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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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Zhang X, Rhubart DC, Monnat SM. Social Infrastructure Availability and Suicide Rates among Working-Age Adults in the United States. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2024; 10:10.1177/23780231241241034. [PMID: 38846792 PMCID: PMC11155474 DOI: 10.1177/23780231241241034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Social infrastructure (SI) may buffer against suicide risk by improving social cohesion, social support, and information and resource sharing. This study uses an ecological approach to examine the relationship between county-level SI availability and suicide rates among working-age adults (ages 25-64) in the United States, a population for whom suicide rates are high, rising, and geographically unequal. Mortality data are from the National Vital Statistics System for 2016-2019. SI data are from the National Neighborhood Data Archive for 2013-2015 and capture the availability of typically free SI (e.g. libraries, community centers) and commercial SI (e.g. coffee shops, diners, entertainment venues). Results from negative binomial models show that suicide rates are significantly lower in counties with more SI availability, net of county demographic, socioeconomic, and health care factors. This relationship held for both typically free and commercial SI. Policymakers should consider strengthening existing and developing new social infrastructure, particularly in counties with less educated populations, as part of a broader strategy to reduce suicide rates in the United States.
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Affiliation(s)
- Xue Zhang
- Lerner Center for Public Health Promotion and Population Health, Syracuse University, NY, 13244
- Center for Policy Research, Syracuse University, NY, 13244, USA
| | - Danielle C. Rhubart
- Department of Biobehavioral Health, The Pennsylvania State University, PA, USA
| | - Shannon M. Monnat
- Lerner Center for Public Health Promotion and Population Health, Syracuse University, NY, 13244
- Center for Policy Research, Syracuse University, NY, 13244, USA
- Department of Sociology, Syracuse University, NY, 13244
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Kandula S, Martinez-Alés G, Rutherford C, Gimbrone C, Olfson M, Gould MS, Keyes KM, Shaman J. County-level estimates of suicide mortality in the USA: a modelling study. Lancet Public Health 2023; 8:e184-e193. [PMID: 36702142 PMCID: PMC9990589 DOI: 10.1016/s2468-2667(22)00290-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of death in the USA and population risk prediction models can inform decisions on the type, location, and timing of public health interventions. We aimed to develop a prediction model to estimate county-level suicide risk in the USA using population characteristics. METHODS We obtained data on all deaths by suicide reported to the National Vital Statistics System between Jan 1, 2005, and Dec 31, 2019, and age, sex, race, and county of residence of the decedents were extracted to calculate baseline risk. We also obtained county-level annual measures of socioeconomic predictors of suicide risk (unemployment, weekly wage, poverty prevalence, median household income, and population density) and state-level prevalence of major depressive disorder and firearm ownership from US public sources. We applied conditional autoregressive models, which account for spatiotemporal autocorrelation in response and predictors, to estimate county-level suicide risk. FINDINGS Estimates derived from conditional autoregressive models were more accurate than from models not adjusted for spatiotemporal autocorrelation. Inclusion of suicide risk and protective covariates further reduced errors. Suicide risk was estimated to increase with each SD increase in firearm ownership (2·8% [95% credible interval (CrI) 1·8 to 3·9]), prevalence of major depressive episode (1·0% [0·4 to 1·5]), and unemployment rate (2·8% [1·9 to 3·8]). Conversely, risk was estimated to decrease by 4·3% (-5·1 to -3·2) for each SD increase in median household income and by 4·3% (-5·8 to -2·5) for each SD increase in population density. An increase in the heterogeneity in county-specific suicide risk was also observed during the study period. INTERPRETATION Area-level characteristics and the conditional autoregressive models can estimate population-level suicide risk. Availability of near real-time situational data are necessary for the translation of these models into a surveillance setting. Monitoring changes in population-level risk of suicide could help public health agencies select and deploy targeted interventions quickly. FUNDING US National Institute of Mental Health.
