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Since the 1970s, suicide has been a major public health issue in Greenland. The World Health Organization has emphasised the importance of the identification of both risk and protective factors in relation to suicide. The aim of this paper was to identify scientific literature on risk and protective factors for suicide and suicidal behaviour among Greenland Inuit. Searches in PubMed and PsycInfo resulted in 420 studies that were screened by three of the authors. After screening, the authors included 15 studies that were subject to quality assessment and data extraction. All 15 studies reported on risk factors, and only three mentioned protective factors. Most reported risk factors were on an individual level and were related to socioeconomic status, mental health, alcohol and substance use, and life stress. Risk factors related to the family mainly related to adverse childhood experiences, while the community level concerned access to education, work, and conflicts. The results indicate a large knowledge gap about protective factors for suicide and suicidal behaviour. The few protective factors reported were related to men having a family, high socioeconomic status, and being born between 1901 and 1950.

Background: Between 1980 and 2018 Greenland has had one of the highest suicide rates in the world with an average rate of 96 suicides per 100,000 people annually. The aim of this study is to investigate suicide rates in Greenland according to age, birth cohort, period, sex, place of residence and suicide method from 1970 until 2018., Methods: Suicide rates were examined using register and census data from 1970-2018 among Greenland Inuit. Rates were calculated by Poisson regression in Stata and by use of Excel. In analyses of the period trends, rates were standardized according to the World Standard Population 2000-2025., Results: The suicide rate has been declining since a peak at 120 suicides per 100,000 people annually in the 1980s but remained high at a rate of 81.3 suicides per 100,000 people annually from 2015-2018. Descriptive analyses point to the decrease in male suicides as the primary factor for the overall decreasing rates while the rate among women has been increasing. Simultaneously, the proportion of women who used a violent suicide method increased from 60% in 1970-1979 to 90% in 2010-2018. The highest rates are seen among young people, especially young men aged 20-24 years and youth suicide rates increased with later birth cohorts. When the rates started to increase in the 1980s both the capital Nuuk and East Greenland had the highest rates. Since then, the rate in Nuuk has declined while the rate in East Greenland was three times the national rate from 2015-2018., Conclusions: From 1970 to 1989 the suicide rate increased from 28.7 to 120.5 per 100,000 people mirroring a rapid societal transition in the post-colonial period. The rate has slowly declined from the peak in the 1980s but remains at a very high level. Young people in general are at risk, but the steady increase in the rate among women is worrying and there is a need to investigate underlying causes for this development., (© 2023. The Author(s).)

Ten percent of all deaths in Greenland are caused by suicide. The aim of this study was to explore if applicable risk factors could be identified among the suicide victims within the health care system up to 6 months prior to the suicide. The study was performed as an age- and gender-matched case control study including all suicides in Greenland from 2012 to 2015, based on review of medical records for risk factors including suicide ideation, suicide attempts, incidence of alcohol intoxication, incidence of violence and treatment for psychiatric illness within the 6 month period leading up to the suicide. In total, 160 cases and 160 controls were included. Presence of any risk factors were observed in around a third of all suicide cases compared a tenth among the controls. The highest odds ratios for suicide were observed for suicide ideation and suicide attempts. However, no contact with the health care system was observed for two thirds of the suicides victims. Thus, focus on suicide ideation and suicide attempts among patients could help health care professionals to assess suicide risk and initiate prevention. Additional preventive strategies targeting the majority without contact to the health care system need to be explored.

Suicide is the leading cause of death among young men aged 15⁻29 in Greenland, but few epidemiological studies have described this problem. We aimed to summarise descriptive epidemiological studies of suicide in young men in Greenland compared with other demographic groups in Denmark and Greenland to inform future suicide prevention strategy. We searched PubMed, PsycINFO, and Embase using an agreed search strategy to identify English-language papers describing suicide epidemiology in Greenlandic men aged 15⁻29. We followed PRISMA guidelines in screening and appraising eligible publications. Eight articles fulfilled inclusion criteria of 64 meeting search criteria. Findings covering 1970⁻2011 supported a dramatic rise in suicide rates in Greenlandic men aged 15⁻24 from 1976, who remained the highest-ranking demographic group over 1976⁻2011 compared with men and women of all age groups in Denmark and Greenland. Highest rates recorded were almost 600 per 100,000 per year in men aged approximately 20⁻23 over 1977⁻1986. No studies described suicide epidemiology after 2011, and no studies described risk factors for suicide in young men. Given the very high suicide rates recorded for young men over 1976⁻2011, such studies will be essential for informing the development and evaluation of appropriate preventive interventions.

