Secular Trends of Suicide in the City of São Paulo, 1904-2017.

Few reports from developing countries have described long-term trends in suicide. To investigate the age-, sex-, and method-specific trends in suicide over the period 1904-2017 in São Paulo. Mortality data were obtained from SEADE, DATASUS, and PRO-AIM. Suicide peaked in the mid-1910s and mid-1950s, being higher among men. There was an upward trend from the 1920s for men and from the 1930s for women. Suicide rates have declined since the mid-1950s, reaching lower rates in the past 40 years. Men aged 60+ had higher rates at the beginning and a decreasing trend. Suicide rates among men aged 20-39 and 40-59 peaked in the mid-1950s and declined until the late 1970s, thereafter remaining stable. Women aged 20-39 years had the highest rates with decreasing trends from the mid-1950s. No trends were detected for the age group 40-59, and women aged 60+ presented a decreasing trend. Rates among women aged 0-19 declined after the late 1970s. Suicide by poisoning peaked in the 1950s, and there was a downward trend for firearms and an upward trend for hanging. Suicide trends vary by sex, age group, and method. Accurate monitoring of these trends is an important task for suicide prevention and public health agencies and personnel.