Mortalidad por suicidio en Chile: tendencias en los años 1998-2011

The Epidemiology of Violent Deaths in Chile between 2001 and 2018: Prevalence, Trends, and Correlates

BACKGROUND

Despite its enormous health and social burden, there are limited published studies describing the epidemiology of violent deaths in Chile. We described violent mortality rate trends in Chile between 2001 and 2018, its current spatial distribution and ecological level correlates.

METHODS

A population-based study using publicly accessible data. We calculated age-adjusted mortality rates per 100,000 persons for sex, age, intention, and mechanism of death. Next, we used linear regression to estimate time trends for sex and intention. We then employed hierarchical Poisson analyses to model the spatial distribution across 345 municipalities and the influence of six ecological level variables.

RESULTS

The average rate of violent death in Chile between 2001 and 2018 was 15.9 per 100,000 people, with the majority (70.3%) of these attributed to suicide. Suffocation was the most common mechanism of death for suicide (82.3%) and cut/pierce for homicide (43.1%), followed by firearm (33.2%). Violent deaths are trending downward in Chile across all categories except suicides by women, which have remained stable. Poverty rates and urban population were positively associated with violent mortality rates.

CONCLUSIONS

Although violence-related deaths seem to be decreasing, disparities across gender, age group, and geographic location may have continuing effects on mortality rates.

[Changes in suicide mortality trends in Chile, 1997-2018]

Using information from the mortality database at Chile's Department of Statistics and Health Information (Ministry of Health), an ecological time-series study was conducted to determine changing trends in suicide rates by sex and age group in Chile from 1997 to 2018. Results show that the mortality rate for men in 2018 was 20.1 per 100,000, almost five times higher than the rate for women. Trends in both sexes show a decrease in aver-age annual percent change of -5.4% [CI95% (-12.9; 1.9)] between 2009 and 2013. Over the same period, the average annual percent change for men was -5.8% [CI95% (-12.5; 2.3)], while for women it was -4.0 [CI95% (-5.8; -2.2)] between 2008 and 2018. No changes have been observed in trends for men aged 60 and over, the group with the high-est rates. Although suicide rates declined following the implementation of policies focus-ing on risk factors for suicide, it is necessary to evaluate the implementation of these pol-icies and devise similar actions geared toward populations with greater risk of suicide.

[Suicide in adolescents and young adults in Chile: relative risks, trends, and inequalitiesSuicídio em adolescentes e jovens no Chile: riscos relativos, tendências e desigualdades]

Objetivo.

Describir cuantitativamente el riesgo relativo, la tendencia y la desigualdad geográfica del suicidio en adolescentes y jóvenes entre las regiones de Chile, en el periodo 2000 al 2017.

Método.

Estudio ecológico poblacional a partir de los registros de defunciones por suicidio. Se estimaron tasas de mortalidad y riesgos relativos (RR) de suicidio por sexo, edad y región. Se estudió la tendencia y desigualdad geográfica del suicidio entre las regiones de Chile; medidas absolutas y relativas de desigualdades geográficas fueron estimadas.

Resultados.

Entre 2000 y 2017 se registraron 6 292 suicidios en adolescentes y jóvenes en Chile. Las tasas promedio de mortalidad por suicidio en Chile fueron de 8,5; 5,4 y 14.7 por 100 000 en los grupos 10-24, 10-19 y 20-24 años, respectivamente, en el periodo 2000-2017. Las tasas más altas de mortalidad por suicidio se encontraron en las regiones de Aisén, Los Lagos, Magallanes y Los Ríos. El riesgo más alto de suicidio se estimó en los hombres (RR=3,5), los jóvenes (RR=2,7) y en la región de Aisén (RR=2,0). La tasa promedio nacional en el grupo 10-24 años se mantuvo en 8,5 por 100 000 en los periodos 2000-2008 y 2009-2017. La mayor desigualdad geográfica se encontró en hombres de 20-24 años en el periodo 2000-2008.

Conclusiones.

El suicidio en jóvenes y adolescentes de Chile se ha mantenido sin mayores cambios en el periodo de estudio. Los hombres tienen un mayor riesgo de suicidio que las mujeres. Existen desigualdades geográficas entre las regiones de Chile en el suicidio y son más elevadas en hombres de 20 a 24 años. Se recomienda evaluar y fortalecer los programas de prevención del suicidio en los adolescentes y jóvenes, en especial en las regiones y los grupos poblacionales específicos en situación de mayor vulnerabilidad.

A Comparative Study of Suicide Rates among 10-19-Year-Olds in 29 OECD Countries

OBJECTIVE

This study had two main objectives: to compare current suicide rates in OECD countries among 10-19-year-olds and to identify patterns of suicide rates based on age, gender and time. Furthermore we investigated the main dimensions that contributed to the variation in child and adolescent suicide rates across countries.