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Affiliation(s)
- Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA.
| | - Gonzalo Martinez-Alés
- Department of Epidemiology, Columbia University, New York, NY, USA; CAUSALab, Harvard T H Chan School of Public Health, Boston, MA, USA; Mental Health Network Biomedical Research Center, Madrid, Spain; Mental Health Research Group, Hospital La Paz Institute for Health Research, Madrid, Spain
| | | | | | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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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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Lane TJ. Associations Between Firearm and Suicide Rates: A Replication of Kleck (2021). Arch Suicide Res 2022:1-16. [PMID: 35686601 DOI: 10.1080/13811118.2022.2083535] [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] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Using data from n = 194 nation-states, Kleck found that firearm availability was only associated with firearm suicide rates, but not total or non-firearm suicides. He thus concluded that while firearm availability influences how people commit suicide, it does not affect total numbers. However, the study contains numerous logical and methodological issues and is at odds with the evidence base. Therefore, I attempt to reproduce the original results. METHOD I reproduce the original study's methods: ordinary least squares regression, weighted by the square root of the population, with log-transformed suicide rates and three separate firearm availability measures: global estimates from the Small Arms Survey, proportion of suicides committed with firearms, and a European Union survey of firearm ownership. I also test several methodological variations and include U.S. suicide data. RESULTS In contrast to Kleck, global analyses with Small Arms Survey data found a significant and positive association between firearm availability and total suicides, as did U.S. analyses. Analyses with other firearm availability measures comported with the original study, finding no association. CONCLUSION The main result in Kleck failed to reproduce, finding instead a significant association between firearm availability and suicide rates, as did U.S. analyses. While reproductions of Kleck's other analyses continued to show no association, they were based on unreliable methods. I therefore reject Kleck's conclusion that that firearm availability does not influence suicide rates. HighlightsUsing data global data, I find firearm availability is positively associated with suicide rates.I identify serious flaws in the logic and methods of Kleck and an earlier review.For transparency, data and code have been archived on a public repository.
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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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7
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Yeom Y. Analysing spatial and temporal dynamics of suicide in South Korea: An application of the dynamic spatial panel data model. GEOSPATIAL HEALTH 2021; 16. [PMID: 33969967 DOI: 10.4081/gh.2021.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
This study examines the relationship between the suicide mortality rate and structural covariates in South Korea from 2008 to 2017 under Durkheim's theory of suicide. It applies the dynamic spatial panel data model to explore both spatial and temporal aspects of the suicide phenomena recognising statistical limitations in previous suicide research based on either cross-sectional or longitudinal methodology. The results demonstrate that the suicide mortality rates in South Korea are spatially and temporally dependent on those of neighbouring units or its own time-lagged suicide mortality rates. Moreover, this study estimates that the divorce rate, unemployment rate and land price index, which are assumed to be proxies of social integration and regulation, significantly impact the suicide mortality rates. The results imply that deteriorating socioeconomic conditions are risk factors for the suicide mortality rate and suggests implementing policies to alleviate the high level of social disintegration caused by Korea's deteriorating socioeconomic conditions.
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Affiliation(s)
- Yunho Yeom
- Department of Public Policy and Management, Pusan National University, Busan.
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8
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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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9
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Tran F, Morrison C. Income inequality and suicide in the United States: A spatial analysis of 1684 U.S. counties using geographically weighted regression. Spat Spatiotemporal Epidemiol 2020; 34:100359. [DOI: 10.1016/j.sste.2020.100359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
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10
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Balestra S. Gun prevalence and suicide. JOURNAL OF HEALTH ECONOMICS 2018; 61:163-177. [PMID: 30149247 DOI: 10.1016/j.jhealeco.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 08/07/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Abstract
In light of the ongoing debate over tighter firearm regulations, this paper considers the relationship between gun prevalence and suicide. I exploit a reform in Switzerland that reduced the prevalence of military-issued guns in private households. In Switzerland, military service is compulsory for men, and military-issued guns account for nearly half of the total number of firearms available. The results show that the firearm suicide rate decreases by 9% for a reduction in gun prevalence of 1000 guns per 100,000 inhabitants. The elasticity of gun suicides with respect to firearm prevalence is +0.48, but converges towards zero for low levels of gun prevalence. The overall suicide rate is negatively and significantly related to firearm prevalence, which indicates that non-gun methods of suicide are not perfect replacements for firearms.