Background: Suicide is a tremendous public health issue and worldwide the second leading cause of death among young people. In 2015, Greenland had the highest burden of disease due to self-harm with loss of 2,952.97 disability-adjusted life years per 100,000 inhabitants, more than six times as many as Denmark., Aims: What are possible reasons for Greenland's higher youth suicide rate compared to Denmark, despite being one kingdom of Denmark?, Method: Mixed methods in the form of qualitative, semi-structured interviews, the analysis of available data for 2003-2016 and a literature review were conducted with the aim to answer this question., Results: Several exposures cause this difference, most significantly adverse effects of the colonial past, such as social issues and experienced traumas in Greenland compared to its former coloniser Denmark., Conclusion: The ongoing burden of youth suicide in Greenland requires enhanced actions of all stakeholders involved in suicide prevention, intervention and postvention.

Background: There is growing evidence that living conditions at birth play a role in medical conditions later in life. Population-based studies from the Northern Hemisphere have shown that persons born in the spring or summer are at greater risk of committing suicide. A statistical correlation with light availability at birth has been observed in past research, but the cause remains unknown. Greenland is one of the most extreme of natural human habitats with regard to seasonal changes in light. The combination of rapid social changes and reliable population statistics offers a unique opportunity to make comparisons between persons born into a Traditional Lifestyle and those born into a Modern Lifestyle. The aim of this work was to assess whether season of birth differed between suicide victims born into an old or into a modern lifestyle., Methods: Official population and mortality registers were used. Suicide victims born (1903-1950) into the Traditional Lifestyle were compared with those born into the Modern Lifestyle (1961-1980). Rayleigh's test for circular distributions was used to assess the season of birth in suicide victims. Data regarding season of birth in the general population were collected., Results: Persons born in March-June in the Traditional Lifestyle were much less likely to commit suicide than those born during other periods of the year. This is contrary to the findings of other studies. The seasonal differences had disappeared for those born into the Modern Lifestyle. The suicide rate increased from very low rates to about 140 suicides/100 000 person-years in the 1980s., Conclusions: The reason behind a variation in season of birth in suicide victims born into the old lifestyle is unknown. It is also unknown why the seasonal difference had disappeared with modern lifestyle. Possible influence of artificial light, nutrition, microbiota and seasonal infections are discussed. The underlying causes behind suicides may be different in traditional and modern Greenland.

Background: Suicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys., Objective: To analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland., Design: Data included the Greenland registry of causes of death for 1970-2011 and 2 cross-sectional health surveys carried out in 1993-1994 and 2005-2010 with 1,580 and 3,102 Inuit participants, respectively., Results: Suicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group., Conclusion: Suicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.

Background: Seasonal variation in suicides has been shown in many countries. We assessed the seasonality and the variation with latitude in suicides and homicides, and the impact of alcohol on the seasonality in suicides., Methods: Official computerized registers on causes of death in all Greenland during 1968-2002 were used. Sales data on beer from one of the major food store chains for July 2005-June 2006 were examined. Seasonal variation was assessed by Rayleigh's test for circular distributions., Results: There were a total of 1351 suicides and 308 homicides. The suicides rate varied from 4.2/100 000 person-years in 1971 to 128.4/100 000 person-years in 1987. The homicide rate varied from 2.1/100000 person-years in 1969-1970 to 34.8/100 000 person-years in 1988. Out of the 1351 suicides, 80.5% were committed by men and 19.5% by women. Median age was 25 years (n = 1351; Range 11-84 years). Violent methods of suicide were used in 95% of all cases (n = 1286). Out of the 308 homicide victims, 61% were men and 39% were women, and 13% were killed in multiple homicide events.There was a significant seasonal variation with peaks in June and troughs in the winter in all suicide cases (n = 1351, r = 0.07; Z = 7.58, p < 0.001), in violent suicides (n = 1286; r = 0.07; Z = 6.97; p < 0,001), in suicides in men (n = 1087; r = 0.07; Z = 5.39; p < 0.002) , and in women (n = 264; r = 0.10; Z = 2.36; p < 0.05), but not in homicides nor in consumption of beer. There was a bi-phasic seasonal variation in suicide victims where an alcohol-related condition was included in the death certificate. Suicides were more concentrated in the summer months north of the Arctic Circle (n = 577, r = 0.09, Z = 4.45, p < 0.01) than south of it (n = 769, r = 0.07, Z = 3.76, p < 0.002) and most concentrated in North Greenland (n = 33; r = 0.35; Z = 4.11; p < 0.01), where 48% of suicides occurred during the period of constant light. When including astronomical twilight in the constant light period 82% occurred during this time., Conclusion: There was a concentration of suicides but not homicides in the summer months in all Greenland. The concentration was most pronounced at high latitudes.

