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Li ZB, Lv JJ, Lu W, Yin MY, Li XY, Yang CH. Burden of depression in adolescents in the Western Pacific Region from 1990 to 2019: An age-period-cohort analysis of the Global Burden of Disease study. Psychiatry Res 2024; 336:115889. [PMID: 38621309 DOI: 10.1016/j.psychres.2024.115889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Depression is a highly prevalent and disabling mental health condition among adolescents. The epidemiology of depression in adolescents has been changing over time, reflecting changes in risk factors as well as disease concepts and diagnosis. However, few studies have characterized the longitudinal epidemiology of depression in adolescents. Understanding trends of disease burden provides key insights to improve resource allocation and design targeted interventions for this vulnerable population. The Western Pacific Region (WPR) is home to over 1.3 billion people with tremendous diversity in culture and socioeconomic development. The epidemiology of adolescent depression in WPR remains largely unknown. In this study, we aimed to estimate trends of disease burden attributable to depressive disorders among adolescents aged 10-24 years in WPR countries between 1990 and 2019, and to investigate period and cohort effects using the Global Burden of Disease (GBD) study database. METHODS The study utilized data from the Global Burden of Disease, Injuries, and Risk Factors Study 2019, concentrating on adolescents aged 10 to 24 years with depression. We conducted an in-depth analysis of depression, including its age-standardized prevalence, incidence, and Disability-Adjusted Life Years (DALYs), across diverse demographics such as regions, ages, genders, and socio-demographic indexes, spanning from 1990 to 2019. RESULTS The analysis found decreasing trends in the prevalence, incidence, and DALYs of adolescent depression in the WPR between 1990-2019, although some countries like Australia and Malaysia showed increases. Specifically, the prevalence of adolescent depression in the region decreased from 9,347,861.6 cases in 1990 to 5,551,341.1 cases in 2019. The incidence rate declined from 2,508.6 per 100,000 adolescents in 1990 to 1,947.9 per 100,000 in 2019. DALYs decreased from 371.9 per 100,000 in 1990 to ASR 299.7 per 100,000 in 2019. CONCLUSION This study found an overall decreasing trend in adolescent depression burden in the Western Pacific Region between 1990 and 2019, with heterogeneity across countries. For 30 years, the 20-24 age group accounted for the majority of depression among adolescents Widening inequality in depression burden requires policy attention. Further analysis of risk factors contributing to epidemiological trends is warranted to inform prevention strategies targeting adolescent mental health in the region.
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Affiliation(s)
- Zhi-Bin Li
- Department of Clinical Psychology, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Jia-Jie Lv
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Wei Lu
- Department of Clinical Psychology, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Min-Yi Yin
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China
| | - Xin-Yu Li
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China; Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.
| | - Cheng-Hao Yang
- Department of Vascular Surgery, Shanghai Putuo People's Hospital, School of Medicine, Tongji University, Shanghai, PR China.
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Marco M, López-Quílez A, Sánchez-Sáez F, Escobar-Hernández P, Montagud-Andrés M, Lila M, Gracia E. The Spatio-Temporal Distribution of Suicide-related Emergency Calls in a European City: Age and Gender Patterns, and Neighborhood Influences. PSYCHOSOCIAL INTERVENTION 2024; 33:103-115. [PMID: 38706710 PMCID: PMC11066811 DOI: 10.5093/pi2024a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 05/07/2024]
Abstract
Objective: The aim of this study was to conduct a comprehensive spatio-temporal analysis of suicide-related emergency calls in the city of Valencia (Spain) over a six-year period. To this end we first examined age and gender patterns and, second, the influence of neighborhood characteristics on general and gender-specific spatio-temporal patterns of suicide-related emergency calls. Method: Geocoded data on suicide-related emergency calls between 2017 and 2022 (N = 10,030) were collected from the 112 emergency service in Valencia. Data were aggregated at the census block group level, used as a proxy for neighborhoods, and trimesters were considered as the temporal unit. Two set of analyses were performed: (1) demographic (age and gender) and temporal descriptive analyses and (2) general and gender-specific Bayesian spatio-temporal autoregressive models. Results: Descriptive analyses revealed a higher incidence of suicide-related emergency calls among females and an increase in calls among the 18-23 age group from 2020 onwards. The general spatio-temporal model showed higher levels of suicide-related emergency calls in neighborhoods characterized by lower education levels and population density, and higher residential mobility, aging population, and immigrant concentration. Relevant gender differences were also observed. A seasonal effect was noted, with a peak in calls during spring for females and summer for males. Conclusions: These findings highlight the need for comprehensive mental health targeted interventions and preventive strategies that account for gender-specific disparities, age-related vulnerabilities, and the specific characteristics of neighborhoods.
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Affiliation(s)
- Miriam Marco
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Antonio López-Quílez
- University of ValenciaDepartment of Statistics and Operational ResearchValenciaSpainDepartment of Statistics and Operational Research, University of Valencia, Spain;
| | - Francisco Sánchez-Sáez
- Universidad Internacional de La RiojaSchool of Engineering and TechnologySpainSchool of Engineering and Technology (ESIT), Universidad Internacional de La Rioja, Spain
| | - Pablo Escobar-Hernández
- University of ValenciaDepartment of Statistics and Operational ResearchValenciaSpainDepartment of Statistics and Operational Research, University of Valencia, Spain;
| | - María Montagud-Andrés
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Enrique Gracia
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
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Ghadipasha M, Talaie R, Mahmoodi Z, Karimi SE, Forouzesh M, Morsalpour M, Mahdavi SA, Mousavi SS, Ashrafiesfahani S, Kordrostami R, Dadashzadehasl N. Spatial, geographic, and demographic factors associated with adolescent and youth suicide: a systematic review study. Front Psychiatry 2024; 15:1261621. [PMID: 38404471 PMCID: PMC10893588 DOI: 10.3389/fpsyt.2024.1261621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024] Open
Abstract
Background Suicide is a public health issue and a main cause of mortality among adolescents and the youth worldwide, particularly in developing countries. Objectives The present research is a systematic review aiming to investigate the spatial, geographical, and demographic factors related to suicide among adolescents and the youth. Methods In this systematic review, two researchers examined PsycINFO, Web of Science, Scopus, and PubMed databases on December 7th, 2022 with no time limits from the beginning of publication until 2022 to identify the primary studies on spatial and geographic analysis on adolescent and youth suicides. Once duplicate studies were identified and removed, the titles and abstracts of studies were examined and irrelevant studies were also removed. Finally, 22 studies were reviewed based on the inclusion criteria. Results Our findings show that suicide rates are generally higher among men, residents of rural and less densely populated regions, coastal and mountainous regions, natives, 15-29 age group, less privileged populations with social fragmentation, unemployed, divorced or lonely people, those who live in single parent families, people with mental health issues, and those with low levels of education. Conclusions Stronger evidence supports the effects of geographic and demographic variables on youth and adolescent suicide rates as compared with spatial variables. These findings suggest that policy makers take spatial and demographic factors into consideration when health systems allocate resources for suicide prevention, and that national policymakers integrate demographic and geographic variables into health service programs. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023430994.
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Affiliation(s)
- Masoud Ghadipasha
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Ramin Talaie
- Department of Gastroenterology and Hepatology, School of Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Salah Eddin Karimi
- Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Forouzesh
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Masoud Morsalpour
- Department of Criminal Law and Criminology, Islamic Azad University, Tehran, Iran
| | | | | | | | - Roya Kordrostami
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
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Huang WC, Hsu CY, Chang CM, Yang AC, Liao SC, Chang SS, Wu CS. Psychiatrist density and risk of suicide: a multilevel case-control study based on a national sample in Taiwan. Psychiatry Clin Neurosci 2024; 78:69-76. [PMID: 37812045 DOI: 10.1111/pcn.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
AIM No previous studies, to our knowledge, have investigated the association between psychiatrist density and suicide, accounting for individual- and area-level characteristics. METHODS We investigated all suicide cases in 2007-2017 identified from the national cause-of-death data files, with each suicide case matched to 10 controls by age and sex and each suicide case/control assigned to one of the 355 townships across Taiwan. Our primary outcome was the odds ratio (OR) of suicide and its 95% confidence interval (CI) estimated via multilevel models, which included both individual- and area-level characteristics. Townships with no psychiatrists were compared with the quartiles of townships with psychiatrists (density per 100,000 population): quartile 1 (Q1) (0.01-3.02); quartile 2 (Q2) (3.02-7.20); quartile 3 (Q3) (7.20-13.82); and quartile 4 (Q4) (>13.82). RESULTS A total of 40,930 suicide cases and 409,300 age- and sex-matched controls were included. We found that increased psychiatrist density was associated with decreased suicide risk (Q1: adjusted OR [aOR], 0.95 [95% CI, 0.90-1.01]; Q2: aOR, 0.90 [95% CI, 0.85-0.96]; Q3: aOR, 0.89 [95% CI, 0.83-0.94]; Q4: aOR, 0.89 [95% CI, 0.83-0.95]) after adjusting for individual-level characteristics (employment state, monthly income, physical comorbidities, and the diagnosis of psychiatric disorders) and area socioeconomic characteristics. CONCLUSIONS The psychiatrist density-suicide association suggests an effect of increased availability of psychiatric services on preventing suicide. Suicide prevention strategies could usefully focus on enhancing local access to psychiatric services.
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Affiliation(s)
- Wei-Chia Huang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chia-Yueh Hsu
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry and Suicide Prevention Center, Chang Gung Memorial Hospital, Lin-Ko, Taiwan
| | - Albert C Yang
- Digital Medicine Center/Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu Hospital, Hsin-Chu City, Taiwan
| | - Shu-Sen Chang
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Institute of Health Behaviors and Community Sciences, and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Population Health Research Center, National Taiwan University, Taipei, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
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Zangeneh A, Khademi N, Farahmandmoghadam N, Ziapour A, Naderlou R, Oghli SS, Teimouri R, Yenneti K, Moghadam S. Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran. Front Psychiatry 2023; 14:1174071. [PMID: 37583840 PMCID: PMC10425239 DOI: 10.3389/fpsyt.2023.1174071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023] Open
Abstract
Background A suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006-14. Methods This study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran's I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide. Results The results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females. Conclusion The results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention.
