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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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Li Z, Cai Z, Yip PS. One stream, two channels? A parallel-process latent class growth model of homicide rates and suicide rates in 183 countries, between 2000 and 2019. SSM Popul Health 2023; 22:101376. [PMID: 36950507 PMCID: PMC10025147 DOI: 10.1016/j.ssmph.2023.101376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/09/2022] [Accepted: 03/01/2023] [Indexed: 03/05/2023] Open
Abstract
Background Suicide and homicide have long been viewed in Western culture as moral, ethical and legal equivalents. This view has underpinned many theoretical and empirical explorations into their relationship over the centuries. However, there has been little evaluation of longitudinal heterogeneity. Methods Suicide and homicide rates in 183 countries between 2000 and 2019 were collected from the World Health Organization Global Health Observatory Repository. Corresponding structural variables (i.e., GDP per capita, unemployment rate, percentage of urban population, percentage of elderly population, and Gini index) were acquired from The World Bank and Standardized World Income Inequality Database. Parallel-process latent class growth modelling was applied to identify different classes within the joint suicide and homicide rate trajectories. Multinomial logistic regression examined relationships between the structural covariates and trajectory classes. Results Four trajectory classes were identified, two with inverse relationships between suicide and homicide, and two with parallel relationships: 1) countries with increasing suicide rates and decreasing homicide rates ("suicide up, homicide down": UD, n = 41) or 2) countries with decreasing suicide rates and increasing homicide rates ("suicide down, homicide up": DU, n = 17); and 3) countries where suicide and homicide rates both trended up (UU, n = 19), or 4) both trended down (DD, n = 106). A higher average annual growth rate (AAGR) of GDP per capita was related to an increased possibility of being in DD than in DU. Countries with higher AAGR in unemployment rates were more likely to be in UD and UU than in DD, while those with higher AAGR in urbanization were less likely to be in UD than in DD. Conclusion The over-time relationship between suicide and homicide is heterogenous and complex. It is influenced differently by GDP per capita, urbanization and unemployment in different countries, and it is not well described by a single theory.
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Affiliation(s)
- Zixu Li
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Ziyi Cai
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, United Kingdom
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong
- Corresponding author. Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom.
| | - Paul S.F. 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, University of Hong Kong, Hong Kong
- Corresponding author. The HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The HKJC Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong, China.
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Jeong KH, Yoon JY, Lee S, Cho S, Woo HJ, Kim S. Changes in the Suicide Rate of Older Adults According to Gender, Age, and Region in South Korea from 2010 to 2017. Healthcare (Basel) 2022; 10:2333. [PMID: 36421657 PMCID: PMC9690192 DOI: 10.3390/healthcare10112333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND South Korea's suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. METHODS the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young-old, old-old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. RESULTS over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old-old group, and those living in rural regions. In the quadratic function change rate, only males and the old-old group were statistically significant. CONCLUSION in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population.
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Affiliation(s)
- Kyu-Hyoung Jeong
- Department of Social Welfare, Semyung University, Jecheon 27136, Republic of Korea
| | - Ji-Yeon Yoon
- Institute for Life and Culture, Sogang University, Seoul 04100, Republic of Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
| | - Sunghwan Cho
- School of Social Work, Virginia Commonwealth University, Richmond, VA 23223, USA
| | - Hyun-Jae Woo
- Health & Welfare Committee, Seoul Metropolitan Council, Seoul 04519, Republic of Korea
| | - Sunghee Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Republic of Korea
