Inter-regional variations in men's attitudes, suicide rates and sociodemographics in Quebec (Canada)

Suicidal ideation and social integration in three Canadian provinces: The importance of social support and community belonging

Extending recent developments in the neo-Durkheimian analysis of suicidality as an indicator of social pathology, this paper analyses individual level survey data on suicidal ideation, perceptions of social support, and the sense of belonging from three Canadian provinces drawn from the Canadian Community Health Survey (2015-16). We ask whether or not social support and a sense of belonging affect suicide ideation differently. In answering this question, we pay attention to both subjective and objective indicators of integration, and how subjective indicators independently affect suicide ideation. Results show that a higher level of social support had the largest effect on suicidal ideation and that the effect of a sense of belonging disappeared when measures of social support are accounted for. These findings are consistent with Durkheim's general theory of suicide and previous studies on mental health, highlighting the importance of regular, proximate social interaction as a prophylactic against suicidality.

Caracterização dos óbitos por suicídio entre 2013-2017

RESUMO Objetivo Descrever a frequência, a distribuição e as principais características dos casos de suicídio no Rio Grande do Sul. Métodos Estudo transversal que incluiu todos os óbitos por suicídio notificados de 01/01/2013 a 31/12/2017. A análise compreendeu a descrição dos casos, a verificação da distribuição do método conforme o sexo e o cálculo das estimativas anuais de mortalidade. Resultados Foram notificados 5.901 casos, a maioria do sexo masculino (79,3%), com idade entre 35 e 59 anos (45,9%), cor de pele branca (90,9%), ensino fundamental (66,6%), sem cônjuge (63,6%) e trabalhadores do setor secundário (54,4%). Do suicídio predominou ocorrência policial como fonte de notificação (90,8%), domicílio como local de ocorrência (68,9%), enforcamento, estrangulamento ou sufocação como causa básica (71%); observaram-se diferenças significativas entre homens e mulheres quanto à escolha do método e aumento nas taxas anuais de mortalidade no período analisado. Conclusão Constatou-se aumento dos óbitos por suicídio no local e período estudados, indicando que é uma importante causa de mortalidade, especialmente, entre homens adultos.

Influence of the global crisis of 2008 and the brazilian political oscillations of 2014 on suicide rates: An analysis of the period from 2002 to 2017

Global suicide rates have increased in recent decades becoming a serious social and public health problem. In Brazil, rates have been increasing annually. We aimed to analyze the correlation between suicide mortality rates and global economic and political crisis periods of 2008 and 2014 in Brazil. The analysis of suicide mortality in Brazil was done using a time-series segmented linear regression model that estimated the trend of rates over time. To obtain the model, changes in the trend of both abrupt and gradual suicide rates were investigated. The results indicate statistically significant changes showing an upward trend of suicide rates during the world economic crisis (2008-2013) and during the economic and political crisis in Brazil (2014-2017) compared to previous periods, especially at the extremes of schooling (3 < years and > 8 years). Among white and parda, there were significant trend rates increases in both periods and in different regions. In the Northeast and South regions, we observed a significant increase in the trend rate for males after the Brazilian economic and political crisis (2014 to 2017). We can conclude that the national suicide rates were influenced by the economic and political instability that our country has been going through since 2008, affecting each region differently. Further studies are needed to explore the reasons for interregional differences and the relation of suicide with unemployment rates and possible economic predictors.

Income-related inequality in completed suicide across the provinces of Iran

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.

Suicídio em Portugal: um retrato do país

RESUMO Objetivo Identificar padrões de tendências do suicídio registrado em Portugal, tendo em conta um conjunto de variáveis socioeconômicas e demográficas entre os anos 2007 e 2014, de modo a obter uma visão geral desse flagelo em Portugal. Métodos Recorrendo a dados do Instituto Nacional de Estatística (INE) e do Sistema de Informação dos Certificados de Óbito (SICO), foi analisado o suicídio segundo a categoria do CID-10 (Classificação Internacional de Doenças), examinando-se as incidências por gênero, faixa etária e região. Resultados Os mais acometidos pelo suicídio são homens (54,8%), com idade superior a 75 anos (30,9%), e ele ocorre nas zonas economicamente mais desfavorecidas. A mortalidade por suicídio mais elevada encontra-se na região do Alentejo (12,8%). Conclusão A mortalidade por suicídio continua a crescer em Portugal e varia em função do gênero e idade, sendo mais elevada nas regiões do Centro e Sul. É necessária uma estratégia de acompanhamento e de prevenção no âmbito da ação social e dos cuidados de saúde, com importantes variações regionais, e maior vigilância sobre a comercialização ilegal de armas de fogo e de pesticidas.