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Affiliation(s)
- Alireza Zangeneh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Khademi
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Farahmandmoghadam
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reyhane Naderlou
- Geography and Urban Planning, University of Zanjan, Zanjan, Iran
| | - Somayyeh Shalchi Oghli
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Teimouri
- UniSA Creative, University of South Australia, Adelaide, SA, Australia
| | - Komali Yenneti
- School of Architecture and the Built Environment, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
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Mahesar RA, Shaikh S, Latif M, Azeema N, Solangi A, Abro SY. Analysis of Newspaper Reporting of Non-fatal Suicide Attempts During the Covid-19 Lockdown in Pakistan. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231172342. [PMID: 37080193 DOI: 10.1177/00302228231172342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: This study was aimed to observe newspaper reports about non-fatal suicide attempts in Pakistan during the COVID-19 lockdown. Methods: We performed content analysis of news reports about incomplete suicides from four vernacular newspapers of Pakistan between March and August 2020. Results: A total of 87 news reports about suicide attempts were examined; the vast majority of the suicide attempters was Muslims (78%), males (64%), females (36%) with (33%) mentions of age, ranging from 19-30 years, and married were (76%). However, occupation was largely missing from (93%) of the news. Self-poisoning was the commonly reported method in (65%) of suicide attempts, whereas familial discord was the leading risk factor for (72%) of suicide attempts. Conclusions: Although psychological intervention is crucial to reduce familial discords as risk factors, monitoring the mental health conditions of people vulnerable to suicide and the figures on attempted suicides should be maintained and collected nationally and regionally.
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Affiliation(s)
- Rameez Ali Mahesar
- Department of Media and Communication Studies, Shah Abdul Latif University, Khairpur, Pakistan
| | - Sadia Shaikh
- Benazir School of Business, Benazir Bhutto Shaheed University, Karachi, Pakistan
| | - Muhammad Latif
- Department of Education, GC Women University, Sialkoat, Pakistan
| | - Nusrat Azeema
- Department of Mass Communication, Allama Iqbal Open University, Islamabad, Pakistan
| | - Aneela Solangi
- Department of English, Shaheed Benazir Bhutto University, Shaheed Benazirabad, Pakistan
| | - Shaila Yaseen Abro
- Department of English, Shaheed Benazir Bhutto University, Shaheed Benazirabad, Pakistan
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The application of spatial analysis to understanding the association between area-level socio-economic factors and suicide: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02441-z. [PMID: 36805762 DOI: 10.1007/s00127-023-02441-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 02/02/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Little is known about what impact the use of different spatial methodological approaches may have on understanding the relationship between area-level socio-economic factors and suicide. METHODS In this systematic review, we searched PubMed, Embase, CINAHL and PsycInfo for original empirical studies examining the relationship between socio-economic factors and suicide with a spatial lens, published up to January 22, 2022. Data on applied spatial methods, indicators of socio-economic factors, and risk of suicide related to socio-economic factors were extracted. The protocol for this systematic review was registered with PROSPERO (CRD42021251387). RESULTS A systematic search yielded 6290 potentially relevant results; 58 studies met the inclusion criteria for review. Of the 58 included studies, more than half of the studies (n = 34; 58.6%) used methods that accounted for spatial effects in analyses of the association between socio-economic factors and suicide or examined spatial autocorrelation, while 24 (41.4%) studies applied univariate and multivariate models without considering spatial effects. Bayesian hierarchical models and spatial regression models were commonly used approaches to correct for spatial effects. The risk of suicide relating to socio-economic factors varied greatly by local areas and between studies using various socio-economic indicators. Areas with higher deprivation, higher unemployment, lower income, and lower education level were more likely to have higher suicide risk. There was no significant difference in results between studies using conventional versus spatial statistic methods. CONCLUSION An increasing number of studies have applied spatial methods, including Bayesian spatial models and spatial regression models, to explore the relationship between area-level socio-economic factors and suicide. This review of spatial studies provided further evidence that area-level socio-economic factors are generally inversely associated with suicide risk, with or without accounting for spatial autocorrelation.
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Yoshioka E, Hanley S, Sato Y, Saijo Y. Associations between social fragmentation, socioeconomic deprivation and suicide risk across 1887 municipalities in Japan, 2009-2017: a spatial analysis using the Bayesian hierarchical model. BMJ Open 2022; 12:e063255. [PMID: 36041759 PMCID: PMC9438050 DOI: 10.1136/bmjopen-2022-063255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Previous studies have indicated that spatial variation in suicide mortality is associated with area-specific socioeconomic characteristics, such as socioeconomic deprivation and social fragmentation. However, most of these studies have been conducted in the West and findings from Asian countries are limited. This study aims to investigate associations between socioeconomic characteristics and suicide mortality rates across 1887 municipalities in Japan between 2009 and 2017. We also assessed these associations by gender and age group. METHODS Suicide data were obtained from the suicide statistics of the Ministry of Health, Labour and Welfare in Japan and included information on the number of suicides by gender, age and municipality location. Social fragmentation, socioeconomic deprivation and urbanicity were used as socioeconomic characteristics in this study and were created from survey data obtained from the 2010 census. Bayesian hierarchical models were used to examine associations between socioeconomic characteristics and suicide risk. RESULTS Suicide rates were significantly higher in municipalities with higher levels of deprivation, with a rate ratio of 1.13 (95% credible interval: 1.10 to 1.17) in the highest quartile compared with the lowest. Higher levels of urbanicity had significantly lower suicide rates, with a rate ratio of 0.79 (95% credible interval: 0.77 to 0.82) in the highest quartile compared with the lowest. However, associations between exposures and suicide varied considerably by gender and age. Among both men and women aged 0-39 years, fragmentation was significantly associated with suicide, with rate ratios of 1.07 and 1.15 for men and women, respectively, in the highest quartile compared with the lowest. CONCLUSION Suicide prevention in Japan should particularly focus on areas with high levels of deprivation or low levels of urbanicity. Furthermore, young Japanese people residing in the most fragmented municipalities were also at high risk of suicide, and appropriate measures need to be taken.
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Affiliation(s)
- Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Sharon Hanley
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
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Barak-Ventura R, Marín MR, Porfiri M. A spatiotemporal model of firearm ownership in the United States. PATTERNS 2022; 3:100546. [PMID: 36033595 PMCID: PMC9403408 DOI: 10.1016/j.patter.2022.100546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/04/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
Firearm injury is a major public health crisis in the United States, where more than 200 people sustain a nonfatal firearm injury and more than 100 people die from it every day. To formulate policy that minimizes firearm-related harms, legislators must have access to spatially resolved firearm possession rates. Here, we create a spatiotemporal econometric model that estimates monthly state-level firearm ownership from two cogent proxies (background checks per capita and fraction of suicides committed with a firearm). From calibration on yearly survey data that assess ownership, we find that both proxies have predictive value in estimation of firearm ownership and that interactions between states cannot be neglected. We demonstrate use of the model in the study of relationships between media coverage, mass shootings, and firearm ownership, uncovering causal associations that are masked by the use of the proxies individually. A spatiotemporal model of firearm prevalence in the United States is created The econometric model predicts firearm ownership in every state for every month Information theory is used to detail causal links related to firearm prevalence The media can influence firearm prevalence, which in turn moderates mass shootings
Firearm violence is a major public health crisis in the United States, where more than 200 people sustain a nonfatal firearm injury and more than 100 people die from it every day. Despite these unsettling figures, scientific research on firearm-related harm significantly lags behind because spatially and temporally resolved data on firearm ownership are unavailable. This paper presents a spatiotemporal model that predicts firearm prevalence at the resolutions of one state and one month from the numbers of background checks and suicides committed with a firearm. Drawing on principles from econometrics, the model also accounts for interactions between states. The model’s output is challenged in causal analysis, which uncovers unprecedented associations between firearm prevalence, media output on firearm regulations, and mass shootings.
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Affiliation(s)
- Roni Barak-Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Center for Urban Science and Progress, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
| | - Manuel Ruiz Marín
- Department of Quantitative Methods, Law and Modern Languages, Technical University of Cartagena, Cartagena, 30201 Murcia, Spain
- Murcia Bio-Health Institute (IMIB-Arrixaca), Health Science Campus, Cartagena, 30120 Murcia, Spain
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Center for Urban Science and Progress, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Corresponding author
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Yeung CY, Men Y, Chen YC, Yip PSF. Home as the first site for suicide prevention: a Hong Kong experience. Inj Prev 2021; 28:225-230. [PMID: 34716180 DOI: 10.1136/injuryprev-2021-044396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/16/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION There has been little research into at-home suicide cases globally, and particularly in Asian regions. This study aimed to investigate the differences in characteristics between suicide cases in Hong Kong that occurred at home and elsewhere; identify at-home suicide hotspots in the community and compare the differences in area-level characteristics between suicide hotspots and other areas. METHODS Suicide cases (2013-2017) were identified from Hong Kong Coroner's Court reports. Area-level socioeconomic data were retrieved from the 2016 Hong Kong census. Wilcoxon signed-rank tests, χ2 tests and multiple logistic regression models were applied to compare differences in characteristics between people committing suicide at home and elsewhere. Global hotspot tests (Moran's I and Getis-Ord General G) and local analysis (Getis-Ord Gi*) identified at-home suicide community hotspots. The Wilcoxon signed-rank test was used to compare differences in area-level characteristics between at-home suicide hotspots and non-hotspots. RESULTS About 60% of suicide cases in Hong Kong occurred at home. Being female, widowed and/or living alone were significant predictors of at-home suicide cases. A U-shaped association between age and at-home suicide was identified, with 32 years of age being the critical turning point. An at-home suicide hotspot was identified in the north-western region of Hong Kong, which had lower median household income, higher income inequality and higher percentages of households with single elderly people, and new arrivals, compared with other areas. CONCLUSION Suicide prevention should start at home by restricting access to suicide methods. Community-based suicide prevention interventions with improvement of social services should target vulnerable members in identified suicide hotspots.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR .,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR
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Skinner A, Occhipinti JA, Song YJC, Hickie IB. Regional suicide prevention planning: a dynamic simulation modelling analysis. BJPsych Open 2021. [PMCID: PMC8444054 DOI: 10.1192/bjo.2021.989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Regional planning may help to ensure that the specific measures implemented as part of a national suicide prevention strategy are aligned with the varying needs of local services and communities; however, there are concerns that the reliability of local programme development may be limited in practice. Aims The potential impacts of independent regional planning on the effectiveness of suicide prevention programmes in the Australian state of New South Wales were quantified using a system dynamics model of mental health services provision and suicidal behaviour in each of the state's ten Primary Health Network (PHN) catchments. Method Reductions in projected suicide mortality over the period 2021–2031 were calculated for scenarios in which combinations of four and five suicide prevention and mental health services interventions (selected from 13 possible interventions) are implemented separately in each PHN catchment. State-level impacts were estimated by summing reductions in projected suicide mortality for each intervention combination across PHN catchments. Results The most effective state-level combinations of four and five interventions prevent, respectively, 20.3% and 22.9% of 10 312 suicides projected under a business-as-usual scenario (i.e. no new policies or programmes, constant services capacity growth). Projected numbers of suicides under the optimal intervention scenarios for each PHN are up to 6% lower than corresponding numbers of suicides projected for the optimal state-level intervention combinations. Conclusions Regional suicide prevention planning may contribute to significant reductions in suicide mortality where local health authorities are provided with the necessary resources and tools to support reliable, evidence-based decision-making.
