Insights into rates, risks and characteristics of suicide by immigration background in Norway
Although most immigrants seem to successfully manage
the challenges their immigration process entails, suicide
mortality of minority groups has become an important
public concern, particularly in countries with growing
segments of immigrant populations such as Norway. The
present article aimed to summarize insights into suicide
among various immigrant populations, obtained by
three Norwegian studies we recently conducted utilizing
the unique possibilities of national population registers.
First-generation immigrants had a relatively lower risk
of suicide than native Norwegians, whereas the risks for
people with mixed Norwegian and immigrant background
were significantly higher. Suicide risk was associated with a
range of socio-economic disadvantages in all populations,
but the strength of the association differed by specific immigration
background, with a generally weaker association in
first-generation-immigrants than natives. In the meantime,
there were notable differences in characteristics of suicide
by immigration background with respect to method of
suicide, month of the year when suicide occurred, and time
to suicide since immigration. All these insights underscore
the importance of treating immigrants as a very heterogeneous
group, and differences in suicides by specific
immigration background should be considered when
planning public health policies and prevention measures
in order to more effectively tailor these measures to at-risk
Alpers, P., & Marcus, W. (2018). Norway — Gun Facts, Figures and the Law. Retrieved from http://www.gunpolicy.org/firearms/region/norway
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Soc Sci Med, 51(6), 843-857.
Bhugra, D. (2004). Migration and mental health. Acta psychiatrica scandinavica, 109(4), 243-258.
Bhugra, D., & Becker, M. A. (2005). Migration, cultural bereavement and cultural identity. World psychiatry, 4(1), 18.
Bramness, J. G., Walby, F. A., Morken, G., & Røislien, J. (2015). Analyzing seasonal variations in suicide with Fourier Poisson time-series regression: a registry-based study from Norway, 1969–2007. American journal of epidemiology, 182(3), 244-254.
Burvill, P. (1998). Migrant suicide rates in Australia and in country of birth. Psychol Med, 28(01), 201-208.
Christodoulou, C., Efstathiou, V., Bouras, G., Korkoliakou, P., & Lykouras, L. (2012). Seasonal variation of suicide. A brief review. Encephalos, 49, 73-79.
Clayton, D., Hills, M., & Pickles, A. (1993). Statistical models in epidemiology (Vol. 161). Oxford: Oxford University Press.
Collett, D. (1991). Modelling binary data. London: Chapman & Hall/CRC.
Dalgard, O. S., & Thapa, S. B. (2007). Immigration, social integration and mental health in Norway, with focus on gender differences. Clinical Practice and Epidemiology in Mental Health, 3(1), 24.
Di Thiene, D., Alexanderson, K., Tinghög, P., La Torre, G., & Mittendorfer-Rutz, E. (2015). Suicide among first-generation and second-generation immigrants in Sweden: association with labour market marginalisation and morbidity. J Epidemiol Community Health, 69(5), 467-473.
Gabennesch, H. (1988). When promises fail: a theory of temporal fluctuations in suicide. Social Forces, 67(1), 129-145.
Hakko, H., Räsänen, P., & Tiihonen, J. (1998). Seasonal variation in suicide occurrence in Finland. Acta psychiatrica scandinavica, 98(2), 92-97.
Hanigan, I. C., Butler, C. D., Kokic, P. N., & Hutchinson, M. F. (2012). Suicide and drought in new South Wales, Australia, 1970–2007. Proceedings of the National Academy of Sciences, 109(35), 13950-13955.
Henrik Mäkinen, I., & Wasserman, D. (2003). Suicide mortality among immigrant Finnish Swedes. Arch Suicide Res, 7(2), 93-106.
Henriksen, K., Østby, L., & Ellingsen, D. (2011). Immigration and immigrants 2010. Retrieved from https://www.ssb.no/en/befolkning/artikler-og-publikasjoner/
Hjern, A., & Allebeck, P. (2002). Suicide in first-and second-generation immigrants in Sweden A comparative study. Soc Psychiatry Psychiatr Epidemiol, 37(9), 423-429.
Hjern, A., Lindblad, F., & Vinnerljung, B. (2002). Suicide, psychiatric illness, and social maladjustment in intercountry adoptees in Sweden: a cohort study. Lancet, 360(9331), 443-448.
Holopainen, J., Helama, S., Björkenstam, C., & Partonen, T. (2013). Variation and seasonal patterns of suicide mortality in Finland and Sweden since the 1750s. Environmental health and preventive medicine, 18(6), 494.
Ide, N., Kolves, K., Cassaniti, M., & De Leo, D. (2012). Suicide of first-generation immigrants in Australia, 1974–2006. Soc Psychiatry Psychiatr Epidemiol, 47(12), 1917-1927.
Johansson, L. M., Sundquist, J., Johansson, S. E., Bergman, B., Qvist, J., & Träskman-Bendz, L. (1997). Suicide among foreign-born minorities and Native Swedes: an epidemiological follow-up study of a defined population. Soc Sci Med, 44(2), 181-187.
Johansson, L. M., Sundquist, J., Johansson, S. E., Qvist, J., & Bergman, B. (1997). The influence of ethnicity and social and demographic factors on Swedish suicide rates. A four year follow-up study. Soc Psychiatry Psychiatr Epidemiol, 32(3), 165-170.
Karasouli, E., & Adams, A. (2014). Assessing the evidence for e-resources for mental health self-management: a systematic literature review. JMIR mental health, 1(1).
Kennedy, S., McDonald, J. T., & Biddle, N. (2006). The healthy immigrant effect and immigrant selection: evidence from four countries. In: Citeseer.