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Oh TK, Park HY, Song IA. Prevalence and risk factors for suicide in patients with sepsis: nationwide cohort study in South Korea. BJPsych Open 2022; 8:e61. [PMID: 35264279 PMCID: PMC8935909 DOI: 10.1192/bjo.2022.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although a recent study reported that survivors of critical illness have an increased risk of suicide, the suicide rate and factors associated with suicide in patients with sepsis have not yet been investigated. AIMS We aimed to examine the prevalence and risk factors of suicide among patients with sepsis in South Korea. METHOD All adult patients who were admitted to all hospitals in South Korea with a main diagnosis of sepsis, from 1 January 2010 to 31 December 2018, were included in the study. The primary outcome was suicide within 1 year after sepsis diagnosis. RESULTS A total of 251 837 adult patients with sepsis were included, of which 132 691 patients (52.7%) died within 1 year after the diagnosis of sepsis, and death by suicide was the cause in 3903 patients (1.5%). Older age, male gender, living in a rural area, higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores, invasive treatment (continuous renal replacement therapy and mechanical ventilator support) and admission to a hospital with low annual case volumes were associated with a higher risk of suicide. In addition, concurrent substance misuse, post-traumatic stress disorder, bipolar disorder, dementia and previous attempt of suicide or self-harm were associated with a higher risk of suicide. CONCLUSIONS During the 1-year follow-up period, 1.5% of patients died by suicide after the diagnosis of sepsis in South Korea. Knowledge of the factors associated with suicide might allow for earlier intervention to potentially reduce the number of suicide attempts in patients with sepsis.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, South Korea; and Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, South Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, South Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, South Korea
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Raschke N, Mohsenpour A, Aschentrup L, Fischer F, Wrona KJ. Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence. BMC Public Health 2022; 22:129. [PMID: 35042490 PMCID: PMC8765829 DOI: 10.1186/s12889-022-12498-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background The economic and human costs of suicide to individuals, families, communities, and society make suicide a major public health problem around the world. Suicide rates in South Korea are among the highest in the world. This paper is the first systematic review investigating socioeconomic risk factors for suicidal behaviors (suicidal ideation, attempted suicides, and completed suicides) in South Korea. Methods We performed a systematic review in Medline and Web of Science. Empirical studies and peer-reviewed articles on the association between individual socioeconomic factors and suicidal behaviors have been included. A total of 53 studies were included in a descriptive synthesis. Results Overall, 35 studies focused on the association between individual socioeconomic factors and suicidal ideation, 16 were related to suicide attempts, while 10 addressed completed suicides. Low income, unemployment, and financial difficulties were identified as risk factors for all suicidal behaviors. Working in precarious conditions, long working hours, self-employment, changes in employment status, shift work/night-time work, and occupational stress were associated with an increased risk for suicidal ideation. Low educational attainment appears to increase the risk for suicide attempts and completed suicide, but the significance of educational attainment on the reporting of suicidal ideation could not be verified. The primary studies were unable to ascertain whether the place of residence impacts on suicidal behaviors. Conclusions The results highlight the relevance of socioeconomic factors for suicidal behaviors in South Korea. Governmental social spending must be increased and redirected more efficiently so that the economically most vulnerable groups are financially protected and income inequality does not widen. Furthermore, comprehensive prevention strategies at the community level are needed. Future research needs to focus on identifying vulnerable groups for whom the effects of low socioeconomic status may have particularly serious consequences with regard to suicidal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12498-1.
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Fitzpatrick SJ, Read D, Brew BK, Perkins D. A sociological autopsy lens on older adult suicide in rural Australia: Addressing health, psychosocial factors and care practices at the intersection of policies and institutions. Soc Sci Med 2021; 284:114196. [PMID: 34271402 DOI: 10.1016/j.socscimed.2021.114196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/20/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022]
Abstract
This paper examines the interrelationship between suicide, health, socioeconomic, and psychosocial factors in contributing to suicide in older adults in rural Australia. Drawing on a coronial dataset of suicide cases and a mixed methods sociological autopsy approach, our study integrated a quantitative analysis of 792 suicide cases with a qualitative analysis of medico-legal reports from 30 cases. The sociological autopsy provided novel insights into the entanglement of policy and service provision at the state-level with individual end-of-life decisions. Particular attention is drawn to age and gendered dimensions of suicide, especially in relation to health and social issues. The study showed a continuity between suicide and the patterning of an individual's life course, including experiences and consequences of inequality and marginality; a desire to meet culturally-normative ideals of autonomy; and a fragmented, under-funded, and intimidating social care system that offered limited options.
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Affiliation(s)
- Scott J Fitzpatrick
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, Australia.