METHODS

We combined the WHO mortality data and the population data released by OECD to calculate the suicide rates in 29 OECD countries. A self-organizing map (SOM), k-means clustering analysis, and multi-dimensional scaling were used to classify countries based on similarities in suicide rate structure and to identify the important dimensions accounting for differences among groups.

RESULTS

We identified significant differences in suicide rates depending on age, sex, country, and time period. Late adolescence and male gender were universal risk factors for suicide, and we observed a general trend of declining suicide rates in OECD countries. The SOM analysis yielded eight types of countries. Most countries showed gender gaps in suicide rates of similar magnitudes; however, there were outliers in which the gender gap was particularly large or small.

CONCLUSION

Significant variation exists with respect to suicide rates and their associated gender gaps in OECD countries.

Transport accident mortality in Chile: trends from 2000 to 2012

Abstract The aim of this study is to describe the trends of transport accident mortality in Chile from 2000 to 2012 by year, geographic distribution, gender, age group, and type of accident. Population-based study. Data for transport accident mortality in Chile between 2000 and 2012 were used. The crude and adjusted per region transport accident mortality rates were calculated per 100,000 inhabitants. The annual percentage change (APC) of the rates and relative risks (RR) were calculated. The average transport accident mortality rate (TAMR) in Chile (2000-2012) was 12.2. The rates were greater in men (19.7) than in women (4.8), with a RR of 4.1. The rates were higher in the country's southern zone (15.9), increasing in recent years in the southern zone, with a significant positive APC in the northern and central zones. The Maule region had the highest rate (21.1), although Coquimbo was the region with the most significant APC (2.2%). The highest rate (20.3) was verified in the 25-40 age group. The highest rate (14.3) was recorded in 2008. The most frequent type of accident was pedestrian. In general the APC trends of the rates are increasing significantly. This, added to rapid annual automotive growth, will only exacerbate mortality due to transport accidents.

Trends and Most Frequent Methods of Suicide in Chile Between 2001 and 2010

Abstract. Background: Despite the many studies trying to evaluate the magnitude of suicide in Chile, none of them include the new valid data, recently published by the DEIS of the Chilean Health Ministry. Aim: This paper sought to describe how suicide rates changed among Chileans who were at least 15 years of age during the period of 2001–2010; these rates were stratified by sex, age, urban/rural status, and region of the country. Method: An exploratory and temporal study was conducted. Suicide mortality rates were calculated by collecting information from the Chilean Ministry of Health’s death registry between 2001 and 2010 among subjects who were at least 15 years of age. Crude and age-adjusted mortality rates were computed. Results: The standardized suicide rate in Chile during 2001–2010 was 14.7 deaths per 100,000, the highest in South America. The minimum age-adjusted suicide rate observed during the examined period was 13.49 per 100,000 in 2005, and the maximum, 16.67 per 100,000 in 2008. Suicide rates among men were up to 4.8 times the suicide rates among women. In addition, rates in rural areas were double compared with urban areas. Hanging was the most common suicide method, followed by use of firearms and explosives in men and poisoning in women. Finally, there was a progressive increase in suicide rates in the southernmost regions of the country. Conclusion: Suicide rates in Chile are relatively high among male subjects in rural areas. There is a disturbing increase in suicide rates among younger individuals and women, although these rates remain lower among younger individuals and women than among adults in general.

Homicide in Chile: Trends 2000-2012

BACKGROUND

Homicide, an external cause of morbidity and mortality, caused 473,000 deaths worldwide in 2012, a rate of 6.2 per 100,000 inhabitants. The aim of this study was to describe homicide mortality trends in Chile between 2000 and 2012 by year, gender, age group, geographic distribution (by zone and by region) and type of homicide.

METHODS

This was a population-based study. Data for homicide mortality in Chile between 2000 and 2012 were used and they were provided by the Chilean Ministry of Health's Department of Statistics and Health Information (DEIS) and PAHO/WHO. The homicide mortality rates were calculated per 100,000 inhabitants. The study variables were year, geographic distribution, gender, age group and type of homicide. The annual percentage change (APC) of the rates was analyzed, and a logarithm of the rates by year and region was fitted by applying linear regression models. In addition, relative risks (RR) were calculated. 95% confidence intervals were considered in all the analyses.

RESULTS

The average yearly rate of homicide (HMR) in Chile (2000-2012) was 4.9. The rates were higher in men (8.7) than in women (1.1), with a RR of 8.2. The rates were higher in the country's central zone (5.0), increasing in recent years in the southern zone, with a significant positive APC of 1.1%. The Aisén Region had the highest rate (7.6), although Antofagasta was the region with the most significant APC (3.1%). The highest rate (9.2) was verified in the 25 to 39 age group. The highest rate (5.5) was recorded in 2005. The most frequent type of homicide was assault with an object (44.8%).

CONCLUSIONS

Although the homicide rates are higher in the southern zone of the country, the northern zone is showing a tendency to increase, becoming an even more serious problem, which not only affects those directly involved, but society as a whole.