Original Research Socio-economic inequalities in suicide attempts and suicide mortality in Que ´ bec, Canada, 1990–2005 S. Burrows a,b,c, *, N. Auger a,b,c , M. Roy d , C. Alix b a Research Centre of the University of Montreal Hospital Centre, 1301 rue Sherbrooke Est, Montre ´al, Que ´bec, H2L 1M3, Canada b Institut national de sante ´ publique du Que ´bec, Montre ´al, Que ´bec, Canada c Department of Social and Preventive Medicine, Universite ´ de Montre ´al, Montre ´al, Que ´bec, Canada d Montre ´al Public Health Department, Re ´gie re ´gionale de Montre ´al-Centre, Que ´bec, Canada article info Article history: Received 13 July 2009 Received in revised form 30 November 2009 Accepted 13 January 2010 Available online 23 February 2010 Keywords: Suicide Suicide attempts Socio-economic factors Deprivation Que ´ bec Area analysis summary Objectives: Little research has evaluated changes in the association between area depriva- tion and suicidal behaviour over time. This study investigated patterns in suicide attempts and suicide mortality according to material deprivation in the province of Que ´ bec, Canada between 1990 and 2005. Study design: Ecological analysis. Methods: Data on suicide attempts were extracted from the hospital discharge summary database (n ¼ 47,516) and data on suicides were extracted from the Que ´ bec death file (n ¼ 20,851). Gender- and age-specific (10–24, 25–44, 45–64 and 65 years) suicide attempt and mortality rates were calculated for four time periods (1990–1993, 1994–1997, 1998–2001 and 2002–2005) for the entire Que ´ bec population aged 10 years and older residing in 162 communities ranked by decile of material deprivation. Absolute and relative measures of inequality were calculated to summarize differences between the most and least materi- ally deprived areas. Commonly used methods of suicidal behaviour were examined. Results: Differentials in suicide attempt hospitalization between the most and least deprived areas were present for all age groups, and these decreased slightly among males and increased among females over time. Inequalities in suicide attempts were greatest among young adults (age 25–44 years) for both genders, and were smallest among the elderly (65 years). For suicide mortality, differentials increased among females but not males; these differentials were greatest among males and 25–44 year olds, and smallest among the elderly. Differentials in commonly used methods were evident for poisoning hospitalizations in both genders and for hanging deaths among males. Conclusions: In Que ´ bec, differences in suicide attempts and mortality between the most and least materially deprived areas persisted or even increased over time. Inequalities were more pronounced for suicide attempts than for suicide mortality, and were greatest among adults of working age. Strategies to reduce socio-economic differences in suicidal behav- iour may be important. ª 2010 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. * Corresponding author at: Research Centre of the University of Montreal Hospital Centre, 1301 rue Sherbrooke Est, Montre ´ al, Que ´ bec, H2L 1M3, Canada. Tel.: þ1 514 528 2400x3507. E-mail address: stephanie.burrows@sympatico.ca (S. Burrows). available at www.sciencedirect.com Public Health journal homepage: www.elsevierhealth.com/journals/pubh public health 124 (2010) 78–85 0033-3506/$ – see front matter ª 2010 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. doi:10.1016/j.puhe.2010.01.008