| | - Donna Read
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, Australia
| | - Bronwyn K Brew
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, School of Women and Children's Health, University of New South Wales, Sydney, Australia
| | - David Perkins
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, Australia
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Sayeed A, Choi Y, Eslami E, Jung J, Lops Y, Salman AK, Lee JB, Park HJ, Choi MH. A novel CMAQ-CNN hybrid model to forecast hourly surface-ozone concentrations 14 days in advance. Sci Rep 2021; 11:10891. [PMID: 34035417 PMCID: PMC8149875 DOI: 10.1038/s41598-021-90446-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
Issues regarding air quality and related health concerns have prompted this study, which develops an accurate and computationally fast, efficient hybrid modeling system that combines numerical modeling and machine learning for forecasting concentrations of surface ozone. Currently available numerical modeling systems for air quality predictions (e.g., CMAQ) can forecast 24 to 48 h in advance. In this study, we develop a modeling system based on a convolutional neural network (CNN) model that is not only fast but covers a temporal period of two weeks with a resolution as small as a single hour for 255 stations. The CNN model uses meteorology from the Weather Research and Forecasting model (processed by the Meteorology-Chemistry Interface Processor), forecasted air quality from the Community Multi-scale Air Quality Model (CMAQ), and previous 24-h concentrations of various measurable air quality parameters as inputs and predicts the following 14-day hourly surface ozone concentrations. The model achieves an average accuracy of 0.91 in terms of the index of agreement for the first day and 0.78 for the fourteenth day, while the average index of agreement for one day ahead prediction from the CMAQ is 0.77. Through this study, we intend to amalgamate the best features of numerical modeling (i.e., fine spatial resolution) and a deep neural network (i.e., computation speed and accuracy) to achieve more accurate spatio-temporal predictions of hourly ozone concentrations. Although the primary purpose of this study is the prediction of hourly ozone concentrations, the system can be extended to various other pollutants.
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Affiliation(s)
- Alqamah Sayeed
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA
| | - Yunsoo Choi
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA.
| | - Ebrahim Eslami
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA.,Houston Advanced Research Center, The Woodlands, TX, 77381, USA
| | - Jia Jung
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA
| | - Yannic Lops
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA
| | - Ahmed Khan Salman
- Departmcnt of Earth and Atmospheric Sciences, University of Houston, Houston, TX, 77004, USA
| | - Jae-Bum Lee
- National Institute of Environmental Research, Incheon, Korea
| | - Hyun-Ju Park
- National Institute of Environmental Research, Incheon, Korea
| | - Min-Hyeok Choi
- National Institute of Environmental Research, Incheon, Korea
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Geography of suicide in Japan: spatial patterning and rural-urban differences. Soc Psychiatry Psychiatr Epidemiol 2021; 56:731-746. [PMID: 33159535 PMCID: PMC8068717 DOI: 10.1007/s00127-020-01978-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 10/24/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE There are notable geographic variations in incidence rates of suicide both in Japan and globally. Previous studies have found that rurality/urbanity shapes intra-regional differences in suicide mortality, and suicide risk associated with rurality can vary significantly by gender and age. This study aimed to examine spatial patterning of and rural-urban differences in suicide mortality by gender and age group across 1887 municipalities in Japan between 2009 and 2017. METHODS Suicide data were obtained from suicide statistics of the Ministry of Health, Labour and Welfare in Japan. We estimated smoothed standardized mortality ratios for suicide for each of the municipalities and investigated associations with level of rurality/urbanity using Bayesian hierarchical models before and after adjusting for socioeconomic characteristics. RESULTS The results of the multivariate analyses showed that, for males aged 0-39 and 40-59 years, rural residents tended to have a higher suicide risk compared to urban ones. For males aged 60+ years, a distinct rural-urban gradient in suicide risk was not observed. For females aged 0-39 years, a significant association between suicide risk and rurality was not observed, while for females aged 40-59 years and females aged 60 years or above, the association was a U-shaped curve. CONCLUSION Our results showed that geographical distribution of and rural-urban differences in suicide mortality in Japan differed substantially by gender and age. These findings suggest that it is important to take demographic factors into consideration when municipalities allocate resources for suicide prevention.
