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Alves FTA, Prates EJS, Carneiro LHP, Sá ACMGND, Pena ÉD, Malta DC. Mortalidade proporcional nos povos indígenas no Brasil nos anos 2000, 2010 e 2018. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202113010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo do estudo foi analisar a mortalidade indígena no Brasil em 2000, 2010 e 2018. Estudo descritivo com dados do Sistema de Informação sobre Mortalidade. Calculou-se a mortalidade proporcional entre indígenas e restante da população brasileira, segundo idade, sexo, causa e regiões do Brasil. A proporção de óbitos em indígenas menores de 1 ano em 2000, 2010 e 2018 foi de 15,3%, 17,7% e 16,2%; e no restante do Brasil, foi de 7,2%, 3,5% e 2,7% respectivamente. A proporção de óbitos a partir de 50 anos nos indígenas nos mesmos anos foi de 47,0%, 48,1% e 52,0%; e no restante do Brasil, foi de 66,8%, 74,4% e 79,4%. Em 2018, indígenas menores de 1 ano morreram mais de afecções perinatais (39,4%), doenças infecciosas e parasitárias (10,1%) e causas externas (9,8%). Em menores de 1 ano do restante da população brasileira, essas causas corresponderam a 57,8%, 3,8% e 2,8%. Indígenas acima de 50 anos morreram mais por doenças circulatórias (28,6%), respiratórias (15,4%) e neoplasias (14,6%); e no restante da população brasileira, essas causas representaram 31,5%, 13,6% e 19,0%. Evidenciaram-se desigualdades em saúde e piores indicadores nos povos indígenas no Brasil.
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de Souza RSB, de Oliveira JC, Alvares-Teodoro J, Teodoro MLM. [Suicide and indigenous populations in Brazil: systematic reviewEl suicidio y los pueblos indígenas brasileños: revisión sistemática]. Rev Panam Salud Publica 2020; 44:e58. [PMID: 32612644 PMCID: PMC7323757 DOI: 10.26633/rpsp.2020.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/28/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To describe the frequency, characteristics, and factors contributing to suicide in indigenous populations in Brazil. METHOD A systematic review of the literature was performed in PubMed, SciELO, PsycINFO, and LILACS. All population-based studies focusing on suicide among indigenous populations in Brazil were included. RESULTS The search identified 111 articles, of which nine met the inclusion criteria. Three of these studies were performed in the Midwest and four in the North of Brazil, while two covered all Brazilian regions. The ethnic groups investigated were specified in three studies (Terena, Kadiweu, Guato, Ofaie-Xavante, Guarani, Guarani-Kaiowá, and Guarani-Nandeva). Suicide rates were highest among males, single individuals, those with 4 to 11 years of schooling, and those aged 15 to 24 years. Suicides occurred most often in the home and on weekends, mostly by hanging. The main risk factors for suicide identified in the articles were poverty, historical and cultural factors, poor wellbeing indicators, family disintegration, social vulnerability, and lack of life or future perspective. CONCLUSIONS All the studies indicated the need to engage communities in developing strategies, considering their cosmovision and the social, historic, and cultural view of each ethnic group to minimize risk factors and reduce suicide rates.
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Affiliation(s)
- Ronaldo Santhiago Bonfim de Souza
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom)Belo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil.
| | - Júlia Costa de Oliveira
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em PsicologiaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia, Belo Horizonte (MG), Brasil.
| | - Juliana Alvares-Teodoro
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Medicamentos e Assistência FarmacêuticaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Belo Horizonte (MG), Brasil.
| | - Maycoln Leôni Martins Teodoro
- Universidade Federal de Minas Gerais (UFMG)Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom)Belo HorizonteMGBrasilUniversidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil.
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Souza MLPD. [Mortality from suicide in indigenous children in Brazil]. CAD SAUDE PUBLICA 2019; 35Suppl 3:e00019219. [PMID: 31433029 DOI: 10.1590/0102-311x00019219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the characteristics, distribution, and mortality rates from suicide in indigenous children in Brazil compared to non-indigenous children. This descriptive study covered the years from 2010 to 2014, using national databases. The study collected deaths in individuals 10 to 14 years of age whose underlying cause was "inentional self-inflicted injury". Hanging was the most frequently used means in both indigenous and non-indigenous children, although it was more frequent in the former. Among indigenous children, suicides in hospitals or other healthcare establishments were less common than in non-indigenous. Approximately three-fourths of suicides in indigenous children occurred in just 17 municipalities. The mortality rate from suicide among indigenous children was 11.0/100,000 (8.4-14.3), or 18.5 times higher (10.9-31.6) than in non-indigenous, which was 0.6/100,000 (0.5-0.6), with no differences between boys and girls. This study showed for the first time on a national scale the specific characteristics of suicide in indigenous children, with high rates, and also identified priority areas for interventions.