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Affiliation(s)
- Simone Balestra
- University of St. Gallen, Rosenbergstrasse 51, CH-9000 St. Gallen, Switzerland.
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11
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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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12
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Religious Activities and Suicide Prevention: A Gender Specific Analysis. RELIGIONS 2018. [DOI: 10.3390/rel9040127] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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13
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Lee H, Seol KH, Kim JW. Age and sex-related differences in risk factors for elderly suicide: Differentiating between suicide ideation and attempts. Int J Geriatr Psychiatry 2018; 33:e300-e306. [PMID: 28967671 DOI: 10.1002/gps.4794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/10/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the age and sex-related differences in socio-demographic factors that influence suicide ideation and attempts in the elderly. METHODS The total number of subjects was 93 151, of whom 8441 belonged to the high suicide-risk group (2064 male; 6377 female). Following this identification, we investigated their socio-demographic information, health status, and depressive symptoms, which might have influenced their suicide ideation and attempts. RESULTS Residence in an urban area was identified as a risk factor for both male and female elderly in their 60s and 70s and female elderly in their 80s. Marital status showed a different influence on suicide ideation depending on age and sex. A negative perception of one's own health status was a significant risk factor that increased the likelihood of suicide ideation in all ages, except the female elderly in their 60s. No factor was identified that significantly influenced suicide attempts in the male elderly. However, in the female elderly, residence in an urban area and a negative perception of one's own health status were identified as significant risk factors. CONCLUSIONS This study revealed that factors known to influence suicide ideation in the elderly from previous studies, such as residence area, separation from a spouse, education level, religion, and drinking, show changed influence as the elderly reach their 70s and 80s. However, a negative perception of one's own health status was a risk factor that encompassed most ages and sexes.
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Affiliation(s)
- Hyuk Lee
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea.,Medical Unit of the 7th Division, Korea Army, Hwacheon, Republic of Korea
| | - Ki Ho Seol
- Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
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14
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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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15
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Morrissey TW. Associations between active shooter incidents and gun ownership and storage among families with young children in the United States. Prev Med 2017; 100:50-55. [PMID: 28389329 DOI: 10.1016/j.ypmed.2017.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 03/28/2017] [Accepted: 04/01/2017] [Indexed: 11/25/2022]
Abstract
The presence of firearms and their unsafe storage in the home can increase risk of firearm-related death and injury, but public opinion suggests that firearm ownership is a protective factor against gun violence. This study examined the effects of a recent nearby active shooter incident on gun ownership and storage practices among families with young children. A series of regression models, with data from the nationally representative Early Childhood Longitudinal Study-Birth Cohort merged with the FBI's Active Shooter Incidents data collected in 2003-2006, were used to examine whether household gun ownership and storage practices differed in the months prior to and following an active shooter incident that occurred anywhere in the United States or within the same state. Approximately one-fifth of young children lived in households with one or more guns; of these children, only two-thirds lived in homes that stored all guns in locked cabinets. Results suggest that the experience of a recent active shooter incident was associated with an increased likelihood of storing all guns locked, with the magnitude dependent on the temporal and geographic proximity of the incident. The severity of the incident, defined as the number of fatalities, predicted an increase in storing guns locked. Findings suggest that public shootings change behaviors related to firearm storage among families with young children.