The incidence of youth suicides has increased dramatically among the Inuit in Greenland since the modernization started in the 1950s. Suicides currently peak at age 15-24 Men: 400-500, Women: 100-150 per 100,000 person-years. The methods are drastic: shooting or hanging. An early peak was seen in the capital, a later peak in the rest of West Greenland, and high and increasing rates in remote East Greenland. Suicidal thoughts occur more often in young people who grew up in homes with a poor emotional environment, alcohol problems and violence. There is a definite correlation with several aspects of the modernization process but it is hard to pinpoint causal relationships. It is rather the "modernization package" that should be regarded as risk factors for suicides.

Greenland is the most extreme of human habitats in regard to annual changes in natural light. From being very low, the rate of suicides in Greenland has increased during the past few decades to be among the highest in the world. Several studies have shown seasonality in suicides with spring or summer peaks, but this has not been previously shown in Greenland. Official data from 1968 to 1995 from West Greenland were pooled. A significant seasonality in the 833 suicides was found using Rayleigh's test, a peak in June and a trough in the winter. Suicides increased during the period, and reached high rates in most age groups, up to 577 per 100,000 person-years in men aged 15-24 years in 1990, and up to 147 per 100,000 person-years in women aged 15-24 years in 1995. Violent methods of suicide were used by 93%. Depression has been reported uncommonly. High alcohol intake and extended periods of light in the summer may contribute to impulsive-aggressive summer suicides.

In Greenland, the rapid sociocultural change of the last 50 years has been paralleled by an epidemiological transition characterized by a reduction in infectious diseases, an increase in cancer and cardiovascular diseases, and an increased prevalence of mental health problems. During 1993-94 and 1997-98, two health interview surveys were conducted among Inuit in Greenland and Inuit migrants in Denmark. The response rates were 71 and 55%. Information on mental health was obtained from 1388 and 1769 adults. As indicators of mental health, the prevalence of potential psychiatric cases according to the General Health Questionnaire (GHQ-12) and the prevalence of suicidal thoughts were studied in relation to childhood residence and father's occupation, current residence, and language. The statistical methods included logistic regression and graphical independence models. The results indicated a U-shaped association in Greenland of GHQ-cases with age and a high prevalence of suicidal thoughts among young people; a low prevalence of GHQ-cases among those who were bilingual or spoke only Danish; and a high prevalence of suicidal thoughts among migrants who grew up in Denmark and among residents of the capital of Greenland. In Greenland, women were more often GHQ-cases and had suicidal thoughts more often than men. The association between language and GHQ-cases is presumed to operate through socioeconomic factors. It is necessary to modify the common notion that rapid societal development is in itself a cause of poor mental health: as a result of successful integration into the modern Greenlandic society, some population groups have better mental health compared to other groups.

In Greenland, the rapid socio-cultural change of the last 50 years has been paralleled by an increasing number of suicides. The suicide rates in Greenland are now among the highest in the world. Especially among men aged 15-24 suicide rates are dramatically high. In the present study, information on the psycho-social background of suicides is provided based on a review of death certificates and police reports for the period 1993-95. Dysfunctional social networks seem to play a predominant role among suicides. Being disconnected from community and family ties seems to increase the vulnerability of young people in Greenland. In addition, temporal trends of suicide rates are described for the different regions of Greenland. The findings are discussed in relation to the societal and cultural transition of the society.

There are great differences in the suicide rates in the closely related Nordic countries. The suicide rates are higher in Finland, especially in males, and Denmark, especially in females, and lower in Norway and Iceland, with Sweden in a middle position. The statistics are found to be comparable. In this article the development from 1880 to the present day is described, and special emphasis is laid on the development from 1960 onwards. Denmark and Finland still keep the top position, while the rise in suicide rates, especially in the age group 15-29 years, has been most marked in Norway. Within the Nordic region Greenland has an extremely high suicide rate, especially in youngsters, while the Faroe islands have a very low rate. Tentative explanations are given for the development of suicide rates in the Nordic countries.

The increased frequency of suicide among Inuit in the North is reviewed and compared with an analysis of public files on suicides in Greenland 1977-86. From these files some kind of small scale "psychological" autopsy is performed, and the material is analyzed in relation to theories of socialization and acculturation.