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da Silva Araújo PS, da Silveira TB, de Moura FR, Dos Santos Maidana M, de Sousa GRD, de Carvalho Dumith S, da Silva Júnior FMR. Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:965-978. [PMID: 37731290 DOI: 10.1080/15287394.2023.2258914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.
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Affiliation(s)
- Paula Santos da Silva Araújo
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Tatiane Britto da Silveira
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Fernando Rafael de Moura
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Merlyn Dos Santos Maidana
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Guaraciaba Ribeiro Duarte de Sousa
- Posto Médico-Legal de Rio Grande, Departamento de Perícias do Interior, Instituto Geral de Perícias, Praça Barão de São José do Norte - Rua Aquidaban - Centro, Rio Grande- RS, Brasil
| | - Samuel de Carvalho Dumith
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Flavio Manoel Rodrigues da Silva Júnior
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
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Davies M, Horsdal HT, Antonsen S, Sigsgaard T, Fan CC, Thompson WK, Pedersen CB, Sabel CE. The complexities of suicide: a multilevel survival analysis examining individual, familial and neighbourhood determinants of suicide risk using Danish register-based data. Psychol Med 2023; 53:6356-6365. [PMID: 36515183 DOI: 10.1017/s0033291722003701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Suicide risk is complex and nuanced, and how place impacts suicide risk when considered alongside detailed individual risk factors remains uncertain. We aimed to examine suicide risk in Denmark with both individual and neighbourhood level risk factors. METHODS We used Danish register-based data to identify individuals born in Denmark from 1972, with full parental information and psychiatric diagnosis history. We fitted a two-level survival model to estimate individual and neighbourhood determinants on suicide risk. RESULTS We identified 1723 cases of suicide in Denmark during the follow-up period from 1982 to 2015. Suicide risk was explained mainly by individual determinants. Parental comorbidities, particularly maternal schizophrenia [incidence rate ratio (IRR): 2.29, 95% CI 1.56-3.16] and paternal death (2.29, 95% CI 1.31-3.72) partly explained suicide risk when adjusted for all other determinants. The general contextual effect of suicide risk across neighbourhoods showed a median incidence rate ratio (MRR) of 1.13 (1.01-1.28), which was further reduced with full adjustment. Suicide risk increased in neighbourhoods with a higher proportion of manual workers (IRR: 1.08; 1.03-1.14), and decreased with a higher population density (IRR: 0.89; 0.83-0.96). CONCLUSION Suicide risk varies mainly between individuals, with parental comorbidities having the largest effect on suicide risk. Suicide risk was less impacted by neighbourhood, though, albeit to a lesser extent than individual determinants, some characteristics were associated with suicide risk. Suicide prevention policies might consider targeting interventions towards individuals more vulnerable due to particular parental comorbidities, whilst taking into account that some neighbourhood characteristics might exacerbate this risk further.
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Affiliation(s)
- Megan Davies
- Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
| | - Henriette Thisted Horsdal
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Sussie Antonsen
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Chun Chieh Fan
- Department of Radiology, Population Neuroscience and Genetics Lab, University of California San Diego, La Jolla, CA, USA
| | - Wesley K Thompson
- Division of Biostatistics and Department of Radiology, Population Neuroscience and Genetics Lab, University of California San Diego, La Jolla, CA, USA
| | - Carsten Bøcker Pedersen
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Clive E Sabel
- BERTHA Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Health Research Institute, University of Canberra, Canberra, Australia
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Troya M, Spittal MJ, Pendrous R, Crowley G, Gorton HC, Russell K, Byrne S, Musgrove R, Hannah-Swain S, Kapur N, Knipe D. Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101399. [PMID: 35518122 PMCID: PMC9065636 DOI: 10.1016/j.eclinm.2022.101399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. METHODS Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. FINDINGS A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. INTERPRETATION The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. FUNDING No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).
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Affiliation(s)
- M.Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, 4.07 Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Grace Crowley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Kirsten Russell
- School of Psychological Sciences and Health, Graham Hills Building, 40 George Street, Glasgow, UK
| | - Sadhbh Byrne
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Musgrove
- Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Navneet Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Corresponding author.
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Kanamori M, Hanazato M, Takagi D, Kondo K, Ojima T, Amemiya A, Kondo N. Differences in depressive symptoms by rurality in Japan: a cross-sectional multilevel study using different aggregation units of municipalities and neighborhoods (JAGES). Int J Health Geogr 2021; 20:42. [PMID: 34565381 PMCID: PMC8474726 DOI: 10.1186/s12942-021-00296-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/07/2021] [Indexed: 04/27/2023] Open
Abstract
Background Rurality can reflect many aspects of the community, including community characteristics that may be associated with mental health. In this study, we focused on geographical units to address multiple layers of a rural environment. By evaluating rurality at both the municipality and neighborhood (i.e., a smaller unit within a municipality) levels in Japan, we aimed to elucidate the relationship between depression and rurality. To explore the mechanisms linking rurality and depression, we examined how the association between rurality and depression can be explained by community social capital according to geographical units. Methods We used cross-sectional data from the 2016 wave of the Japan Gerontological Evaluation Study involving 144,822 respondents aged 65 years or older residing in 937 neighborhoods across 39 municipalities. The population density quintile for municipality-level rurality and the quintile for the time required to reach densely inhabited districts for neighborhood-level rurality were used. We calculated the prevalence ratios of depressive symptoms by gender using a three-level (individual, neighborhood, and municipality) Poisson regression. Community social capital was assessed using three components: civic participation, social cohesion, and reciprocity. Results The prevalence of depressive symptoms was higher in municipalities with lower population density than those with the highest population density; the ratios were 1.22 (95% confidence intervals: 1.15, 1.30) for men and 1.22 (1.13, 1.31) for women. In contrast, when evaluating rurality at the neighborhood level, the prevalence of depressive symptoms was 0.9 times lower for men in rural areas; no such association was observed for women. In rural municipalities, community civic participation was associated with an increased risk of depressive symptoms. In rural neighborhoods, community social cohesion and reciprocity were linked to a lower risk of depressive symptoms. Conclusions The association between rurality and depression varied according to geographical unit. In rural municipalities, the risk of depression may be higher for both men and women, and the presence of an environment conducive to civic participation may contribute to a higher risk of depression, as observed in this study. The risk of depression in men may be lower in rural neighborhoods in Japan, which may be related to high social cohesion and reciprocity. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-021-00296-8.
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Affiliation(s)
- Mariko Kanamori
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Bldg. 3, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.,Department of Social Epidemiology, Graduate School of Medicine, Science Frontier Laboratory, Kyoto University, Floor 2, Yoshida-konoe-cho, Sakyo-ku, Kyotoshi, Kyoto, Japan
| | - Masamichi Hanazato
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba, Chiba, Japan.,Design Research Institute, Chiba University, 1-19-1, Bunka, Sumida-ku, Tokyo, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Bldg. 3, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33, Yayoicho, Inage-ku, Chiba, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7 Chome 430, Moriokacho, Obu, Aichi, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan
| | - Airi Amemiya
- Department of Social Epidemiology, Graduate School of Medicine, Science Frontier Laboratory, Kyoto University, Floor 2, Yoshida-konoe-cho, Sakyo-ku, Kyotoshi, Kyoto, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, Science Frontier Laboratory, Kyoto University, Floor 2, Yoshida-konoe-cho, Sakyo-ku, Kyotoshi, Kyoto, Japan.
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