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Abramowicz S, Allareddy V, Rampa S, Lee MK, Nalliah RP, Allareddy V. Facial Fractures in Patients With Firearm Injuries: Profile and Outcomes. J Oral Maxillofac Surg 2017; 75:2170-2176. [PMID: 28672134 DOI: 10.1016/j.joms.2017.05.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 05/30/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Firearm injuries (FAIs) are a major public health issue in the United States. The objective of this study was to examine characteristics and outcomes of patients presenting to emergency departments (EDs) with facial fractures attributed to FAIs. MATERIALS AND METHODS The Nationwide Emergency Department Sample for the years 2008 to 2013 was used. All patients who visited EDs with FAIs and facial fractures were selected. The study focused on the following variables: 1) demographic characteristics, 2) types of facial fractures, 3) disposition status after ED visit or subsequent hospitalization, 4) charges (ED and hospitalization), and 5) patient outcomes. The inclusion criteria were a visit to a hospital-based ED with facial fractures and an external cause of FAI. Descriptive statistics were used to summarize findings. Multivariate logistic regression analysis was used to examine the simultaneous effects of patient-related factors on ED death. RESULTS During the study period, a total of 15,469 patients (mean age, 34 years) visited hospital-based EDs with facial fractures attributed to FAIs. Most were uninsured male patients. The most common etiology of FAIs was assault. The most common facial fractures were open mandibular fractures and open maxillary and/or malar bone fractures. Approximately 27% of patients had a concomitant intracranial injury. After the ED visit, 74% were admitted. The mean ED charge per patient was $6,403, and the total ED charge across the United States was $76.48 million. The mean hospitalization charge per patient was $167,203. The total hospitalization charge across the United States was $1.9 billion. Patients with intracranial injuries (odds ratio [OR], 21.21; 95% confidence interval [CI], 7.16 to 62.85; P < .01), uninsured patients (OR, 4.24; 95% CI, 1.44 to 12.51; P < .01), and patients residing in areas with high household incomes (OR, 5.60; 95% CI, 2.51 to 12.46; P < .01) were high-risk groups for ED death. CONCLUSIONS FAIs require substantial resources for stabilization and treatment by EDs. This study highlights the burden and impact of facial fractures in patients with FAIs in the United States.
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Affiliation(s)
- Shelly Abramowicz
- Assistant Professor, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA; and Associate Chief, Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, Atlanta, GA.
| | - Veerasathpurush Allareddy
- Professor, Department of Orthodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA
| | - Sankeerth Rampa
- Graduate Student, Health Services Research & Administration Department, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Min Kyeong Lee
- Assistant Professor, Department of Dentistry, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Romesh P Nalliah
- Associate Professor, College of Dentistry, University of Michigan at Ann Arbor, Ann Arbor, MI
| | - Veerajalandhar Allareddy
- Associate Professor, Division of Critical Care, Stead Family Children's Hospital, University of Iowa, Iowa City, IA
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17
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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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18
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Kalesan B, Adhikarla C, Pressley JC, Fagan JA, Xuan Z, Siegel MB, Galea S. The Hidden Epidemic of Firearm Injury: Increasing Firearm Injury Rates During 2001-2013. Am J Epidemiol 2017; 185:546-553. [PMID: 28338922 DOI: 10.1093/aje/kww147] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/11/2016] [Indexed: 11/12/2022] Open
Abstract
Investigating firearm injury trends over the past decade, we examined temporal trends overall and according to race/ethnicity and intent in fatal and nonfatal firearm injuries (FFIs and NFIs) in United States during 2001-2013. Counts of FFIs and estimated counts of NFIs were obtained from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System. Poisson regression was used to analyze overall and subgroup temporal trends and to estimate annual change per 100,000 persons (change). Total firearm injuries (n = 1,328,109) increased annually by 0.36 (Ptrend < 0.0001). FFIs remained constant (change = 0.02; Ptrend = 0.22) while NFIs increased (change = 0.35; Ptrend < 0.0001). Homicide FFIs declined (change = -0.05; Ptrend < 0.0001) while homicide NFIs increased (change = 0.43; Ptrend < 0.0001). Suicide FFIs increased (change = 0.07; Ptrend < 0.0001) while unintentional FFIs and NFIs declined (changes = -0.01 and -0.09, respectively; Ptrend < 0.0001 and 0.005). Among whites, FFIs (change = 0.15; Ptrend < 0.0001) and NFIs (change = 0.13; Ptrend < 0.0001) increased; among blacks, FFIs declined (change = -0.20; Ptrend < 0.0001). Among Hispanics, FFIs declined (change = -0.28; Ptrend < 0.0001) while NFIs increased (change = 0.55; Ptrend = 0.014). The endemic firearm-related injury rates during the first decade of the 21st century mask a shift from firearm deaths towards a rapid rise in nonfatal injuries.