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Lin CY, Hsu CY, Chen YY, Chang SS, Gunnell D. Method-Specific Suicide Rates and Accessibility of Means. CRISIS 2021; 43:375-384. [PMID: 34003021 PMCID: PMC9578364 DOI: 10.1027/0227-5910/a000793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract.Background: Few studies have investigated whether means accessibility is related to the spatial distribution of suicide. Aims: To examine the hypothesis that indicators of the accessibility to specific suicide methods were associated with method-specific suicide rates in Taipei City, Taiwan. Method: Smoothed standardized mortality ratios for method-specific suicide rates across 432 neighborhoods and their associations with means accessibility indicators were estimated using Bayesian hierarchical models. Results: The proportion of single-person households, indicating the ease of burning charcoal in the home, was associated with charcoal-burning suicide rates (adjusted rate ratio [aRR] = 1.13, 95% credible interval [CrI] = 1.03–1.25). The proportion of households living on the sixth floor or above, indicating easy access to high places, was associated with jumping suicide rates (aRR = 1.16, 95% CrI, 1.04–1.29). Neighborhoods’ adjacency to rivers, indicating easy access to water, showed no statistical evidence of an association with drowning suicide rates (aRR = 1.27, 95% CrI = 0.92–1.69). Hanging and overall suicide rates showed no associations with any of these three accessibility indicators. Limitations: This is an ecological study; associations between means accessibility and suicide cannot be directly inferred as causal. Conclusion: The findings have implications for identifying high-risk groups for charcoal-burning suicide (e.g., vulnerable individuals living alone) and preventing jumping suicides by increasing the safety of high buildings.
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Affiliation(s)
- Chien-Yu Lin
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chia-Yueh Hsu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan.,Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, UK.,National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
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13
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Chang SS, Lin CY, Hsu CY, Chen YY, Yip PSF. Assessing the effect of restricting access to barbecue charcoal for suicide prevention in New Taipei City, Taiwan: A controlled interrupted time series analysis. J Affect Disord 2021; 282:795-802. [PMID: 33601720 DOI: 10.1016/j.jad.2020.12.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/08/2020] [Accepted: 12/24/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Suicides by carbon monoxide poisoning from burning charcoal increased markedly and contributed to a rise in overall suicides in Taiwan in the early 2000s. A previous study indicated short-term effectiveness on reducing suicides of a charcoal restriction programme, which involved voluntary actions from large chain retail stores to move charcoal bags from open shelves to locked cabinets starting from 1st May 2012, in New Taipei City, Taiwan. We investigated the longer-term effect of this programme. METHODS We calculated quarterly age-standardised charcoal-burning and overall suicide rates in New Taipei City and two comparison cities in 2007-2017. Controlled interrupted time-series analysis was used to examine the effect of the charcoal restriction programme. RESULTS There was no difference between the intervention and comparison cities in step changes in the rates (per 100,000) of charcoal-burning suicide (intervention minus comparison = -0.336, 95% confidence interval -1.173 to 0.502) and overall suicide (-0.270, -1.844 to 1.303) after the intervention, or changes in trends (slopes) in charcoal-burning suicide rates (0.007, -0.055 to 0.069) and overall suicide rates (0.049, -0.138 to 0.236) before and after the intervention. LIMITATIONS There was no legislative requirement to enforce the charcoal restriction. The programme was also restricted to a subset of retail stores. CONCLUSION The charcoal restriction programme in New Taipei City showed no effect on reducing charcoal-burning or overall suicides in the five years after its implementation. Future means restriction strategies for suicide prevention should optimise the programme sustainability, ensure the comprehensive means restriction, and monitor the long-term intervention effectiveness.
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Affiliation(s)
- Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Yu Lin
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chia-Yueh Hsu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China; Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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14
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Geography of suicide in Japan: spatial patterning and rural-urban differences. Soc Psychiatry Psychiatr Epidemiol 2021; 56:731-746. [PMID: 33159535 PMCID: PMC8068717 DOI: 10.1007/s00127-020-01978-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/24/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE There are notable geographic variations in incidence rates of suicide both in Japan and globally. Previous studies have found that rurality/urbanity shapes intra-regional differences in suicide mortality, and suicide risk associated with rurality can vary significantly by gender and age. This study aimed to examine spatial patterning of and rural-urban differences in suicide mortality by gender and age group across 1887 municipalities in Japan between 2009 and 2017. METHODS Suicide data were obtained from suicide statistics of the Ministry of Health, Labour and Welfare in Japan. We estimated smoothed standardized mortality ratios for suicide for each of the municipalities and investigated associations with level of rurality/urbanity using Bayesian hierarchical models before and after adjusting for socioeconomic characteristics. RESULTS The results of the multivariate analyses showed that, for males aged 0-39 and 40-59 years, rural residents tended to have a higher suicide risk compared to urban ones. For males aged 60+ years, a distinct rural-urban gradient in suicide risk was not observed. For females aged 0-39 years, a significant association between suicide risk and rurality was not observed, while for females aged 40-59 years and females aged 60 years or above, the association was a U-shaped curve. CONCLUSION Our results showed that geographical distribution of and rural-urban differences in suicide mortality in Japan differed substantially by gender and age. These findings suggest that it is important to take demographic factors into consideration when municipalities allocate resources for suicide prevention.
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Occhipinti JA, Skinner A, Freebairn L, Song YJC, Ho N, Lawson K, Lee GY, Hickie IB. Which Social, Economic, and Health Sector Strategies Will Deliver the Greatest Impacts for Youth Mental Health and Suicide Prevention? Protocol for an Advanced, Systems Modelling Approach. Front Psychiatry 2021; 12:759343. [PMID: 34721120 PMCID: PMC8548722 DOI: 10.3389/fpsyt.2021.759343] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Current global challenges are generating extensive social disruption and uncertainty that have the potential to undermine the mental health, wellbeing, and futures of young people. The scale and complexity of challenges call for engagement with systems science-based decision analytic tools that can capture the dynamics and interrelationships between physical, social, economic, and health systems, and support effective national and regional responses. At the outset of the pandemic mental health-related systems models were developed for the Australian context, however, the extent to which findings are generalisable across diverse regions remains unknown. This study aims to explore the context dependency of systems modelling insights. Methods: This study will employ a comparative case study design, applying participatory system dynamics modelling across eight diverse regions of Australia to answer three primary research questions: (i) Will current regional differences in key youth mental health outcomes be exacerbated in forward projections due to the social and economic impacts of COVID-19?; (ii) What combination of social policies and health system strengthening initiatives will deliver the greatest impacts within each region?; (iii) To what extent are optimal strategic responses consistent across the diverse regions? We provide a detailed technical blueprint as a potential springboard for more timely construction and deployment of systems models in international contexts to facilitate a broader examination of the question of generalisability and inform investments in the mental health and wellbeing of young people in the post COVID-19 recovery. Discussion: Computer simulation is known as the third pillar of science (after theory and experiment). Simulation allows researchers and decision makers to move beyond what can be manipulated within the scale, time, and ethical limits of the experimental approach. Such learning when achieved collectively, has the potential to enhance regional self-determination, help move beyond incremental adjustments to the status quo, and catalyze transformational change. This research seeks to advance efforts to establish regional decision support infrastructure and empower communities to effectively respond. In addition, this research seeks to move towards an understanding of the extent to which systems modelling insights may be relevant to the global mental health response by encouraging researchers to use, challenge, and advance the existing work for scientific and societal progress.
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Affiliation(s)
- Jo-An Occhipinti
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Adam Skinner
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Louise Freebairn
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,Computer Simulation & Advanced Research Technologies (CSART), Sydney, NSW, Australia
| | - Yun Ju Christine Song
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Nicholas Ho
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kenny Lawson
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Grace Yeeun Lee
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ian B Hickie
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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McLaren S. Rurality, reasons for living, and suicidal ideation among Australian men. DEATH STUDIES 2020; 46:1853-1861. [PMID: 33345725 DOI: 10.1080/07481187.2020.1863520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Within Australia, men who reside in rural areas are at higher risk for suicide compared to men who reside in more populated areas. The aim of the current study was to examine the role that fewer reasons for living might play in the higher rates of suicide among men who reside in rural areas by testing a mediation model. Given the protective nature of reasons for living, I proposed that rurality would be associated with fewer reasons for living which, in turn, would be associated with higher levels of suicidal ideation. A convenience sample of 609 Australian men aged from 18 to 90 years (M = 51.42, SD = 20.61) completed the Reasons for Living Inventory and the suicide subscale of the General Health Questionnaire. The mediation model was supported for Survival and Coping Beliefs, Responsibility to Family, Child-related Concerns, and Moral Objections. In addition, rurality was directly associated with higher levels of suicidal ideation. Results indicate that increasing four key reasons for living among men who live in rural areas may be beneficial for their mental health. Identifying other protective factors is important to reduce suicide among rural men.