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Pollock NJ, Naicker K, Loro A, Mulay S, Colman I. Global incidence of suicide among Indigenous peoples: a systematic review. BMC Med 2018; 16:145. [PMID: 30122155 PMCID: PMC6100719 DOI: 10.1186/s12916-018-1115-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 07/02/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among adolescents worldwide, and is a major driver of health inequity among Indigenous people in high-income countries. However, little is known about the burden of suicide among Indigenous populations in low- and middle-income nations, and no synthesis of the global data is currently available. Our objective was to examine the global incidence of suicide among Indigenous peoples and assess disparities through comparisons with non-Indigenous populations. METHODS We conducted a systematic review of suicide rates among Indigenous peoples worldwide and assessed disparities between Indigenous and non-Indigenous populations. We performed text word and Medical Subject Headings searches in PubMed, MEDLINE, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), PsycINFO, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) for observational studies in any language, indexed from database inception until June 1, 2017. Eligible studies examined crude or standardized suicide rates in Indigenous populations at national, regional, or local levels, and examined rate ratios for comparisons to non-Indigenous populations. RESULTS The search identified 13,736 papers and we included 99. Eligible studies examined suicide rates among Indigenous peoples in 30 countries and territories, though the majority focused on populations in high-income nations. Results showed that suicide rates are elevated in many Indigenous populations worldwide, though rate variation is common, and suicide incidence ranges from 0 to 187.5 suicide deaths per 100,000 population. We found evidence of suicide rate parity between Indigenous and non-Indigenous populations in some contexts, while elsewhere rates were more than 20 times higher among Indigenous peoples. CONCLUSIONS This review showed that suicide rates in Indigenous populations vary globally, and that suicide rate disparities between Indigenous and non-Indigenous populations are substantial in some settings but not universal. Including Indigenous identifiers and disaggregating national suicide mortality data by geography and ethnicity will improve the quality and relevance of evidence that informs community, clinical, and public health practice in Indigenous suicide prevention.
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Affiliation(s)
- Nathaniel J Pollock
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada. .,Labrador Institute of Memorial University, P.O. Box 490, Stn. B, 219 Hamilton River Road, Happy Valley-Goose Bay, ,Newfoundland and Labrador, A0P 1E0, Canada.
| | - Kiyuri Naicker
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - Alex Loro
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - Shree Mulay
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
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Azuero AJ, Arreaza-Kaufman D, Coriat J, Tassinari S, Faria A, Castañeda-Cardona C, Rosselli D. Suicide in the Indigenous Population of Latin America: A Systematic Review. ACTA ACUST UNITED AC 2017; 46:237-242. [PMID: 29122231 DOI: 10.1016/j.rcp.2016.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/16/2016] [Accepted: 12/27/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Due to the high rates of suicide reported among many ethnic minorities, a systematic review is presented on suicide in indigenous populations of Latin America. METHODS Systematic review in PubMed, Scopus, PsycNET, Scielo and Scholar Google. RESULTS From an initial total of 1862 articles, 41 were included for data extraction. They include 21 from Brazil, 13 from Colombia, 2 from Chile, 1 from Peru, and 4 articles grouped from different countries. Suicide is a public health issue in many communities. Lifestyle changes, industrialisation, environmental degradation, and alcohol have led the indigenous population experiencing what has been described as "cultural death."
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Affiliation(s)
- Andres J Azuero
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Jeanette Coriat
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Stefano Tassinari
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Annette Faria
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Diego Rosselli
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia.
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Orellana JD, Balieiro AA, Fonseca FR, Basta PC, Ponte de Souza ML. Spatial-temporal trends and risk of suicide in Central Brazil: an ecological study contrasting indigenous and non-indigenous populations. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2016; 38:222-30. [PMID: 26786195 PMCID: PMC7194261 DOI: 10.1590/1516-4446-2015-1720] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine spatial-temporal distribution and risk of suicide, as well as trends in suicide mortality rates, in the indigenous and non-indigenous population of the state of Mato Grosso do Sul, Brazil. METHODS Data were obtained from the Information Department of the Brazilian Unified Health System. Deaths recorded as voluntary self-inflicted injuries (ICD-10 codes X60.0 to X84.9) were considered suicide. Suicide rates were estimated and adjusted by age in the population > 9 years of age. Kernel analysis was used to assess the spatial distribution of suicide cases, while trend analysis was carried out using a non-parametric test (Mann-Kendall). RESULTS The suicide risk among the indigenous population was 8.1 (95%CI 7.2-9.0) times higher than in the non-indigenous population. For indigenous residents in the 15-24 age group, the risk was 18.5 (95%CI 17.5-19.6) times higher than in the non-indigenous population. The majority of indigenous cases were concentrated in a few villages in reservation areas, mainly occupied by Guarani-Kaiowá and Guarani-Ñandeva groups. Rate patterns remained stable over time in both groups. CONCLUSION Suicide is a serious public health problem in Mato Grosso do Sul, and has had an alarming and disproportionate impact on the indigenous population for more than a decade.