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Morrissey TW. Parents' Depressive Symptoms and Gun, Fire, and Motor Vehicle Safety Practices. Matern Child Health J 2017; 20:799-807. [PMID: 26733482 DOI: 10.1007/s10995-015-1910-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study examined associations between mothers' and fathers' depressive symptoms and their parenting practices relating to gun, fire, and motor vehicle safety. METHODS Using data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), a nationally representative sample of children birth to age five, linear probability models were used to examine associations between measures of parents' depressive symptoms and their use of firearms, smoke detectors, and motor vehicle restraints. Parents reported use of smoke detectors, motor vehicle restraints, and firearm ownership and storage. RESULTS Results suggest mothers with moderate or severe depressive symptoms were 2 % points less likely to report that their child always sat in the back seat of the car, and 3 % points less likely to have at least one working smoke detector in the home. Fathers' depressive symptoms were associated with a lower likelihood of both owning a gun and of it being stored locked. Fathers' depressive symptoms amplified associations between mothers' depressive symptoms and owning a gun, such that having both parents exhibit depressive symptoms was associated with an increased likelihood of gun ownership of between 2 and 6 % points. CONCLUSIONS Interventions that identify and treat parental depression early may be effective in promoting appropriate safety behaviors among families with young children.
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Affiliation(s)
- Taryn W Morrissey
- Department of Public Administration and Policy, School of Public Affairs, American University, Ward Circle Building, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
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20
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Kposowa A, Hamilton D, Wang K. Impact of Firearm Availability and Gun Regulation on State Suicide Rates. Suicide Life Threat Behav 2016; 46:678-696. [PMID: 26999372 DOI: 10.1111/sltb.12243] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/03/2016] [Indexed: 11/30/2022]
Abstract
Past studies on suicide have investigated the association of firearm ownership and suicide risk in the United States. The aim of the present study was to build on previous work by examining the impact of firearm storage practices and the strictness of firearm regulation on suicide rates at the state level. Data were compiled from primarily three sources. Suicide and firearm ownership information was obtained from the Centers for Disease Control and Prevention. Strictness of handgun regulation was derived from figures available at the Law Center to Prevent Violence, and controls were taken from the US Bureau of the Census. Mixed models were fitted to the data. Household firearm ownership was strongly associated with both suicide by all mechanisms, and firearm suicide. Storage practices had especially elevated consequences on suicide rates. Percent with loaded guns and gun readiness increased suicide rates, and strictness of gun regulation reduced suicide rates. Ready access to firearms can make a difference between life and death. Loaded and unlocked firearms within reach become risk factors for fatal outcomes from suicidal behavior. Future research might want to examine ways of obtaining more recent data on individual firearm ownership. This study proposes several policy recommendations for suicide prevention.
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Affiliation(s)
- Augustine Kposowa
- Department of Sociology, University of California Riverside, Riverside, CA, USA
| | | | - Katy Wang
- Department of Statistics, University of California Riverside, Riverside, CA, USA
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Abstract
OBJECTIVES Studies have highlighted the association between the degree of urbanicity and spatial disparities in suicide, but few have evaluated its changes across time. We explored the geospatial trends of suicide in South Korea from 1992 to 2012, and their relationship to the nation's evolving urbanicity. SETTING South Korea. PRIMARY OUTCOME MEASURES Age-sex-specific suicide rate. RESULTS Suicide rates increased in all regions of South Korea during the study period. Controlling the effects of age and sex, there was an overall inverse relationship between the degree of urbanicity and regional suicide rates. These associations were, however, attenuated across the periods, as there were smaller increases in suicide rates in mid-sized urban regions as compared to larger cities and to rural areas. Increases over time in the suicide rates among youth and working-age adults were greater in large urban centres and in rural regions. For elders, the increase was far greater in rural regions. CONCLUSIONS The association of urbanicity and the geospatial pattern of suicide in South Korea was a dynamic process and varied by age groups across the course of two decades. Internal migration and related social processes most likely contributed to these changes.
