Alcohol-related suicide across Australia: a geospatial analysis

Self-reported suicidal behaviours and associated factors in the general population of Latvia (2010-2018)

BACKGROUND

Latvia has the second highest suicide rate in the European Union - with a total population age-standardized suicide rate of 16.1 per 100,000 inhabitants.

AIMS

We aimed to assess the prevalence of different types of self-reported suicidal behaviours in Latvia and determine the associated sociodemographic and health-related factors.

METHODS

This study was based on secondary data obtained from the Health Behaviour Among Latvian Adult Population survey. A representative sample of the general population was used, aged 15 to 64 years in 2010, 2012, 2014; and 15 to 74 years in 2016 and 2018 (n = 16,084). Respondents were asked to report the occurrence of life weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts during the previous year. We assessed socio-demographics and health-related factors associated with suicidality. We performed univariate analysis and constructed stepwise multivariate logistic regression models.

RESULTS

In 2010 to 2018, 15.6% of responders reported some type of suicidal behaviour (95% CI [15.1, 16.2]). Sociodemographic factors - including non-cohabitation status and Latvian nationality - were associated with mild (life-weariness and death wishes) and serious (suicidal ideation, plans to commit suicide, suicide attempts) types of behaviour. Older age was associated with mild suicidal behaviours, whereas lower educational levels were associated with serious suicidal behaviours. Diagnosed depression, self-reported depression, self-reported anxiety, stress, low mood, alcohol intake habits with heavy drinking episodes (less than monthly, monthly and weekly), perceived health as average or below average, disuse of primary health services were associated with mild and serious types of suicidal behaviour. Current smoking status and absenteeism were associated with mild suicidal behaviour types. Self-reported insomnia, having at least two somatic diagnoses, occasional smoking status, absenteeism with 11 or more days in the last year, receiving disability pension were associated with serious suicidal behaviour types. Musculoskeletal diseases exhibited preventive effects.

CONCLUSIONS

Our findings indicate that certain groups of individuals might exhibit greater vulnerability to suicidality.

The application of spatial analysis to understanding the association between area-level socio-economic factors and suicide: a systematic review

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.

"There's No Sewing Classes, There's No Bedazzling Seminars": The Impact of Masculinity on Social Connectedness and Mental Health for Men Living in Inner-Regional Australia

Regional Australian masculinities are typified by 'traditional' values (e.g., stoicism, self-reliance) known to restrict social connectedness. Thus, these masculinities have been implicated in worsening men's mental health. What remains unclear, however, is how men living in inner-regional communities (i.e., townships on the fringes of major cities) might uniquely experience masculinity, social connectedness, and mental health. We interviewed 29 boys/men and one non-binary participant (M _age = 43.77 years) living in the Macedon Ranges (an inner-regional Australian community). Using reflexive thematic analysis, we generated three themes. Participants described inner-regional masculinities as traditional and rigid, and attributed the Macedon Ranges' comparatively high suicide rate to these masculinities. Conversely, migration from the neighbouring city of Melbourne was implicated in introducing more inclusive masculinities to the area that conflicted with existing masculine norms. Thus, Macedon Ranges men were framed as ultimately lacking a cohesive community identity. Proximity to Melbourne was described as encouraging local men to commute daily for work instead of working locally, thereby further weakening community identity. Overall, these phenomena were implicated in damaging the psychosocial wellbeing of local men via reducing social connectedness. Because men's mental illness is so pervasive within regional Australian communities, these findings have direct implications for policymakers. Namely, policies need to acknowledge that masculinities directly influence mental health and that inner-regional masculinities are impacted by unique place-based considerations distinct from men living in other regional communities.

A Predictive Model of Regional Dementia Prevalence Using Geographic Weighted Regression Analysis

Globally, dementia is one of the highest priority public health policy issues. This study was conducted to analyze the spatial distribution pattern of dementia prevalence using geographic weighted regression analysis and to identify preventable risk factors at the regional level of dementia prevalence. For the data to be analyzed, this work used the 2020 regional dementia prevalence index of the Korea Central Dementia Center and the regional health statistics of the Korea Centers for Disease Control and Prevention Agency (KDCA). Spatial autocorrelation analysis, hot spot analysis, and geographic weighted regression analysis were performed to identify regional associations of dementia prevalence, cluster regions with high dementia prevalence, and risk factors for regional dementia prevalence. As a result of the hot spot analysis, the regions corresponding to the hot spots with the high prevalence of dementia were found to be adjacent to each other, such as in Jeonnam, Jeonbuk, and Gyeongbuk, and the regions corresponding to the cold spots with the low prevalence of dementia were adjacent to each other, such as Seoul, Gyeonggi, Incheon, Busan, and Ulsan. The results of geographic weighted regression analysis showed that educational level, walking practice rate, hypertension prevalence, and a low-sodium diet preference were found to be risk factors for the prevalence of dementia. These results suggest that there is a need for a dementia prevalence management strategy to increase the walking practice rate and low-sodium diet preference rate, and decrease the hypertension prevalence, centering on the hot spot area, which is a cluster area with high dementia prevalence. This study is expected to be useful as basic data that can help in prioritizing health policies considering spatial characteristics for community health promotion.