Socio-Economic Determinants of Suicide Rates in Transforming China: A Spatial-Temporal Analysis from 1990 to 2015

Background China has experienced dramatic economic and social changes in the last three decades. The aims of this study were to investigate socio-economic factors related to suicide rates in China from 1990 to 2015, and to examine how the impacts of these factors on suicide rates changed over time.Methods This study made use of suicide rates in 31 provinces in mainland China over 1990–2015 from the Global Burden of Disease (GBD) Study 2019. Spatial autoregression with provincial- and time-fixed effects was adopted to assess the effects of socio-economic factors on provincial suicide rates.Findings Suicide rates in all provinces decreased from 1990 to 2015, and there was considerable spatial variation regarding the magnitude of change.  Economic development and urbanisation initially played an important role in lowering suicide rates in the first decade, but their protective role has diminished over time. The association between employment and suicide rates has shifted from positive to negative over the study period. The effects of divorce on increasing female suicide rates started to emerge in recent years, while the mitigating effect of children on female suicide rates has strengthened. Migration was a constant risk factor for higher suicide rates over the study period.Interpretation This study highlighted the dynamic effects of economic and social factors on suicide rates in the context of transforming China. Addressing China’s suicide rate presents ongoing challenges. To achieve further reduction cannot merely rely on improving people’s materialistic and economic conditions. A more holistic approach to improve overall well-being among the population is needed. Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: MISSING