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Affiliation(s)
- Chee Hon Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Eric D Caine
- Injury Control Research Center for Suicide Prevention and Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
- VA Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Republic of Korea
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
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Short SE, Mollborn S. Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances. Curr Opin Psychol 2015; 5:78-84. [PMID: 26213711 PMCID: PMC4511598 DOI: 10.1016/j.copsyc.2015.05.002] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied "social determinants" approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity.
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Affiliation(s)
- Susan E. Short
- Department of Sociology, Brown University, Box 1916, Providence, RI 02912, USA
| | - Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO 80309-0483, USA
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23
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DeFina R, Hannon L. The changing relationship between unemployment and suicide. Suicide Life Threat Behav 2015; 45:217-29. [PMID: 25215938 DOI: 10.1111/sltb.12116] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 05/30/2014] [Indexed: 11/29/2022]
Abstract
The relationship between unemployment and suicide has changed over time and in particular during the Great Recession. Using state-level panel data covering the years 1979-2010, the study indicates that unemployment's impact was insignificant during the first half of the sample period, but was highly significant during the second half. In addition, while the impact has generally become stronger over recent decades, it fell during the Great Recession although remained significant. Evidence suggesting that increased economic insecurity helps explain the growing sensitivity over time is offered. The models fit the data well, explaining up to 90% of the variation in state suicide rates.
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Affiliation(s)
- Robert DeFina
- Sociology and Criminology Department, Villanova University, Villanova, PA, USA
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Nowotny KM, Peterson RL, Boardman JD. Gendered contexts: variation in suicidal ideation by female and male youth across U.S. states. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2015; 56:114-30. [PMID: 25722128 PMCID: PMC6097623 DOI: 10.1177/0022146514568350] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We use data from the National Longitudinal Study of Adolescent Health (13,186 respondents in 30 states) to develop a unique state-level measure of the gendered context in order to examine the influence of gender normative attitudes and behaviors on state rates of suicidal ideation and individual-level suicidal ideation for female and male youth (ages 13 to 22). The findings demonstrate the negative consequences for youth, especially females who report feminine-typical traits, who live in contexts defined by restrictive gender norms at both the ecological and individual levels. This study points to the importance of fatalistic suicide for female youth and suggests possible mechanisms to explain this association.
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25
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Kalesan B, Vasan S, Mobily ME, Villarreal MD, Hlavacek P, Teperman S, Fagan JA, Galea S. State-specific, racial and ethnic heterogeneity in trends of firearm-related fatality rates in the USA from 2000 to 2010. BMJ Open 2014; 4:e005628. [PMID: 25239291 PMCID: PMC4185336 DOI: 10.1136/bmjopen-2014-005628] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To document overall, racial, ethnic and intent-specific spatiotemporal trends of firearm-related fatality rates (FRF rates) in the USA. DESIGN Cross-sectional study per year from 2000 to 2010. SETTING USA PARTICIPANTS Aggregate count of all people in the USA from 2000 to 2010. OUTCOME MEASURES Data from the Web-based Injury Statistics Query and Reporting System from 2000 to 2010 was used to determine annual FRF rates per 100,000 and by states, race, ethnicity and intent. RESULTS The average national 11-year FRF rate was 10.21/100,000, from 3.02 in Hawaii to 18.62 in Louisiana: 60% of states had higher than national rates and 41 states showed no temporal change. The average national FRF rates among African-Americans and Caucasians were 18.51 and 9.05/100,000 and among Hispanics and non-Hispanics were 7.13 and 10.13/100,000; Hispanics had a decreasing change of -0.18, p trend<0.0001. In states with increasing trends (Florida and Massachusetts), Caucasians and non-Hispanics drove the rise; while in states with decreasing trends (California, North Carolina, Arizona, Nevada, New York, Illinois, Maryland), Hispanics and African-Americans drove the fall. The average national FRF rates due to homicides (4.1/100,000) and suicides (5.8/100,000) remained constant, but varied between states. CONCLUSIONS Endemic national FRF rates mask a wide variation in time trends between states. FRF rates were twice as high in African-Americans than Caucasians but decreased among Hispanics. Efforts to identify state-specific best practices can contribute to changes in national FRF rates that remain high.
