Seasonality of Suicide in Spain (2000-2019): Considering the Bioclimatic Perspective

Daniel Perea Milla Fernandez , Centre d'Estudis Demogràfics
Enrique Acosta, Universitat Autonoma de Barcelona
Sergi Trias-Llimós , Universitat Pompeu Fabra

The COVID-19 pandemic disrupted mortality patterns beyond direct COVID-19 deaths. Non-pharmaceutical interventions altered behavioural exposures, healthcare access, and social conditions affecting external causes of mortality (e.g., deaths from transport accidents, falls, suicides, poisonings, and other injuries). These causes disproportionately affect younger and working-age populations, offering insights into pandemic impacts beyond those groups most directly affected by COVID-19. This study examines cause-specific external mortality disturbances in Spain (2016-2022), with attention to time-sensitive educational inequalities. Using individual-level mortality data from Spain's National Statistics Institute across four educational levels, we calculated excess mortality for external causes by fitting quasi-Poisson generalized additive models on pre-pandemic data (January 2016-March 2020). Models incorporated smooth temporal trends and cyclic seasonal patterns, with expected deaths extrapolated into the pandemic period. Excess deaths reveal substantial heterogeneity during March 2020-2022: accidental poisoning showed the largest relative increase (+18.9%), while Intentional self-harm increased persistently (+5.8%). Educational gradients varied markedly: primary education showed protective effects, while first-stage secondary education experienced the largest excess mortality burden. This ongoing analysis builds on novel decomposition frameworks for analysing cause-specific mortality disturbances, applying them to the complete Spanish pandemic experience with enhanced temporal and socioeconomic resolution. Planned next steps include calculating proportional scores (p-scores) to formally quantify each cause's contribution to total mortality disturbances within educational strata, and systematically assessing how educational gradients in external mortality evolved across crisis phases through rate ratio and absolute difference analyses. This work will contribute to understanding how pandemic-related disruptions differentially affected external cause mortality across vulnerable populations in Spain.

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 Presented in Session 102. Flash Session Seasonal, Climate- and COVID-19-Related Mortality