Is there a relationship between suicide and alcohol related mortality in Hungary? A spatial panel approach

Lajos Bálint, Hungarian Central Statistical Office (HCSO)

The association between alcohol and suicide has been demonstrated extensively. Several studies have confirmed that alcohol consumption is a serious risk factor for suicide at macro and micro level as well. Hungarian suicide rate has been outstandingly high for more than a century. In addition to this, alcohol induced mortality has been extremely high in Hungary for decades. The relationship of these two self-destructive behaviours is especially relevant in a country where both have played a permanent and prominent role in the prevailing high levels of mortality. The aim of this paper is to estimate how suicide mortality rates in Hungary were affected by alcoholic mortality at ecological level (N=175) between 1980 and 2014. The data were collected from vital statistics of the Hungarian Central Statistical Office. Alcohol consumption was substituted by mortality data. Alcohol related mortality was defined in two ways. According to the narrower definition, only alcohol-related liver diseases (ICD 9: 571.0-571.3, ICD 10: K70.0-K70.9) were taken into consideration. The other definition of alcohol induced deaths only includes those causes regarded as being most directly due to alcohol consumption. Standardized mortality rates were calculated for five- year periods which enabled the analysis of seven independent periods. Methods: Spatial fixed and random effect panel model were employed to assess the possible effect of alcohol related mortality on suicide. Findings: Investigation on an ecological level showed that alcohol mortality significantly and positively influenced suicide mortality. The effect was larger in the model based on broader definition of alcohol mortality and this model fitted slightly better. The traditional causal mechanism gave a satisfactory explanation for the relationship of suicide and alcohol-related mortality. Conclusion: The public health relevance of the study is that by reducing alcohol alcohol-related mortality, mortality resulting from suicide will also decrease.