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Chen YY, Yang CT, Cha ES, Sha F, Yip PSF. Quantifying the contributions of age, sex, methods, and urbanicity to the changing suicide rate trends in South Korea, 2001-2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1121-1132. [PMID: 32189039 DOI: 10.1007/s00127-020-01855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Suicide rates in South Korea have been one of the highest in the world. The aim of this study is to quantify the contributions of age, sex, method, and place of residence to the trends of the suicide rates between 2001 and 2016 in South Korea. METHODS Using the suicide data obtained from the South Korean National Death Registration data set for the years 2001-2016, a Joinpoint regression analysis was conducted to determine if there was a significant change in the trend of suicide rates. Next, a decomposition analysis method was used to quantify the contributions of age, sex, method, and places of residence to the changes in the suicide rates. RESULTS Suicide rates increased between 2001 and 2010, and decreased between 2010 and 2016. Among all the age groups, the 65-79 age group contributed most to the rise (18% in men and 7% in women) and fall (- 15% in men and - 14% in women) of suicide rates. Men contributed much more than women to the increasing trend of suicide rate (63.0% vs. 37.0%). Hanging was the key method of suicide, dominating the ups and downs of the suicide rates. The rates of suicide by pesticide poisoning have been decreasing since 2005 and suicide by charcoal burning continued to increase against a decreasing trend of suicide rate during the period of 2010-2016. The gap of the metropolitan-city-rural suicide rates was narrowing during the period under study, although the rural areas remained to have the highest suicide rates. CONCLUSION The ups and downs of suicide rates in South Korea were not uniform across different sociodemographic groups. Age, sex, method, and place of residence contributed differently to the changes in suicide rates. Suicide prevention measures can be more focused on certain age-sex-method-region subgroups.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Chi-Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eun-Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Feng Sha
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong. .,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
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Choi DW, Lee SA, Lee DW, Joo JH, Han KT, Kim S, Park EC. Effect of socioeconomic deprivation on outcomes of diabetes complications in patients with type 2 diabetes mellitus: a nationwide population-based cohort study of South Korea. BMJ Open Diabetes Res Care 2020; 8:8/1/e000729. [PMID: 32611580 PMCID: PMC7332202 DOI: 10.1136/bmjdrc-2019-000729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 05/04/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION This study aimed to examine the effect of socioeconomic deprivation on the outcomes of diabetes complications in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS We conducted a cohort study using claims data and 2005 national census data. We included of 7510 patients newly diagnosed with T2DM from 2004 to 2012 and aged 40 years or above. We excluded participants who had onset of diabetes complications and hospitalization within 1 year after initial onset T2DM, aged less than 40 years and with missing covariates. We used the regional socioeconomic deprivation index and classified study participants into five categories according to the quintile distribution. We calculated the adjusted HR and 95% CI for hospitalization related to diabetes complications and all-cause mortality by applying Cox proportional hazards model and the adjusted subdistribution hazards model. RESULTS The percentages of participants in the first quintile (least deprived) to fifth quintile (most deprived) were 27.0%, 27.9%, 19.5%, 14.8%, and 10.8% for socioeconomic deprivation; 25.4%, 28.8%, 32.4%, 34.6%, and 37.6% for hospitalization due to diabetes complications; 1.3%, 2.1%, 2.5%, 2.9%, and 3.6% for deaths from diabetes complications; and 5.7%, 7.2%, 9.7%, 9.7%, and 13.1% for deaths from all causes, respectively. Participants with higher socioeconomic deprivation had a higher HR for hospitalization and mortality from all-cause and diabetes complications. These associations were the strongest among men and participants in their 40s in hospitalization related to diabetes complications, 50s in diabetes complications-specific mortality and 50s and 60s in all-cause mortality. CONCLUSIONS Patients with T2DM with high socioeconomic deprivation had higher hospital admission and mortality rates for diabetes complications than those with low deprivation. We cannot fully explain the effect of socioeconomic deprivation on diabetes outcomes. Therefore, further studies are needed in order to find underlying mechanisms for these associations.
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Affiliation(s)
- Dong-Woo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea (the Republic of)
| | - Sang Ah Lee
- Research and Analysis Team, National Health Insurance Corporation Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)
| | - Doo Woong Lee
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea (the Republic of)
| | - Jae Hong Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea (the Republic of)
| | - Kyu-Tae Han
- Division of Cancer Management Policy, National Cancer Center, Goyang, Gyeonggi-do, Korea (the Republic of)
| | - SeungJu Kim
- Department of Nursing, Eulji University, Seongnam, Gyeonggi-do, Korea (the Republic of)
| | - Eun-Cheol Park
- Department Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
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Yang CT, Yip PSF, Cha ES, Zhang Y. Seasonal changes in suicide in South Korea, 1991 to 2015. PLoS One 2019; 14:e0219048. [PMID: 31251776 PMCID: PMC6599115 DOI: 10.1371/journal.pone.0219048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 06/14/2019] [Indexed: 11/26/2022] Open
Abstract
Seasonality of suicidal behavior has been widely reported in many epidemiological studies with a well replicated suicide peak in spring followed by a trough in winter season. Research from some regions over the past few decades has shown a diminishing seasonal pattern of suicides and this introduced a new perspective on the suicide study. Data on all suicide deaths from the period 1991 to 2015 was extracted from the South Korean National Death Registration data set which was made available by Statistics Korea. Our findings confirmed a strong seasonal effect of suicides in South Korea throughout the study period and a marked diminishing pattern was observed since the period of 2006–2010. The rhythm of suicides kept changing across the time intervals with a spring peak followed by a second peak in late summer/autumn. The seasonality varied across age groups and the seasonal effect among the Korean elderly suicides was still found to be significant though a diminishing pattern was observed recently.