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Affiliation(s)
- Suzanne McLaren
- School of Science, Psychology and Sport, Federation University, Ballarat, Australia
- School of Psychology, Charles Sturt University, Port Macquarie, Australia
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17
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Lersch KM. COVID-19 and Mental Health: An Examination of 911 Calls for Service. POLICING: A JOURNAL OF POLICY AND PRACTICE 2020. [PMCID: PMC7454910 DOI: 10.1093/police/paaa049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The purpose of this study was to explore the rate and geographic distribution of 911 calls for service related to mental health issues during the Coronavirus Disease 2019 (COVID-19) pandemic in the City of Detroit, MI, USA. The results suggest that the total number of calls for mental health issues was at the lowest level when compared with the same time period for the previous 3 years. Furthermore, as both the daily reported COVID-19 cases and related deaths increased over time, there was a significant decline in both suicide threats and suicides in progress. Significant hot spots were found for the total calls as well as for threats of suicide. These hot spots did not coincide with the spatial distribution of reported cases of COVID-19 by ZIP code. While higher and lower areas of reported cases were found, these differences by ZIP code were not found to be significant. When compared with the previous 3 years of data, the hot spot area was much smaller in 2020, implying that the mental health-related calls for service were more evenly spread throughout the city.
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Affiliation(s)
- Kim M Lersch
- School of Information University of South Florida, Tampa, FL, USA. E-mail:
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18
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Regional Variation of Suicide Mortality in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155433. [PMID: 32731583 PMCID: PMC7432038 DOI: 10.3390/ijerph17155433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 01/22/2023]
Abstract
South Korea’s suicide rate is the highest among the members of the Organization for Economic Cooperation and Development. This study seeks to verify regional variation in suicide rates in South Korea and to identify correlating factors. We used age-adjusted suicide rates for 252 administrative districts, and a Community Health Survey, national representative data, and other national representative data such as censuses were used to obtain information on socioeconomic, health related and social integration variables according to each administrative district. Regional variation in suicide rates was analyzed by using Extremal Quotient (EQ), and multiple linear regression analyses were used to investigate associations between variation in suicide rates and regional socioeconomic, public service factors and health related factors. The average suicide rate from 252 regions was 142.7 per 100,000 people. The highest region was Hongchun-gun (217.8) and the lowest was Gwachen-si (75.5). The EQ was 2.89, meaning that there is significant regional variation in suicide rates. Financial independence (β = −0.662, p < 0.001), social welfare budget (β = −0.754, p < 0.001) and divorce rates (β = 17.743, p < 0.001) were significant, along with other adjusted variables. This study suggests considering these factors in order to reduce suicide rates in South Korea.
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19
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Factors Associated with Regional Years of Life Lost (YLLs) due to Suicide in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144961. [PMID: 32660073 PMCID: PMC7400422 DOI: 10.3390/ijerph17144961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 01/06/2023]
Abstract
South Korea’s suicide rate has remained among the highest in the world for some years, and there is also a gap in suicide rates among regions within the country. This study investigates the differences in years of life lost (YLLs) due to suicide in 250 districts and the factors associated with regional YLLs in South Korea in 2016. The relationships between YLLs due to suicide by region and factors such as population characteristics, health behaviors, socioeconomic factors, and mental health resources in the community were examined through multiple linear regression analysis. The gap between districts with the highest and lowest YLL due to suicide per 100,000 people was more than a 7-times difference. Factors related to YLLs due to suicide by region were physical activity rates and community mental healthcare centers, and there were differences in these factors according to gender. In conclusion, to prevent suicide at the community level, it is necessary to consider gender in establishing intervention strategies. The community needs to play an active role in promoting mental health and reducing suicide among local residents and to continue to invest in the support and management of those at high risk of suicide.
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20
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Lersch KM. Exploring the geography of suicide threats and suicide attempts: An application of Risk Terrain Modeling. Soc Sci Med 2020; 249:112860. [PMID: 32106000 DOI: 10.1016/j.socscimed.2020.112860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/19/2019] [Accepted: 02/13/2020] [Indexed: 01/27/2023]
Abstract
The purpose of this research is twofold: first, the spatial distribution of 911 emergency calls for service to the police for suicides in progress and threats of suicide in the City of Detroit, Michigan will be explored to determine whether these events exhibit different patterns of spatial clustering. Second, this research will explore the utility of Risk Terrain Modeling (RTM) to assist in our understanding of the locations of calls for service to the police related to suicide threats and suicides in progress. The results suggest that these events are different social phenomenon, both with respect to the spatial clustering of these events as well as qualitative differences in the environmental factors that may contribute to their occurrence.
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Affiliation(s)
- Kim M Lersch
- School of Information, University of South Florida, 4202 E. Fowler Avenue, CIS 1020 Tampa, FL, 33620, USA.
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21
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Kanamori M, Kondo N. Suicide and Types of Agriculture: A Time-Series Analysis in Japan. Suicide Life Threat Behav 2020; 50:122-137. [PMID: 31215073 PMCID: PMC7027827 DOI: 10.1111/sltb.12559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/07/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In recent years, rural areas have reported higher suicide rates than urban areas worldwide. Although agricultural activity is a key characteristic of many rural areas, rurality may also have heterogeneous qualities based on the type of agriculture pursued. However, to date, no study has examined potential linkages between suicide rate and types of agriculture. METHOD In this study, we used 1983-2007 annual time-series data of the standardized mortality ratio (SMR) of suicide and product-specific agricultural outputs in Japanese municipalities to shed light on this phenomenon. We conducted a multilevel linear regression analysis, taking into account a hierarchical structure of the time-series data, limiting our analysis to municipalities where agricultural land use was high. RESULTS Our multilevel analysis showed that the animal husbandry output was positively associated with suicide SMR in both women and men, with a stronger relationship among women, whereas no association was observed in agricultural crop output. Temporal analysis showed that the association could be observed consistently throughout the period between 1983 and 2007. CONCLUSIONS This study raises the possibility that the industrial and cultural characteristics of communities that rely on animal husbandry may be associated with an increased risk of suicide.
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Affiliation(s)
- Mariko Kanamori
- Department of Health Education and Health SociologyThe University of TokyoTokyoJapan
| | - Naoki Kondo
- Department of Health Education and Health SociologyThe University of TokyoTokyoJapan
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22
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Demirci Ş, Konca M, Yetim B, İlgün G. Effect of economic crisis on suicide cases: An ARDL bounds testing approach. Int J Soc Psychiatry 2020; 66:34-40. [PMID: 31564187 DOI: 10.1177/0020764019879946] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicide events observed in various groups, community or countries, especially in the periods of economic recession. It is thought that suicide cases increase when people's income decreases dramatically and they lose their jobs. AIM/OBJECTIVE In this study, it was aimed to investigate whether the 2008 economic crisis had any effect on suicides in the United States. METHODS Autoregressive distributed lag method was used. For the purpose of the study, the number of suicide-related deaths was taken as the dependent variable, while unemployment rates and 2008 economic crisis were taken as independent variables. FINDINGS The short-term and long-term relationships obtained within the scope of the study indicated that the 2008 economic crisis had a statistically significant effect on suicide cases in the United States. RESULTS AND CONCLUSION It can be said that the results of this study are consistent with the information which emphasizes that economic crises increase suicide cases in the literature.
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Affiliation(s)
- Şenol Demirci
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
| | - Murat Konca
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
| | - Birol Yetim
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
| | - Gülnur İlgün
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University, Ankara, Turkey
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23
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Guo Y, Chau PPH, Chang Q, Woo J, Wong M, Yip PSF. The geography of suicide in older adults in Hong Kong: An ecological study. Int J Geriatr Psychiatry 2020; 35:99-112. [PMID: 31663178 DOI: 10.1002/gps.5225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 09/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The geography of suicide has been widely explored among the general population. However, little is known of the geographic variations in suicides among the older adults and their spatial correlates. This study aims to explore the spatial variations in the elderly suicide rates and their correlates in Hong Kong. METHODS Bayesian hierarchical models have been used to estimate smoothed standardized mortality ratios (2006-2015) on suicide in people aged 65 years or older in each geographic unit in Hong Kong. Their associations with the Social Vulnerability Index and the accessibility of eight types of services (ie, recreational services, rehabilitation services, food services, daily necessity services, community services, and transportation services) were further analyzed. RESULTS The results suggested that compared with the simple "inner-city high suicide rate and suburban low" pattern in the Western studies and the "central low suicide rate and peripheral high" pattern in the Asian studies, the spatial variations of elderly suicides in Hong Kong exhibit a much more complicated pattern. In Hong Kong, higher elderly suicide clusters were found in both the lower-density areas located in the New Territories and in some inner-city areas. The spatial variations of suicide in the older adults cannot be explained by the Social Vulnerability Index. Instead, service provision such as recreational services, daily necessity resources, and community centers played a more significant role in affecting suicides in the older adults. CONCLUSIONS Strengthening public services, providing more public spaces and activities, and making good use of the community resources might be key and efficient strategies in elderly suicide prevention in Hong Kong. Key points The spatial variations of elderly suicides in Hong Kong show a much more complicated pattern compared with the simple "inner-city high suicide rate and suburban low" pattern in the Western countries and the "central low suicide rate and peripheral high" pattern in some of the Asian countries. In Hong Kong, suicide rates in the city centers were not higher than the average in the city. Clusters of higher suicide rates were mainly found in the New Territories, which is somewhat disconnected from the city and, in some inner-city neighborhoods, with high-density population. The spatial variations of suicide in the older adults in Hong Kong cannot be explained by the neighborhood Social Vulnerability Index as in the existing literature. Neighborhood service provision such as recreational services, daily necessity resources, and community centers played a significant role in affecting suicides in the older adults in Hong Kong.
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Affiliation(s)
- Yingqi Guo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
| | - Patsy P H Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Qingsong Chang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China.,School of Sociology and Anthropology, Xiamen University, Xiamen, China
| | - Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Moses Wong
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, SAR, China
| | - Paul S F Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
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Abstract
AIMS To investigate the spatial distribution of self-harm incidence rates, their socioeconomic correlates and sex/age differences using data on self-harm presentations to emergency departments from The Manchester Self-Harm Project (2003-2013). METHODS Smoothed standardised incidence ratios for index self-harm episodes (n = 14 771) and their associations with area-level socioeconomic factors across 258 small areas (median population size = 1470) in the City of Manchester municipality were estimated using Bayesian hierarchical models. RESULTS Higher numbers and rates of self-harm were found in the north, east and far southern zones of the city, in contrast to below average rates in the city centre and the inner city zone to the south of the centre. Males and females aged 10-24, 25-44 and 45-64 years showed similar geographical patterning of self-harm. In contrast, there was no clear pattern in the group aged 65 years and older. Fully adjusted analyses showed a positive association of self-harm rates with the percentage of the unemployed population, households privately renting, population with limiting long-term illness and lone-parent households, and a negative association with the percentage of ethnicity other than White British and travel distance to the nearest hospital emergency department. The area-level characteristics investigated explained a large proportion (four-fifths) of the variability in area self-harm rates. Most associations were restricted to those aged under 65 years and some associations (e.g. with unemployment) were present only in the youngest age group. CONCLUSIONS The findings have implications for allocating prevention and intervention resources targeted at high-risk groups in high incidence areas. Targets for area-based interventions might include tackling the causes and consequences of joblessness, better treatment of long-term illness and consideration of the accessibility of health services.