Risk factors for self-directed violence in US Soldiers: A case-control study

Military suicide has escalated in recent years, however almost no research has used military surveillance data to examine suicide risk factors. The aims of the current study were to compare suicide risk factors among US Soldiers who died by suicide, attempted suicide, and controls using a prospective case-control design. Controls were 247 Soldiers completing standard post-deployment assessment procedures. Cases were 276 suicide decedents (n=85) or suicide attempters (n=191), drawn from the Department of Defense Suicide Event Report. Compared to controls, suicide attempters and decedents had greater odds of failed intimate relationships, legal problems, and substance abuse problems in the past 90 days. Suicide attempters and decedents also had greater odds of a history of a mood disorder and prior suicide attempt compared to controls. Suicide decedents had greater odds of exposure to legal problems in the past 90 days and lower odds of ever having an anxiety disorder, compared to suicide attempters. Vigilance toward early detection of modifiable suicide risk factors such as relationship dissolution, mood disorders, substance abuse, and legal problems may help reduce suicide risk among US Soldiers.

Impact of income inequality and other social determinants on suicide rate in Brazil

Studies about suicide worldwide have mainly focused on individual-level psychiatric risk factors. In Brazil, suicide is an important public health problem. Brazil has evidenced important socioeconomic changes over the last decades, leading to decreasing income inequality. However, the impact of income inequality on suicide rate has never been studied in the country.

Suicídio no Brasil, de 2000 a 2012

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.

Association of suicide rates, gun ownership, conservatism and individual suicide risk

OBJECTIVES

The purpose of the study was to examine the association of suicide rates, firearm ownership, political conservatism, religious integration at the state level, and individual suicide risk. Social structural and social learning and social integration theories were theoretical frameworks employed. It was hypothesized that higher suicide rates, higher state firearm availability, and state conservatism elevate individual suicide risk.

METHOD

Data were pooled from the Multiple Cause of Death Files. Multilevel logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide.

RESULTS

The state suicide rate significantly elevated individual suicide risk (AOR = 1.042, CI = 1.037, 1.046). Firearm availability at the state level was associated with significantly higher odds of individual suicide (AOR = 1.004, CI = 1.003, 1.006). State political conservatism elevated the odds of individual suicides (AOR = 1.005, CI = 1.003, 1.007), while church membership at the state level reduced individual odds of suicide (AOR = 0.995, CI = 0.993, 0.996). The results held even after controlling for socioeconomic and demographic variables at the individual level.

CONCLUSION

It was concluded that the observed association between individual suicide odds and national suicide rates, and firearm ownership cannot be discounted. Future research ought to focus on integrating individual level data and contextual variables when testing for the impact of firearm ownership. Support was found for social learning and social integration theories.

Suicide rates and income in São Paulo and Brazil: a temporal and spatial epidemiologic analysis from 1996 to 2008

BACKGROUND

In a classical study, Durkheim noted a direct relation between suicide rates and wealth in the XIX century France. Since that time, several studies have verified this relationship. It is known that suicide rates are associated with income, although the direction of this association varies worldwide. Brazil presents a heterogeneous distribution of income and suicide across its territory; however, evaluation for an association between these variables has shown mixed results. We aimed to evaluate the relationship between suicide rates and income in Brazil, State of São Paulo (SP), and City of SP, considering geographical area and temporal trends.

METHODS

Data were extracted from the National and State official statistics departments. Three socioeconomic areas were considered according to income, from the wealthiest (area 1) to the poorest (area 3). We also considered three regions: country-wide (27 Brazilian States and 558 Brazilian micro-regions), state-wide (645 counties of SP State), and city-wide (96 districts of SP city). Relative risks (RR) were calculated among areas 1, 2, and 3 for all regions, in a cross-sectional approach. Then, we used Joinpoint analysis to explore the temporal trends of suicide rates and SaTScan to investigate geographical clusters of high/low suicide rates across the territory.

RESULTS

Suicide rates in Brazil, the State of SP, and the city of SP were 6.2, 6.6, and 5.4 per 100,000, respectively. Taking suicide rates of the poorest area (3) as reference, the RR for the wealthiest area was 1.64, 0.88, and 1.65 for Brazil, State of SP, and city of SP, respectively (p for trend <0.05 for all analyses). Spatial cluster of high suicide rates were identified at Brazilian southern (RR = 2.37), state of SP western (RR = 1.32), and city of SP central (RR = 1.65) regions. A direct association between income and suicide were found for Brazil (OR = 2.59) and the city of SP (OR = 1.07), and an inverse association for the state of SP (OR = 0.49).

CONCLUSIONS

Temporospatial analyses revealed higher suicide rates in wealthier areas in Brazil and the city of SP and in poorer areas in the State of SP. We further discuss the role of socioeconomic characteristics for explaining these discrepancies and the importance of our findings in public health policies. Similar studies in other Brazilian States and developing countries are warranted.