Kliewer, E. (1991). Immigrant suicide in Australia, Canada, England and Wales, and the United States. J Aust Popul Assoc, 8(2), 111-128.
Kliewer, E. V., & Ward, R. (1988). Convergence of immigrant suicide rates to those in the destination country. Am J Epidemiol, 127(3), 640-653.
Kposowa, A. J., McElvain, J. P., & Breault, K. D. (2008). Immigration and suicide: The role of marital status, duration of residence, and social integration. Arch Suicide Res, 12(1), 82-92.
Kyung-Sook, W., SangSoo, S., Sangjin, S., & Young-Jeon, S. (2018). Marital status integration and suicide: A meta-analysis and meta-regression. Soc Sci Med, 197, 116-126. doi:10.1016/j.socscimed.2017.11.053
Law, C.-k., Kõlves, K., & De Leo, D. (2014). Suicide mortality in second-generation migrants, Australia, 2001–2008. Soc Psychiatry Psychiatr Epidemiol, 49(4), 601-608.
Marmot, M. G., Adelstein, A. M., & Bulusu, L. (1984). Lessons from the study of immigrant mortality. Lancet, 323(8392), 1455-1457.
Mirsky, J., Kohn, R., Dolberg, P., & Levav, I. (2011). Suicidal behavior among immigrants. Soc Psychiatry Psychiatr Epidemiol, 46(11), 1133-1141.
Mirsky, J., Kohn, R., Levav, I., Grinshpoon, A., & Ponizovsky, A. M. (2008). Psychological distress and common mental disorders among immigrants: results from the Israeli-based component of the World Mental Health Survey. J Clin Psychiatry, 69(11), 1715-1720.
Norredam, M., Garcia-Lopez, A., Keiding, N., & Krasnik, A. (2010). Risk of mental disorders in family reunification migrants and native Danes: a register-based historically prospective cohort study. International journal of public health, 55(5), 413.
Nystadnes, T. (2010). Identifikatorer for personer. Retrieved from Petridou, E., Papadopoulos, F. C., Frangakis, C. E., Skalkidou, A., & Trichopoulos, D. (2002). A role of sunshine in the triggering of suicide. Epidemiology, 13(1), 106-109.
Postolache, T. T., Mortensen, P. B., Tonelli, L. H., Jiao, X., Frangakis, C., Soriano, J. J., & Qin, P. (2010). Seasonal spring peaks of suicide in victims with and without prior history of hospitalization for mood disorders. Journal of affective disorders, 121(1), 88-93.
Puzo, Q., Mehlum, L., & Qin, P. (2017). Suicide among immigrant population in Norway: a national register-based study. Acta Psychiatr Scand, 135(6), 584-592. doi:10.1111/acps.12732
Puzo, Q., Mehlum, L., & Qin, P. (2018a). Rates and characteristics of suicide by immigration background in Norway. PloS ONE, 13(9). doi:10.1371/journal.pone.0205035
Puzo, Q., Mehlum, L., & Qin, P. (2018b). Socio-economic status and risk for suicide by immigration background in Norway: A register-based national study. Journal of Psychiatric Research, 100, 99-106. doi:10.1016/j.jpsychires.2018.02.019
Ratkowska, K. A., & Leo, D. D. (2013). Suicide in Immigrants: An Overview. Open J Med Psychol, Vol.02No.03, 10.
RCoreTeam. (2017). R: A language and environment for statistical
computing. Retrieved from https://www.R-project.org/
Shaw, R. J., Atkin, K., Bécares, L., Albor, C. B., Stafford, M., Kiernan, K. E., . .. Pickett, K. E. J. T. B. J. o. P. (2012). Impact of ethnic density on adult mental disorders: narrative review. 201(1), 11-19.
SSB. (2003). Norwegian Standard Classification of Education. Revised 2000. Retrieved from https://www.ssb.no/a/english/publikasjoner/pdf/nos_c751_en/nos_c751_en.pdf
SSB. (2008). Living conditions among immigrants. Retrieved from
SSB. (2015). Adoptions. Retrieved from https://www.ssb.no/en/befolkning/statistikker/adopsjon/aar
SSB. (2016a). Employment among immigrants. Retrieved from
SSB. (2016b). Immigrants by reason for immigration. Retrieved from https://www.ssb.no/en/befolkning/statistikker/innvgrunn
SSB. (2017a). Immigrants and Norwegian-born to immigrant parents. Retrieved from http://www.ssb.no/en/befolkning/statistikker/innvbef
SSB. (2017b). Table 03031: Population, by sex, age and marital status. 1 January (C). Retrieved from https://www.ssb.no/statistikkbanken/selecttable/
SSB. (2017c). Table 05182: Persons, by immigration category and sex (C). Retrieved from https://www.ssb.no/statistikkbanken/selecttable/hovedtabellHjem.
SSB. (2017d). Tax statistics for personal tax payers. Retrieved from
Sumarokov, Y. A., Brenn, T., Kudryavtsev, A. V., & Nilssen, O. (2015). Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study. BMC psychiatry, 15(1), 224.
Titelman, D., Oskarsson, H., Wahlbeck, K., Nordentoft, M., Mehlum, L., Jiang, G.-X., . . . Wasserman, D. (2013). Suicide mortality trends in the Nordic countries 1980–2009. Nord J Psychiatry, 67(6), 414-423.
Westman, J., Sundquist, J., Johansson, L. M., Johansson, S.-E., & Sundquist, K. (2006). Country of birth and suicide: a follow-up study of a national cohort in Sweden. Archives of Suicide Research, 10(3), 239-248.
WHO. (2014). Suicide rates (per 100 000 population). Retrieved from http://www.who.int/gho/mental_health/suicide_rates/en/