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25
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Bagheri N, Batterham PJ, Salvador-Carulla L, Chen Y, Page A, Calear AL, Congdon P. Development of the Australian neighborhood social fragmentation index and its association with spatial variation in depression across communities. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1189-1198. [PMID: 30989255 DOI: 10.1007/s00127-019-01712-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE We know little about how community structures influence the risk of common mental illnesses. This study presents a new way to establish links between depression and social fragmentation, thereby identifying pathways to better target mental health services and prevention programs to the right people in the right place. METHOD A principal components analysis (PCA) was conducted to develop the proposed Australian neighborhood social fragmentation index (ANSFI). General practice clinical data were used to identify cases of diagnosed depression. The association between ANSFI and depression was explored using multilevel logistic regression. Spatial hot spots (clusters) of depression prevalence and social fragmentation at the statistical area level 1 (SA1) were examined. RESULTS Two components of social fragmentation emerged, reflecting fragmentation related to family structure and mobility. Individuals treated for depression in primary care were more likely to live in neighborhoods with lower socioeconomic status and with higher social fragmentation related to family structure. A 1-SD increase in social fragmentation was associated with a 16% higher depression prevalence (95% CI 11%, 20%). However, the association attenuated with adjustment for neighborhood socio-economic status. Considerable spatial variation in social fragmentation and depression patterns across communities was observed. CONCLUSIONS Developing a social fragmentation index for the first time in Australia at a small area level generates a new line of knowledge on the impact of community structures on health risks. Findings may extend our understanding of the mechanisms that drive geographical variation in the incidence of common mental disorders and mental health care.
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Affiliation(s)
- Nasser Bagheri
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
- Visual and Decision Analytics (VIDEA) Lab, Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia.
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Yingxi Chen
- Research School of Population Health, The Australian National University, Canberra, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Peter Congdon
- School of Geography, Queen Mary University of London, London, UK
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Chang C, Yeh M, Chien W, Chung C, Li T, Lai EC. Interactions between psychiatric and physical disorders and their effects on the risks of suicide: a nested case–control study. Ann N Y Acad Sci 2019; 1462:79-91. [DOI: 10.1111/nyas.14216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/24/2019] [Accepted: 07/22/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Ching‐Feng Chang
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Ming‐kung Yeh
- Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
- School of Pharmacy, Graduate Institute of Medical SciencesNational Defense Medical Center Taipei Taiwan
| | - Wu‐Chien Chien
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Chi‐Hsiang Chung
- School of Public HealthNational Defense Medical Center Taipei Taiwan
| | - Tzu‐Ting Li
- Department of RadiologyTri‐Service General Hospital Taipei Taiwan
| | - Edward Chia‐Cheng Lai
- School of Pharmacy, College of Medicine, Institute of Clinical Pharmacy and Pharmaceutical SciencesNational Cheng Kung University Tainan Taiwan
- Department of PharmacyNational Cheng Kung University Hospital Tainan Taiwan
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Lin CY, Hsu CY, Gunnell D, Chen YY, Chang SS. Spatial patterning, correlates, and inequality in suicide across 432 neighborhoods in Taipei City, Taiwan. Soc Sci Med 2019; 222:20-34. [DOI: 10.1016/j.socscimed.2018.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/01/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
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Shaw FFT, Chiang WH. An evaluation of suicide prevention hotline results in Taiwan: Caller profiles and the effect on emotional distress and suicide risk. J Affect Disord 2019; 244:16-20. [PMID: 30292022 DOI: 10.1016/j.jad.2018.09.050] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/25/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Hotlines are among commonly available and recommended suicide prevention strategies in many countries, but only a few empirical studies have focused on people who used this service and the proximal outcomes of calls made to the hotlines. This study is designed to investigate the demographic characteristics of the Taiwan National Suicide Prevention Hotline (NSPH) callers and whether the NSPH service helps to alleviate the callers' emotional distress and suicide risk. METHODS Descriptive statistics were used to describe the gender, age and county/city distribution of the 63,696 callers from 2009 to 2011. Three hundred telephone records of 100 acute suicidal callers, 100 suicidal callers, and 100 non-suicidal callers were then randomly selected for further investigation of the proximal changes in the callers' emotional disturbance and suicidality. RESULTS Notwithstanding the suicide status of the callers, significant decreases in their emotional distress and suicidality could be detected during the course of the telephone session. Men, the elderly, and people living outside northern Taiwan, however, were less likely to call the NSPH. An unexpected yet significant finding is that people with an ongoing suicide attempt were less emotionally distressed than those with only suicidal thoughts. CONCLUSIONS The hotline is a useful suicide preventive and crisis intervention service. However, further creative and consistent work is needed to make the service more appealing to the hard-to-reach population.
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Affiliation(s)
- Fortune Fu-Tsung Shaw
- National Chi Nan University, Department of Counseling Psychology and Human Resource Development, 1 University Rd., Puli, Nantou 54561, Taiwan.
| | - Wen-Hsien Chiang
- Shiuhli Foundation, 8F-2, No. 245, Sec. 3, Roosevelt Rd., Daan District, Taipei City 10647, Taiwan.
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Orndahl CM, Wheeler DC. Spatial analysis of the relative risk of suicide for Virginia counties incorporating uncertainty of variable estimates. Spat Spatiotemporal Epidemiol 2018; 27:71-83. [PMID: 30409378 DOI: 10.1016/j.sste.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/11/2018] [Accepted: 10/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This research aimed to identify significantly elevated areas of risk for suicide in Virginia adjusting for risk factors and risk factor uncertainty. METHODS We fit three Bayesian hierarchical spatial models for relative risk of suicide adjusting for risk factors and considering different random effects. We compared models with and without incorporating parameter estimates' margin of error (MOE) from the American Community Survey and identified counties with significantly elevated risk and highly significantly elevated risk for suicide. RESULTS Incorporating MOEs and using a mixing parameter between unstructured and spatially structured random effects achieved the best model fit. Fifty-two counties had significantly elevated risk and 18 had highly significantly elevated risk of suicide. Models without MOEs underestimated relative risk and over-identified counties with elevated risk. CONCLUSIONS Accounting for uncertainty in parameter estimates achieved better model fit. Efficient allocation of resources for suicide prevention can be attained by targeting clusters of counties with elevated risk.
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Affiliation(s)
- Christine M Orndahl
- Department of Biostatistics, Virginia Commonwealth University, One Capitol Square, Seventh Floor, 830 East Main Street, P.O. Box 980032, Richmond, VA 23219, USA.
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, One Capitol Square, Seventh Floor, 830 East Main Street, P.O. Box 980032, Richmond, VA 23219, USA.
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Liu CH, Wang JH, Weng SC, Cheng YH, Yeh MK, Bai MY, Chang JC. Is Heart Failure Associated With Risk of Suicide? J Card Fail 2018; 24:795-800. [PMID: 30053581 DOI: 10.1016/j.cardfail.2018.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/26/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The high prevalence of heart failure (HF) in developed countries imposes a substantial burden on health care resources. Depression is widely recognized as a risk factor associated with HF. This study examined the relationship between suicide and HF after controlling for depression and other comorbidities. METHODS AND RESULTS The population comprised 52,749 adult patients who died from suicide from 2000 to 2012 and 210,996 living control subjects matched by age, sex, and residence area. Data were obtained from the Health and Welfare Data Science Center, Taiwan. Multivariable models were constructed to evaluate the relationship between HF and suicide. In the case and control groups 1624 (3.08%) and 4053 (1.92%) patients had HF, respectively, indicating that HF was associated with an increased risk of suicide (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.59-1.79). The risk of suicide was highest during the initial 6 months after HF (adjusted OR 7.04, 95% CI 5.37-9.22) and subsequently declined gradually. Among psychiatric disorders, mood disorders (adjusted OR 7.42, 95% CI 7.06-7.79) yielded the highest odds of suicide. CONCLUSIONS The risk of suicide is higher for patients with HF than for healthy individuals without HF. This risk is particularly high during the first 6 months after HF diagnosis. This study provides strong evidence that depression is a negative prognostic factor for patients with HF and increases the risk of suicide. The results suggest that early screening and treatment for depression and suicide risk should be conducted for patients with HF.
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Affiliation(s)
- Chao-Han Liu
- Biomedical Engineering Program, Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan; Division of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ji-Hung Wang
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Cardiology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Shu-Chuan Weng
- Bachelor Degree Program of Golden-Age Well-Being Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Yen-Huang Cheng
- Division of Emergency Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Ming-Kung Yeh
- School of Pharmacy, National Defense Medical Center, Taiwan
| | - Meng-Yi Bai
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology & Adjunct Appoint to the Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan.
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
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Rossen LM, Hedegaard H, Khan D, Warner M. County-Level Trends in Suicide Rates in the U.S., 2005-2015. Am J Prev Med 2018; 55:72-79. [PMID: 29773489 PMCID: PMC6038117 DOI: 10.1016/j.amepre.2018.03.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/12/2018] [Accepted: 03/26/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Understanding the geographic patterns of suicide can help inform targeted prevention efforts. Although state-level variation in age-adjusted suicide rates has been well documented, trends at the county-level have been largely unexplored. This study uses small area estimation to produce stable county-level estimates of suicide rates to examine geographic, temporal, and urban-rural patterns in suicide from 2005 to 2015. METHODS Using National Vital Statistics Underlying Cause of Death Files (2005-2015), hierarchical Bayesian models were used to estimate suicide rates for 3,140 counties. Model-based suicide rate estimates were mapped to explore geographic and temporal patterns and examine urban-rural differences. Analyses were conducted in 2016-2017. RESULTS Posterior predicted mean county-level suicide rates increased by >10% from 2005 to 2015 for 99% of counties in the U.S., with 87% of counties showing increases of >20%. Counties with the highest model-based suicide rates were consistently located across the western and northwestern U.S., with the exception of southern California and parts of Washington. Compared with more urban counties, more rural counties had the highest estimated suicide rates from 2005 to 2015, and also the largest increases over time. CONCLUSIONS Mapping county-level suicide rates provides greater granularity in describing geographic patterns of suicide and contributes to a better understanding of changes in suicide rates over time. Findings may inform more targeted prevention efforts as well as future research on community-level risk and protective factors related to suicide mortality.
