrelation on a global scale may provide an indication for more detailed regional investigations. In the regression models, the different effects of unemployment, economic freedom, population density, and alcohol consumption by sex may highlight the importance of gender-based approaches in suicide prevention policies.