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Affiliation(s)
- Bindu Kalesan
- Department of Surgery, Columbia University, New York, New York, USA
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Sowmya Vasan
- Department of Surgery, Columbia University, New York, New York, USA
| | - Matthew E Mobily
- Department of Epidemiology, Columbia University, New York, New York, USA
| | | | - Patrick Hlavacek
- Department of Epidemiology, Columbia University, New York, New York, USA
| | - Sheldon Teperman
- Trauma and Critical Care Services, Jacobi Medical Center, Bronx, New York, USA
| | - Jeffrey A Fagan
- Department of Epidemiology, Columbia University, New York, New York, USA
- Department of Law, Columbia University, New York, New York, USA
| | - Sandro Galea
- Department of Epidemiology, Columbia University, New York, New York, USA
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26
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Phillips JA. A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States. Soc Sci Med 2014; 114:151-60. [DOI: 10.1016/j.socscimed.2014.05.038] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/15/2022]
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Cylus J, Glymour MM, Avendano M. Do generous unemployment benefit programs reduce suicide rates? A state fixed-effect analysis covering 1968-2008. Am J Epidemiol 2014; 180:45-52. [PMID: 24939978 DOI: 10.1093/aje/kwu106] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (β = -0.57, 95% confidence interval: -0.86, -0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude.
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28
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Balint L, Dome P, Daroczi G, Gonda X, Rihmer Z. Investigation of the marked and long-standing spatial inhomogeneity of the Hungarian suicide rate: a spatial regression approach. J Affect Disord 2014; 155:180-5. [PMID: 24238954 DOI: 10.1016/j.jad.2013.10.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 10/24/2013] [Accepted: 10/25/2013] [Indexed: 01/16/2023]
Abstract
BACKGROUND In the last century Hungary had astonishingly high suicide rates characterized by marked regional within-country inequalities, a spatial pattern which has been quite stable over time. AIMS To explain the above phenomenon at the level of micro-regions (n=175) in the period between 2005 and 2011. METHODS Our dependent variable was the age and gender standardized mortality ratio (SMR) for suicide while explanatory variables were factors which are supposed to influence suicide risk, such as measures of religious and political integration, travel time accessibility of psychiatric services, alcohol consumption, unemployment and disability pensionery. When applying the ordinary least squared regression model, the residuals were found to be spatially autocorrelated, which indicates the violation of the assumption on the independence of error terms and - accordingly - the necessity of application of a spatial autoregressive (SAR) model to handle this problem. According to our calculations the SARlag model was a better way (versus the SARerr model) of addressing the problem of spatial autocorrelation, furthermore its substantive meaning is more convenient. RESULTS SMR was significantly associated with the "political integration" variable in a negative and with "lack of religious integration" and "disability pensionery" variables in a positive manner. Associations were not significant for the remaining explanatory variables. LIMITATIONS Several important psychiatric variables were not available at the level of micro-regions. We conducted our analysis on aggregate data. CONCLUSION Our results may draw attention to the relevance and abiding validity of the classic Durkheimian suicide risk factors - such as lack of social integration - apropos of the spatial pattern of Hungarian suicides.
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Affiliation(s)
- Lajos Balint
- Demographic Research Institute of the Hungarian Central Statistical Office, Buday Laszlo u. 1-3, 1204 Budapest, Hungary.
| | - Peter Dome
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Kutvolgyi ut 4, 1125 Budapest, Hungary; National Institute of Psychiatry and Addictions, Laboratory for Suicide Research and Prevention, Lehel u. 59, 1135 Budapest, Hungary
| | - Gergely Daroczi
- Rapporter.net, Easystats Ltd., 145-157 St John Street, EC1V 4PW London, United Kingdom
| | - Xenia Gonda
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Kutvolgyi ut 4, 1125 Budapest, Hungary; National Institute of Psychiatry and Addictions, Laboratory for Suicide Research and Prevention, Lehel u. 59, 1135 Budapest, Hungary
| | - Zoltan Rihmer
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Kutvolgyi ut 4, 1125 Budapest, Hungary; National Institute of Psychiatry and Addictions, Laboratory for Suicide Research and Prevention, Lehel u. 59, 1135 Budapest, Hungary
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