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Affiliation(s)
- Lauren M Rossen
- Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland.
| | - Holly Hedegaard
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Diba Khan
- Division of Research Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Margaret Warner
- Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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Haghparast-Bidgoli H, Rinaldi G, Shahnavazi H, Bouraghi H, Kiadaliri AA. Socio-demographic and economics factors associated with suicide mortality in Iran, 2001-2010: application of a decomposition model. Int J Equity Health 2018; 17:77. [PMID: 29898724 PMCID: PMC6001008 DOI: 10.1186/s12939-018-0794-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/04/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Suicide is a major global health problem, especially among youth. Suicide is known to be associated with a variety of social, economic, political and religious factors, vary across geographical and cultural regions. The current study aimed to investigate the effects of socioeconomic factors on suicide mortality rate across different regions in Iran. METHODS The data on distribution of population and socio-economic factors (such as unemployment rate, divorce rate, urbanization rate, average household expenditure etc.) at province level were obtained from the Statistical Centre of Iran and the National Organization for Civil Registration. The data on the annual number of deaths caused by suicide in each province was extracted from the published reports of the Iranian Forensic Medicine Organization. We used a decomposition model to distinguish between spatial and temporal variation in suicide mortality. RESULTS The average rate of suicide mortality was 5.5 per 100,000 population over the study period. Across the provinces (spatial variation), suicide mortality rate was positively associated with household expenditure and the proportion of people aged 15-24 and older than 65 years and was negatively associated with the proportion of literate people. Within the provinces (temporal variation), higher divorce rate was associated with higher suicide mortality. By excluding the outlier provinces, the results showed that in addition to the proportion of people aged 15-24 and older than 65, divorce and unemployment rates were also significant predictors of spatial variation in suicide mortality while divorce rate was associated with higher suicide mortality within provinces. CONCLUSION The findings indicate that both spatial and temporal variations in suicide mortality rates across the provinces and over time are determined by a number of socio-economic factors. The study provides information that can be of importance in developing preventive strategies.
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Affiliation(s)
| | | | | | - Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Aliasghar A. Kiadaliri
- Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund University, Faculty of Medicine, Lund, Sweden
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Abstract
Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780–6.
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Affiliation(s)
- C-F. Chang
- General Institute of Medical Science,
National Defense Medical Center and Department of Radiology,
Tri-Service General Hospital, Taipei, Taiwan
| | - E. C-C. Lai
- School of Pharmacy,
Institute of Clinical Pharmacy and Pharmaceutical Sciences, National
Cheng Kung University, Tainan, Taiwan
| | - M-K. Yeh
- School of Pharmacy, Graduate Institute
of Medical Science, National Defense Medical Center, Taipei, Taiwan
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Liu CH, Yeh MK, Weng SC, Bai MY, Chang JC. Suicide and chronic kidney disease: a case-control study. Nephrol Dial Transplant 2018; 32:1524-1529. [PMID: 27638910 DOI: 10.1093/ndt/gfw244] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 05/05/2016] [Indexed: 01/22/2023] Open
Abstract
Background The association of chronic kidney disease (CKD) and dialysis with suicide is not well established. The objectives of this study were to assess the association of suicide with CKD and dialysis and investigate whether differences exist between dialysis modalities or the durations of dialysis. Methods Data were obtained from the Taiwan National Health Insurance Research Database. A total of 51 642 patients who died from suicide between 2000 and 2012 and 206 568 living control patients matched by age, gender and residency area were examined. Known risk factors included sociodemographic characteristics, physical comorbidities and psychiatric disorders, which were controlled for as covariates in the analysis. The crude odds ratios (ORs) and adjusted ORs (aORs) for various risk factors were obtained using conditional logistic regression. Results After potential confounders were controlled for, CKD was significantly associated with an increased risk of suicide [aOR = 1.25, 95% confidence interval (CI) = 1.17-1.34]. End-stage renal disease patients on haemodialysis (HD) had an increased risk of suicide compared with controls (aOR = 3.35, 95% CI = 3.02-3.72). Moreover, patients who initially underwent dialysis within 0-3 months had a significantly increased risk of suicide (aOR = 20.26, 95% CI = 15.99-25.67). Conclusions CKD and HD are positively associated with suicide. Suicide is preventable; therefore, assessing mental and physical disorders is essential and recommended to all physicians, particularly those treating patients in the early phase of HD.
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Affiliation(s)
- Chao-Han Liu
- Biomedical Engineering Program, Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Ming-Kung Yeh
- Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan.,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Chuan Weng
- Department of Business Administration, Taipei City University of Science and Technology, Taipei, Taiwan
| | - Meng-Yi Bai
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Abstract
PURPOSE OF REVIEW This was a retrospective ecological study to examine the relationship between suicide rates and economic indicators in large Brazilian urban centers. Data on macroeconomic indicators (GDP and unemployment rates) and suicide rates of the largest Brazilian cities were collected from January 2006 to December 2015. RECENT FINDINGS Six cities were included in the study: Porto Alegre in the South, Recife and Salvador in the Northeast, and Belo Horizonte, São Paulo and Rio de Janeiro in the Southeast region. We observed a 4% increase in the age-adjusted suicide rate in these large Brazilian urban centers from 2006 to 2015, which is less pronounced than the 9% increase in the national rates of suicide observed in the same period. SUMMARY The effect of economic indicators was heterogeneous among the centers, but, overall, the variation in suicide rates was inversely related to unemployment and did not show a significant relationship with GDP. These findings indicate a more complex link between economics and suicide whenever looking at local regional indicators. Further research should focus on possible intervening factors, what may inform better preventive interventions.
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Marco M, Gracia E, López-Quílez A, Lila M. What calls for service tell us about suicide: A 7-year spatio-temporal analysis of neighborhood correlates of suicide-related calls. Sci Rep 2018; 8:6746. [PMID: 29712990 PMCID: PMC5928118 DOI: 10.1038/s41598-018-25268-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/18/2018] [Indexed: 11/09/2022] Open
Abstract
Previous research has shown that neighborhood-level variables such as social deprivation, social fragmentation or rurality are related to suicide risk, but most of these studies have been conducted in the U.S. or northern European countries. The aim of this study was to analyze the spatio-temporal distribution of suicide in a southern European city (Valencia, Spain), and determine whether this distribution was related to a set of neighborhood-level characteristics. We used suicide-related calls for service as an indicator of suicide cases (n = 6,537), and analyzed the relationship of the outcome variable with several neighborhood-level variables: economic status, education level, population density, residential instability, one-person households, immigrant concentration, and population aging. A Bayesian autoregressive model was used to study the spatio-temporal distribution at the census block group level for a 7-year period (2010–2016). Results showed that neighborhoods with lower levels of education and population density, and higher levels of residential instability, one-person households, and an aging population had higher levels of suicide-related calls for service. Immigrant concentration and economic status did not make a relevant contribution to the model. These results could help to develop better-targeted community-level suicide prevention strategies.
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Affiliation(s)
- Miriam Marco
- Department of Social Psychology, University of Valencia, Valencia, 46010, Spain.
| | - Enrique Gracia
- Department of Social Psychology, University of Valencia, Valencia, 46010, Spain
| | - Antonio López-Quílez
- Department of Statistics and Operations Research, University of Valencia, Valencia, 46100, Spain
| | - Marisol Lila
- Department of Social Psychology, University of Valencia, Valencia, 46010, Spain
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An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040671. [PMID: 29617301 PMCID: PMC5923713 DOI: 10.3390/ijerph15040671] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/28/2018] [Accepted: 04/01/2018] [Indexed: 12/23/2022]
Abstract
Suicide is a serious but preventable public health issue. Several previous studies have revealed a positive association between altitude and suicide rates at the county level in the contiguous United States. We assessed the association between suicide rates and altitude using a cross-county ecological study design. Data on suicide rates were obtained from a Web-based Injury Statistics Query and Reporting System (WISQARS), maintained by the U.S. National Center for Injury Prevention and Control (NCIPC). Altitude data were collected from the United States Geological Survey (USGS). We employed an ordinary least square (OLS) regression to model the association between altitude and suicide rates in 3064 counties in the contiguous U.S. We conducted a geographically weighted regression (GWR) to examine the spatially varying relationship between suicide rates and altitude after controlling for several well-established covariates. A significant positive association between altitude and suicide rates (average county rates between 2008 and 2014) was found in the dataset in the OLS model (R2 = 0.483, p < 0.001). Our GWR model fitted the data better, as indicated by an improved R2 (average: 0.62; range: 0.21–0.64) and a lower Akaike Information Criteria (AIC) value (13,593.68 vs. 14,432.14 in the OLS model). The GWR model also significantly reduced the spatial autocorrelation, as indicated by Moran’s I test statistic (Moran’s I = 0.171; z = 33.656; p < 0.001 vs. Moran’s I = 0.323; z = 63.526; p < 0.001 in the OLS model). In addition, a stronger positive relationship was detected in areas of the northern regions, northern plain regions, and southeastern regions in the U.S. Our study confirmed a varying overall positive relationship between altitude and suicide. Future research may consider controlling more predictor variables in regression models, such as firearm ownership, religion, and access to mental health services.
