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ABSTRACT BACKGROUND: Suicide is one of the leading causes of death worldwide, accounting for one million deaths annually. Greater understanding of the causal risk factors is needed, especially in large urban centers. OBJECTIVE: To ascertain the epidemiological profile and temporal trend of suicides over two decades and correlate prevalence with social indicators. DESIGN AND SETTING: Descriptive population-based longitudinal retrospective study conducted in the city of São Paulo, Brazil. METHODS: A temporal trend series for suicide mortality in this city was constructed based on data from the Ministry of Health’s mortality notification system, covering 2000-2017. It was analyzed using classic demographic variables relating to social factors. RESULTS: Suicide rates were high throughout this period, increasing from 4.6/100,000 inhabitants in the 2000s to 4.9/100,000 in 2017 (mean: 4.7/100,000). The increase in mortality was mainly due to increased male suicide, which went from 6.0/100,000 to the current 8.0/100,000. Other higher coefficients corresponded to social risk factors, such as being a young adult (25-44 years old), being more educated (eight years of schooling) and having white ethnicity (67.2%). Suicide was also twice as likely to occur at home (47.8%). CONCLUSION: High suicide rates were seen over the period 2000-2017, especially among young adults and males. High schooling levels and white ethnicity were risk factors. The home environment is the crucial arena for preventive action. One special aspect of primary prevention is the internet and especially social media, which provides a multitude of information for suicide prevention.

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