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Affiliation(s)
- Chi Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong
| | - Paul S. F. Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- * E-mail: (PSFY); (YZ)
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yi Zhang
- Institute of Population and Labor Economics, The Chinese Academy of Social Sciences, Bejing, People’s Republic of China
- * E-mail: (PSFY); (YZ)
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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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13
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Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis. BMC Public Health 2017; 17:193. [PMID: 28196502 PMCID: PMC5310090 DOI: 10.1186/s12889-016-3961-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 12/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Between 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka's 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period. METHODS We mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka's suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman's rank correlation and negative binomial models. RESULTS The rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = -0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = -0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively. CONCLUSIONS The findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka's suicide rate, but the impact of other factors cannot be ruled out.
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14
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Fernández-Arteaga V, Tovilla-Zárate CA, Fresán A, González-Castro TB, Juárez-Rojop IE, López-Narváez L, Hernández-Díaz Y. Association between completed suicide and environmental temperature in a Mexican population, using the Knowledge Discovery in Database approach. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2016; 135:219-224. [PMID: 27586493 DOI: 10.1016/j.cmpb.2016.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/01/2016] [Accepted: 08/03/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Suicide is a worldwide health problem and climatological characteristics have been associated with suicide behavior. However, approaches such as the Knowledge Discovery in Database are not frequently used to search for an association between climatological characteristics and suicide. The aim of the present study was to assess the association between weather data and suicide in a Mexican population. METHODS We used the information of 1357 patients who completed suicide from 2005 to 2012. Alternatively, weather data were provided by the National Water Commission. We used the Knowledge Discovery in Database approach with an Apriori algorithm and the data analyses were performed with the Waikato Environment for Knowledge Analysis software. One hundred rules of association were generated with a confidence of 0.86 and support of 1. RESULTS We found an association between environmental temperature and suicide: days with no rain and temperatures between 30 °C and 40 °C (86-104 °F) were related to males completing suicide by hanging. CONCLUSIONS In the prevention of suicidal behavior, the Knowledge Discovery in Database could be used to establish climatological characteristics and their association with suicide. This approach must be considered in future prevention strategies.
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Affiliation(s)
- Verónica Fernández-Arteaga
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, Mexico.
| | - Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de Mexico, Mexico
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - Isela E Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico
| | | | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
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15
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Sha F, Yip PSF, Law YW. Decomposing change in China's suicide rate, 1990-2010: ageing and urbanisation. Inj Prev 2016; 23:40-45. [PMID: 27312962 DOI: 10.1136/injuryprev-2016-042006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/13/2016] [Accepted: 05/24/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The study empirically quantifies the contributions of age composition and urbanisation to changes in the suicide rate in China over the periods 1990-2000 and 2000-2010. METHODS A decompositional method was used to quantify the absolute and relative contributions of the age structure; the age-specific proportion of the urban population and the suicide rate of each age-specific, gender-specific and urban/rural cohort to the overall suicide rates in the two 10-year intervals. RESULTS In the period between 1990 and 2000, a significant decline in the suicide rate among younger age groups (especially young rural women) was identified as the main driving force of the downward trend in the overall suicide rate. In 2000-2010, the rate of decline in suicide was predominantly explained by the drop in the suicide rate among all age groups in rural areas, with the exception of those aged over 80. The positive impact of urbanisation on the decline of the suicide rate has gradually diminished relative to the earlier period. CONCLUSION As the positive impact of urbanisation on suicide rates is diminishing, further urbanisation and rapid change in society may induce stress and adjustment problems that are not conducive to the promotion of well-being. Furthermore, as China is facing the prospects of slower economic growth and a rapidly ageing population, suicides among older adults may also be elevated, particularly among those in rural areas with insufficient healthcare and social support. In order to maintain the decreasing trend of suicide in China, it is important for the Chinese government to pay more attention to the mental well-being of the population and to mitigate the stress of urban life and to provide timely support to older adults especially in rural areas.
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Affiliation(s)
- Feng Sha
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
| | - Paul S F Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong
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