Acceptance of suicide in Moscow

PURPOSE

Attitudes concerning the acceptability of suicide have been emphasized as being important for understanding why levels of suicide mortality vary in different societies across the world. While Russian suicide mortality levels are among the highest in the world, not much is known about attitudes to suicide in Russia. This study aims to obtain a greater understanding about the levels and correlates of suicide acceptance in Russia.

METHODS

Data from a survey of 1,190 Muscovites were analysed using logistic regression techniques. Suicide acceptance was examined among respondents in relation to social, economic and demographic factors as well as in relation to attitudes towards other moral questions.

RESULTS

The majority of interviewees (80%) expressed condemnatory attitudes towards suicide, although men were slightly less condemning. The young, the higher educated, and the non-religious were more accepting of suicide (OR > 2). However, the two first-mentioned effects disappeared when controlling for tolerance, while a positive effect of lower education on suicide acceptance appeared. When controlling for other independent variables, no significant effects were found on suicide attitudes by gender, one's current family situation, or by health-related or economic problems.

CONCLUSIONS

The most important determinants of the respondents' attitudes towards suicide were their tolerance regarding other moral questions and their religiosity. More tolerant views, in general, also seemed to explain the more accepting views towards suicide among the young and the higher educated. Differences in suicide attitudes between the sexes seemed to be dependent on differences in other factors rather than on gender per se. Suicide attitudes also seemed to be more affected by one's earlier experiences in terms of upbringing and socialization than by events and processes later in life.

Alcohol consumption predicts the EU suicide rates in young women aged 15-29 years but not in men: analysis of trends and differences among early and new EU countries since 2004

The aims of this study were to study suicide rates in youths aged 15-29 years in the European Union (EU), to identify differences between early members and new members to the EU since 2004, and to evaluate the association between alcohol-related variables and suicide rates, while controlling for indicators of social stress. We explored temporal trends in age-adjusted suicide rates for youths aged 15-29 years resident in EU nations since 1980. Social changes in EU nations were associated with increased inequalities between the countries in suicide, especially in male youths (new/early EU members: relative risk=1.55; 95% confidence interval: 1.48/1.61). Pure alcohol consumption predicts suicide rates in female youths, whereas social stress related to violence against youths predicts suicide rates in male youths. EU political and heath agencies should devise policies to prevent youth suicide with a focus on alcohol misuse and societal stress associated with violence against youths.

Suicide and marital status in Northern Ireland

INTRODUCTION

Studies show marriage to be protective against suicide though with variation in the extent to which suicide rates are higher among the never married, separated or divorced and widowed. We examined suicide in Northern Ireland by marital status and examined whether the observed variation differed by sex and age.

METHODS

Data relating to all 1,398 suicide deaths (ICD-9 E950-959 and ICD-10 X60-84) registered in 1996-2005 were analysed using Poisson regression.

RESULTS

The total, male and female age-standardised suicide rates were 8.4, 13.6 and 3.3 per 100,000, respectively. Never marrying increased male suicide risk and its effect increased with age (incidence rate ratio (IRR) among 20-34 year-olds = 1.47, 95% confidence interval (CI) = 1.19-1.84; IRR among over 55 year-olds = 2.33, 95% CI = 1.55-3.50). Never marrying was a risk factor for women only if aged 20-34 years (IRR = 3.05, 95% CI = 1.70-5.47). Among over 55 year-olds, widowhood increased risk of male suicide only (IRR = 2.47, 95% CI = 1.64-3.70) whereas divorce was associated with an almost threefold increase in male (IRR = 2.61, 95% CI = 1.39-4.88) and female (IRR = 2.57, 95% CI = 0.89-7.42) suicide relative to married persons. The effect of divorce was far more pronounced in 20-34 year-old men (IRR = 5.59, 95% CI = 3.58-8.67) and women (IRR = 9.46, 95% CI = 3.81-23.37).

CONCLUSIONS

In Northern Ireland, marriage protects both sexes against suicide though men more so than women. Divorced young men, in particular, are a population at high risk of suicide.

Association of temporal factors and suicides in the United States, 2000-2004

OBJECTIVE

The purpose of the study was to examine the association of temporal factors, in particular days of the week and seasons of the year and death from suicide in the United States.

METHOD

Data were pooled from the Multiple Cause of Death Files. Hierarchical logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide.

RESULTS

The incidence of suicide was significantly higher on Wednesdays, compared to Sunday. Specifically, individuals were 99% more likely to kill themselves on Wednesday than on Sunday. Suicides were more prevalent in the summer months, and they were less likely to occur in winter. The state suicide rate significantly elevated individual suicide risk. The results held even after controlling for the potentially confounding effects of socio-economic and demographic variables at both the individual and state levels.

CONCLUSION

It was concluded that the observed association between seasonality and suicide cannot be discounted as a mere coincidence. Future research ought to focus on integrating individual level data and contextual variables when testing for seasonality effects.