Asociación entre desigualdad y tasa de suicidio en Colombia (1994-2013)

The association between nation-level social and economic indices and suicide rates: A pilot study

Ever since the pioneering work of Emile Durkheim, it has been known that regional or national suicide rates can be influenced by a variety of social and economic factors. Recent research has found a robust association between two country-level economic indices-gross national product and unemployment rate-and suicide rates, particularly in men. However, the association between other country-level social indices-such as measures of social integration, inequality, environmental preservation and political freedom-and suicide rates has not been studied at the cross-national level. In the current study, national suicide rates for men and women were examined in relation to seven indices measuring subjective wellbeing, sustainable development, type of political regime, economic and gender inequality, and social capital. It was found that the Happy Planet Index, a composite measure of subjective wellbeing and sustainable development, was negatively associated with suicide rates independent of gender, and even after adjusting for possible confounding factors. Economic inequality was associated with suicide in men, and social capital was associated with suicide in women. Moreover, the strength and direction of the associations observed between socioeconomic indices and suicide varied across income groups. These results highlight the need for a closer evaluation of the link between large-scale ("macro") social factors and individual ("micro") psychological factors, as well as the importance of integrating these factors into suicide prevention programmes at the national level.

The trend in mortality due to suicide in urban and rural areas of Colombia, 1979-2014

Introduction: Suicide is a serious social and public health problem that affects the population in most countries in the world. Differences in suicide rates in rural and urban areas have been previously described. Objective: To study the trend of mortality rates by suicide in Colombia, in rural and urban areas by gender, age group, and suicide method during the years 1979-2014. Materials and methods: We conducted a temporal trend ecologic study using death certificates from the Departamento Administrativo Nacional de Estadística, DANE. Specific and adjusted by age and gender mortality rates were calculated. We estimated negative binomial and inflection point regression models to study the trends in mortality rates stratified by gender, age group, and suicide method. Results: A total of 56,448 suicides was reported in Colombia between 1979 and 2014. The risk of suicide was higher in urban areas for men, individuals between 25 and 44 years, and 65 and over; and for those who used hanging as the suicide method. Also, the risk of suicide was higher in the rural area for men between 45 and 64 years old, and those who used firearms, sharp weapons, hanging, and others as suicide methods. The trend of suicide rates in urban areas showed its maximum peak in 1999 and in the rural ones in 2000. Then, in the two areas, there was a gradual decrease. Hanging in both areas presented a tendency to rise in men. Conclusions: Suicide has shown a tendency toward reduction after the year 2000, with differences between urban and rural areas.

Riesgo de muerte por suicidio en población Colombiana 2000-2013

Resumen Analizar el riesgo de muerte por suicidio en Colombia, a partir de covariables sexo, grupo etario, año, región y/o departamento de 2000 a 2013. Se utilizaron las bases de datos de muertes por suicidio y proyecciones poblacionales del DANE. Se realizó un estudio longitudinal y analítico. De 2000 a 2013, se establecieron las tendencias anuales de muertes por suicidio por covariables mediante modelación y se recogieron estimaciones de riegos Se utilizó el modelo de regresión de Poisson (MRP). Se emplearon IRR según el MRP con nivel de significancia (P < 0,05). Los colombianos entre los años 2000-2013, de sexo masculino, de 15 a 34 años, de las regiones Central y Oriental y de los Departamentos de Vaupés, Huila y Quindío fueron los que mayor riesgo tuvieron de morir por suicidio. La tasa de suicidios fue levemente decreciente conforme pasaron los años. El mayor riesgo de suicidio ocurrió en hombres en edad productiva, adultos mayores y en regiones poco desarrolladas. Colombia requiere una política de salud mental que implemente estrategias de atención primaria, promoción de la salud y prevención de la enfermedad, orientadas a fomentar la calidad de vida, detección de ideación suicida, tratamiento y rehabilitación a estas personas desde el enfoque de derechos y atención integral.