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Kazemi-Galougahi MH, Mansouri A, Akbarpour S, Bakhtiyari M, Sartipi M, Moradzadeh R. Income-related inequality in completed suicide across the provinces of Iran. Epidemiol Health 2018; 40:e2018012. [PMID: 29642654 PMCID: PMC6004429 DOI: 10.4178/epih.e2018012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/31/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to measure income-related inequality in completed suicide across the provinces of Iran. METHODS This ecological study was performed using data from the Urban and Rural Household Income and Expenditure Survey-2010 conducted by the Iranian Center of Statistics, along with data on completed suicide from the Iranian Legal Medicine Organization in 2012. We calculated the Gini coefficient of per capita income and the completed suicide rate, as well as the concentration index for per capita income inequality in completed suicide, across the provinces of Iran. RESULTS The Gini coefficients of per capita income and the completed suicide rate in the provinces of Iran were 0.10 (95% confidence interval [CI], 0.06 to 0.13) and 0.34 (95% CI, 0.21 to 0.46), respectively. We found a trivial decreasing trend in the completed suicide incidence rate according to income quintile. The poorest-to-richest ratio in the completed suicide rate was 2.01 (95% CI, 1.26 to 3.22). The concentration index of completed suicide in the provinces of Iran was -0.12 (95% CI, -0.30 to 0.06). CONCLUSIONS This study found that lower income might be considered as a risk factor for completed suicide. Nonetheless, further individual studies incorporating multivariable analysis and repeated cross-sectional data would allow a more fine-grained analysis of this phenomenon.
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Affiliation(s)
| | - Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samaneh Akbarpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Bakhtiyari
- Noncommunicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Majid Sartipi
- Department of Epidemiology and Biostatistics, School of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
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Chang SS, Gunnell D. Natural environments and suicide. Lancet Planet Health 2018; 2:e109-e110. [PMID: 29615223 DOI: 10.1016/s2542-5196(18)30024-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
| | - David Gunnell
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
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Fontanella CA, Saman DM, Campo JV, Hiance-Steelesmith DL, Bridge JA, Sweeney HA, Root ED. Mapping suicide mortality in Ohio: A spatial epidemiological analysis of suicide clusters and area level correlates. Prev Med 2018; 106:177-184. [PMID: 29133266 DOI: 10.1016/j.ypmed.2017.10.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/24/2017] [Accepted: 10/30/2017] [Indexed: 11/15/2022]
Abstract
Previous studies have investigated spatial patterning and associations of area characteristics with suicide rates in Western and Asian countries, but few have been conducted in the United States. This ecological study aims to identify high-risk clusters of suicide in Ohio and assess area level correlates of these clusters. We estimated spatially smoothed standardized mortality ratios (SMR) using Bayesian conditional autoregressive models (CAR) for the period 2004 to 2013. Spatial and spatio-temporal scan statistics were used to detect high-risk clusters of suicide at the census tract level (N=2952). Logistic regression models were used to examine the association between area level correlates and suicide clusters. Nine statistically significant (p<0.05) high-risk spatial clusters and two space-time clusters were identified. We also identified several significant spatial clusters by method of suicide. The risk of suicide was up to 2.1 times higher in high-risk clusters than in areas outside of the clusters (relative risks ranged from 1.22 to 2.14 (p<0.01)). In the multivariate model, factors strongly associated with area suicide rates were socio-economic deprivation and lower provider densities. Efforts to reduce poverty and improve access to health and mental health medical services on the community level represent potentially important suicide prevention strategies.
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Affiliation(s)
- Cynthia A Fontanella
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Columbus, OH 43210, United States.
| | - Daniel M Saman
- Essentia Institute of Rural Health, 502 East Second St, Duluth, MN 55805, United States.
| | - John V Campo
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Columbus, OH 43210, United States.
| | | | - Jeffrey A Bridge
- The Research Institute at Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205, United States.
| | - Helen Anne Sweeney
- Ohio Department of Mental Health and Addition Services, 30 East Broad Street, 8th Floor, Columbus, OH 43215, United States.
| | - Elisabeth D Root
- Department of Geography, Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, Columbus, OH 43210, United States.
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Helbich M, Blüml V, de Jong T, Plener PL, Kwan MP, Kapusta ND. Urban-rural inequalities in suicide mortality: a comparison of urbanicity indicators. Int J Health Geogr 2017; 16:39. [PMID: 29084555 PMCID: PMC5663034 DOI: 10.1186/s12942-017-0112-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Urban–rural disparities in suicide mortality have received considerable attention. Varying conceptualizations of urbanity may contribute to the conflicting findings. This ecological study on Germany assessed how and to what extent urban–rural suicide associations are affected by 14 different urban–rural indicators. Methods Indicators were based on continuous or k-means classified population data, land-use data, planning typologies, or represented population-based accessibility indicators. Agreements between indicators were tested with correlation analyses. Spatial Bayesian Poisson regressions were estimated to examine urban–rural suicide associations while adjusting for risk and protective factors. Results Urban–rural differences in suicide rates per 100,000 persons were found irrespective of the indicator. Strong and significant correlation was observed between different urban–rural indicators. Although the effect sign consistently referred to a reduced risk in urban areas, statistical significance was not universally confirmed by all regressions. Goodness-of-fit statistics suggested that the population potential score performs best, and that population density is the second best indicator of urbanicity. Numerical indicators are favored over classified ones. Regional planning typologies are not supported. Conclusions The strength of suicide urban–rural associations varies with respect to the applied indicator of urbanicity. Future studies that put urban–rural inequalities central are recommended to apply either unclassified population potentials or population density indicators, but sensitivity analyses are advised. Electronic supplementary material The online version of this article (10.1186/s12942-017-0112-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht, The Netherlands.
| | - V Blüml
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, 1090, Vienna, Austria
| | - T de Jong
- Department of Logistics, University of Stellenbosch, Van der Sterrbuilding 3017, Bosmanstreet, Matieland, Stellenbosch, South Africa
| | - P L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, 89075, Ulm, Germany
| | - M-P Kwan
- Department of Human Geography and Spatial Planning, Utrecht University, Heidelberglaan 2, 3584 CS, Utrecht, The Netherlands.,Department of Geography and Geographic Information Science, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - N D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, 1090, Vienna, Austria
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Torok M, Konings P, Batterham PJ, Christensen H. Spatial clustering of fatal, and non-fatal, suicide in new South Wales, Australia: implications for evidence-based prevention. BMC Psychiatry 2017; 17:339. [PMID: 28985736 PMCID: PMC5639600 DOI: 10.1186/s12888-017-1504-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 10/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rates of suicide appear to be increasing, indicating a critical need for more effective prevention initiatives. To increase the efficacy of future prevention initiatives, we examined the spatial distribution of suicide deaths and suicide attempts in New South Wales (NSW), Australia, to identify where high incidence 'suicide clusters' were occurring. Such clusters represent candidate regions where intervention is critically needed, and likely to have the greatest impact, thus providing an evidence-base for the targeted prioritisation of resources. METHODS Analysis is based on official suicide mortality statistics for NSW, provided by the Australian Bureau of Statistics, and hospital separations for non-fatal intentional self-harm, provided through the NSW Health Admitted Patient Data Collection at a Statistical Area 2 (SA2) geography. Geographical Information System (GIS) techniques were applied to detect suicide clusters occurring between 2005 and 2013 (aggregated), for persons aged over 5 years. The final dataset contained 5466 mortality and 86,017 non-fatal intentional self-harm cases. RESULTS In total, 25 Local Government Areas were identified as primary or secondary likely candidate regions for intervention. Together, these regions contained approximately 200 SA2 level suicide clusters, which represented 46% (n = 39,869) of hospital separations and 43% (n = 2330) of suicide deaths between 2005 and 2013. These clusters primarily converged on the Eastern coastal fringe of NSW. CONCLUSIONS Crude rates of suicide deaths and intentional self-harm differed at the Local Government Areas (LGA) level in NSW. There was a tendency for primary suicide clusters to occur within metropolitan and coastal regions, rather than rural areas. The findings demonstrate the importance of taking geographical variation of suicidal behaviour into account, prior to development and implementation of prevention initiatives, so that such initiatives can target key problem areas where they are likely to have maximal impact.
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Affiliation(s)
- Michelle Torok
- Black Dog Institute, University of NSW, Sydney, Australia.
| | - Paul Konings
- 0000 0001 2180 7477grid.1001.0National Centre for Geographic Resources & Analysis in Primary Health Care, Australian National University, Canberra, Australia
| | - Philip J. Batterham
- 0000 0001 2180 7477grid.1001.0Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Helen Christensen
- 0000 0004 4902 0432grid.1005.4Black Dog Institute, University of NSW, Sydney, Australia
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Dimitrovová K, Costa C, Santana P, Perelman J. "Evolution and financial cost of socioeconomic inequalities in ambulatory care sensitive conditions: an ecological study for Portugal, 2000-2014". Int J Equity Health 2017; 16:145. [PMID: 28810869 PMCID: PMC5558734 DOI: 10.1186/s12939-017-0642-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 08/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) are specific conditions for which hospitalization is thought to be avoidable through patient education, health promotion initiatives, early diagnosis and by appropriate chronic disease management, and have been shown to be greatly influenced by socioeconomic (SE) characteristics. We examined the SE inequalities in hospitalization rates for ACSC in Portugal, their evolution over time (2000-2014), and their associated financial burden. METHODS We modeled municipality-level ACSC hospitalization rates per 1000 inhabitants and ACSC hospitalization-related costs per inhabitant, for the 2000-2014 period (n = 4170), as a function of SE indicators (illiteracy and purchasing power, in quintiles), controlling for the proportion of elderly, sex, disease specific mortality rate, population density, PC supply, and time trend. The evolution of inequalities was measured interacting SE indicators with a time trend. Costs attributable to ACSC related hospitalization inequalities were measured by the predicted values for each quintile of the SE indicators. RESULTS Hospitalization rate for ACSC was significantly higher in the 4th quintile of illiteracy compared with the 1st quintile (beta = 1.97; p < 0.01), and significantly lower in the 5th quintile of purchasing power, compared with the 1st quintile (beta = - 1.19; p < 0.05). ACSC hospitalization-related costs were also significantly higher in the 4th quintile of illiteracy compared with the 1st quintile (beta = 4.04€; p < 0.05), and significantly lower in the 5th quintile of purchasing power, compared with the 1st quintile (beta = - 4,69€; p < 0.01). The SE gradient significantly increased over the 2000-2014 period, and the annual cost of inequalities were estimated at more than 15 million euros for the Portuguese NHS. CONCLUSION There was an increasing SE patterning in ACSC related hospitalizations, possibly reflecting increasing SE inequalities in early and preventive high-quality care, imposing a substantial financial burden to the Portuguese NHS.