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Affiliation(s)
- Jesem D. Orellana
- Instituto Leônidas e Maria Deane (ILMD), Fundação Oswaldo Cruz (FIOCRUZ), Manaus, AM, Brazil
| | - Antônio A. Balieiro
- Instituto Leônidas e Maria Deane (ILMD), Fundação Oswaldo Cruz (FIOCRUZ), Manaus, AM, Brazil
| | - Fernanda R. Fonseca
- Instituto Leônidas e Maria Deane (ILMD), Fundação Oswaldo Cruz (FIOCRUZ), Manaus, AM, Brazil
| | - Paulo C. Basta
- Escola Nacional de Saúde Pública Sergio Arouca (ENSP), FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Souza MLPD. Narrativas indígenas sobre suicídio no Alto Rio Negro, Brasil: tecendo sentidos. SAUDE E SOCIEDADE 2016. [DOI: 10.1590/s0104-12902016145974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Taxas de mortalidade por suicídio mais elevadas são recorrentemente encontradas em indígenas quando comparadas a populações circunvizinhas, inclusive em São Gabriel da Cachoeira, Amazonas, município brasileiro com maior percentual de autodeclarados indígenas. Entender como o suicídio é representado em contextos indígenas específicos é uma dimensão qualitativa, pouco explorada e relevante. O objetivo deste artigo foi analisar sete narrativas sobre sui cídio de um kumu (curandeiro tradicional) da mais populosa comunidade indígena de São Gabriel da Cachoeira. No processo analítico-interpretativo realizou-se uma dupla hermenêutica, ou seja, inter pretar a interpretação do narrador, buscando apoio na literatura etnográfica clássica e contemporânea, nas teorias sobre o processo de construção da pessoa e do parentesco no contexto ameríndio. A análise das narrativas permitiu reconstruir o suicídio como um fenômeno associado a conflitos que se ancoram pro fundamente em aspectos socioculturais e históricos dos povos indígenas daquela região, que remetem a tensões intergeracionais, de gênero e no campo do parentesco. O gerenciamento desses conflitos parece estar comprometido, já que estratégias tradicionais parecem perder a eficácia simbólica e outras não fo ram adequadamente encontradas para substituí-las. O consumo de álcool, embora seja um elemento im portante para compreensão do suicídio, não deveria ser tomado como elemento explicativo central, mas, sobretudo como um catalisador desses conflitos.
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Abstract
Objetivos Identificar as causas e o perfil das vítimas, analisar a mortalidade nos últimos 13 anos e mapear mudanças assistenciais e socioeconômicas. Métodos Utilizaram-se dados do SIM e Datasus. Calcularam-se as proporções das causas de suicídio segundo as categorias do CID10, X60-X84, estratificando-se por lesões (X70-X84) e autointoxicações (X60-X69). Analisaram-se as incidências por raça/cor, escolaridade e faixa etária, de 2000 a 2012. Compararam-se variações na mortalidade por suicídio com mudanças regionais nos indicadores de cobertura, características socioeconômicas e demográficas. Resultados As maiores causas de suicídio foram enforcamento, lesão por armas de fogo e autointoxicação por pesticidas. Os mais acometidos foram os menos escolarizados, indígenas (132% superior à população geral) ou maiores de 59 anos (29% superior). As taxas entre homens são três vezes maiores em todas as regiões, embora tenha maior crescimento entre as mulheres (35%). A mortalidade mais elevada se encontra na região Sul (9,8/100.000) e o maior crescimento percentual, no Nordeste (72,4%). Conclusão A mortalidade por suicídio continua a crescer no país, com importantes variações regionais. A assistência à saúde também apresenta inequidades regionais, com importantes lacunas nos serviços de saúde. O Brasil ainda carece de programas governamentais que trabalhem efetivamente na prevenção do suicídio. Considera-se necessário estabelecer uma estratégia nacional de prevenção focalizando as populações de maior risco identificadas: índios, pessoas com menor escolaridade, homens e maiores de 60 anos, além da necessidade de ampliar a vigilância na comercialização ilegal de pesticidas.
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