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Affiliation(s)
- Klára Dimitrovová
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Cláudia Costa
- Centre of Studies on Geography and Spatial Planning, University of Coimbra, Faculdade de Letras Colégio de S. Jerónimo, 3004-530 Coimbra, Portugal
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning, Department of Geography, University of Coimbra, Faculdade de Letras Colégio de S. Jerónimo, 3004-530 Coimbra, Portugal
| | - Julian Perelman
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
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Spatiotemporal Suicide Risk in Germany: A Longitudinal Study 2007-11. Sci Rep 2017; 7:7673. [PMID: 28794489 PMCID: PMC5550498 DOI: 10.1038/s41598-017-08117-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/11/2017] [Indexed: 12/24/2022] Open
Abstract
Despite comprehensive prevention programs in Germany, suicide has been on the rise again since 2007. The underlying reasons and spatiotemporal risk patterns are poorly understood. We assessed the spatiotemporal risk of suicide per district attributable to multiple risk and protective factors longitudinally for the period 2007–11. Bayesian space–time regression models were fitted. The nationwide temporal trend showed an increase in relative risk (RR) of dying from suicide (RR 1.008, 95% credibility intervals (CI) 1.001–1.016), whereas district-specific deviations from the grand trend occurred. Striking patterns of amplified risk emerged in southern Germany. While the number of general practitioners was positively related (RR 1.003, 95% CI 1.000–1.006), income was negatively and non-linearly related with suicide risk, as was population density. Unemployment was associated and showed a marked nonlinearity. Neither depression prevalence nor mental health service supply were related. The findings are vital for the implementation of future suicide prevention programs. Concentrating preventive efforts on vulnerable areas of excess risk is recommended.
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Spatio-Temporal Analysis of Suicide-Related Emergency Calls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070735. [PMID: 28684714 PMCID: PMC5551173 DOI: 10.3390/ijerph14070735] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 06/28/2017] [Accepted: 06/30/2017] [Indexed: 11/17/2022]
Abstract
Considerable effort has been devoted to incorporate temporal trends in disease mapping. In this line, this work describes the importance of including the effect of the seasonality in a particular setting related with suicides. In particular, the number of suicide-related emergency calls is modeled by means of an autoregressive approach to spatio-temporal disease mapping that allows for incorporating the possible interaction between both temporal and spatial effects. Results show the importance of including seasonality effect, as there are differences between the number of suicide-related emergency calls between the four seasons of each year.
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Carcach C. A spatio-temporal analysis of suicide in El Salvador. BMC Public Health 2017; 17:339. [PMID: 28427363 PMCID: PMC5397781 DOI: 10.1186/s12889-017-4251-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 04/08/2017] [Indexed: 11/26/2022] Open
Abstract
Background In 2012, international statistics showed El Salvador’s suicide rate as 40th in the world and the highest in Latin America. Over the last 15 years, national statistics show the suicide death rate declining as opposed to an increasing rate of homicide. Though completed suicide is an important social and health issue, little is known about its prevalence, incidence, etiology and spatio-temporal behavior. The primary objective of this study was to examine completed suicide and homicide using the stream analogy to lethal violence within a spatio-temporal framework. Methods A Bayesian model was applied to examine the spatio-temporal evolution of the tendency of completed suicide over homicide in El Salvador. Data on numbers of suicides and homicides at the municipal level were obtained from the Instituto de Medicina Legal (IML) and population counts, from the Dirección General de Estadística y Censos (DIGESTYC), for the period of 2002 to 2012. Data on migration were derived from the 2007 Population Census, and inequality data were obtained from a study by Damianović, Valenzuela and Vera. Results The data reveal a stable standardized rate of total lethal violence (completed suicide plus homicide) across municipalities over time; a decline in suicide; and a standardized suicide rate decreasing with income inequality but increasing with social isolation. Municipalities clustered in terms of both total lethal violence and suicide standardized rates. Conclusions Spatial effects for suicide were stronger among municipalities located in the north-east and center-south sides of the country. New clusters of municipalities with large suicide standardized rates were detected in the north-west, south-west and center-south regions, all of which are part of time-stable clusters of homicide. Prevention efforts to reduce income inequality and mitigate the negative effects of weak relational systems should focus upon municipalities forming time-persistent clusters with a large rate of death by suicide. In municipalities that are part of newly-formed suicide clusters and also are located in areas with a large rate of homicide, interrupting the expansion of spatial concentrations of suicide over time may require the implementation of both public health and public safety interventions.
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Affiliation(s)
- Carlos Carcach
- Center for Public Policy, Escuela Superior de Economía y Negocios, Santa Tecla, El Salvador.
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47
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The effectiveness of suicide prevention programmes: urban and gender disparity in age-specific suicide rates in a Taiwanese population. Public Health 2017; 147:136-143. [PMID: 28404489 DOI: 10.1016/j.puhe.2017.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/20/2016] [Accepted: 01/31/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The effectiveness of suicide prevention programmes is an important issue worldwide today. The impact of urbanization and gender is controversial in suicide rates. Hence, this study adjusted on potential risk factors and secular changes for suicide rates in gender and rural/urban areas. STUDY DESIGN Observational study. METHODS A Suicide Prevention Center was established by the Executive Yuan in Taiwan in 2005 and tried to carry out suicidal intervention in the community in every city and town. There were two phases, including the first phase of the programme from 2005 to 2008, and the second phase of the programme from 2009 to 2013. The crude suicide rates data from the period of 1991-2013, which recruited nine urban and 14 rural areas in Taiwan, were extracted from the Taiwanese national mortality data file. The suicide rates in two areas of Taiwan (Taipei city and Yilan County) were further used to compare the differences between urban and rural areas. RESULTS The results show that unemployment increased the suicide rate in men aged 45-64 years and in women older than 65 years of age in Taiwan. High divorce and unemployment rates resulted in increased suicide rates in men in the city, whereas emotional distress was the main cause of suicides in men in rural areas. The main method of suicide was jumping from a high building for both sexes in the city, whereas drowning was the most common method of suicide for men in rural areas. CONCLUSION Following the intervention programme, suicide behaviour began to decrease in all urban and rural areas of Taiwan. This study showed the cumulative effect of the intervention programme in decreasing the suicide rate in Taiwan. Moreover, the gender-specific suicidal rate and disparity in suicidal methods in urban and rural areas should be considered in further preventive strategies in Taiwan.
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Chiang CL, Chen PC, Huang LY, Kuo PH, Tung YC, Liu CC, Chen WJ. Time trends in first admission rates for schizophrenia and other psychotic disorders in Taiwan, 1998-2007: a 10-year population-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2017; 52:163-173. [PMID: 28028581 DOI: 10.1007/s00127-016-1326-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/15/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE To examine the trend in annual first admission rates for psychotic disorders as a whole as well as individual psychotic disorders in Taiwan from 1998 to 2007, and influences of age, sex, and geographic region on the trend. METHOD Using the inpatient claims records in the National Health Insurance Research Database, we estimated the yearly first admission rates for schizophrenia and other psychotic disorders, including voluntary (1998-2007) and involuntary (2004-2007) admissions. Both narrow and broad definitions of psychotic disorders were examined. RESULTS While involuntary first admission rates were stable, a crescendo-decrescendo change in voluntary first admission rates for psychotic disorders was observed, peaking in 2001. The increase from 1998 to 2001 was closely associated with health insurance expansion. Before 2001, the voluntary first admission rates in males aged 15-24 were underestimated as military personnel records were not included in the database. From 2001 to 2007, voluntary first admissions for psychotic disorders decreased 38%; the decrease could not be accounted for by the mild diagnostic shifts away from schizophrenia to affective psychosis or substance-induced psychosis. During the entire observation period, first admission rates for schizophrenia decreased 48%, while affective psychosis increased 84%. Gender disparities in the first admission rates gradually diminished, but geographic disparities persisted. CONCLUSIONS First admission rates for psychosis significantly reduced in Taiwan between 1998 and 2007, mainly driven by the reduced hospitalization risk for schizophrenia. Special attention should be paid to the increased hospitalization for other types of psychotic disorders (especially affective psychosis) and the unresolved geographic disparities.
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Affiliation(s)
- Chih-Lin Chiang
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, 100, Taiwan.,Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.,Division of New Drugs, Center for Drug Evaluation, Taipei, Taiwan
| | - Pei-Chun Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
| | - Ling-Ya Huang
- Health Data Research Center, National Taiwan University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Chi Tung
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei J Chen
- Master of Public Health Degree Program, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, 100, Taiwan. .,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. .,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. .,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Spatial Patterns and Neighborhood Characteristics of Overall Suicide Clusters in Florida From 2001 to 2010. Am J Prev Med 2017; 52:e1-e7. [PMID: 27692756 DOI: 10.1016/j.amepre.2016.07.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 07/11/2016] [Accepted: 07/11/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Although spatial examination of mortality and morbidity is becoming more common in health studies, the investigation of suicide death clusters within the neighborhood context is underutilized. The purpose of this ecological study is to detect high- and low-risk clusters of suicide deaths in Florida and determine which neighborhood characteristics distinguish clusters from non-clusters. METHODS The scan statistic method was used to detect overall clusters of completed suicides in Florida from 2001 to 2010. Regression analysis was used to investigate the association of neighborhood characteristics with identified clusters. All data synthesis and statistical analyses were conducted in 2015. RESULTS Twenty-four high-risk and 25 low-risk clusters were identified. The risk of suicide was up to 3.4 times higher in high-risk clusters than in areas outside of clusters (relative risk ranged from 1.36 to 3.44, p≤0.05). Low-risk clusters were associated with 30%-94% decreased risk of suicide (relative risk ranged from 0.06 to 0.70, p≤0.05). Areas with high levels of elderly concentration and household singularity were more likely to be in high-risk clusters, whereas areas with higher economic deprivation and residential density were more likely to be in low-risk clusters. CONCLUSIONS This study identified general suicide patterns across space in the state of Florida and described the characteristics of those areas.
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Alamri Y. Does the choice of religion have an influence on suicidal behaviour? Acta Psychiatr Scand 2016; 134:558. [PMID: 27575049 DOI: 10.1111/acps.12634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Y Alamri
- New Zealand Brain Research Institute, Christchurch, New Zealand
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