Self-harm amongst people of Chinese origin versus White people living in England: a cohort study

Health disparities between native and foreign-born older population in India: Does migration status matter in later life?

BACKGROUND

Ageing and migration are both contemporary phenomena and challenging for modern society in the 21st century. Persons ageing with migration status might have a double risk of vulnerability to poor health outcomes. This study examines the health disparities between foreign-born and native populations in India.

METHODS

The data drawn for the study from the Longitudinal Ageing Study in India (LASI) Wave-I (2017-18). The study used univariate and bivariate analysis to examine health disparities between native and foreign-born groups, and logistic regression analysis was used to examine the association between migration status and health outcomes of older persons.

RESULTS

Over fifty percent (56.5%) of the older persons (age 60+ years) were migrants; of these migrants of older persons, 55% were internally migrated, and 1.5% were foreign-born migrants in India. The foreign-born migrants persons showed a higher prevalence of poor SRH, chronic conditions, depression symptoms, and physical limitations than internal migrants and non-migrant groups. Further, the logistic regression result shows that foreign-born migrants were more likely to have poor SRH [AOR:1.72; CI: 1.45-2.04], chronic conditions [AOR=1.56; CI: 1.26-1.81], depression symptoms [AOR 1.14; CI: 1.07-1.21], and physical limitations [AOR 1.29; CI: 1.21-1.38], than non-migrants. Moreover, the study shows that the migrants' health disparities also vary with their length of stay and country of origin.

CONCLUSIONS

This cross-sectional study suggests that persons with internal and foreign-born migrant status were more vulnerable to poor health outcomes than non-migrants in their later life. This study predicts that migrants need separate health policies as they are in poorer health conditions than non-migrants. Policymakers should initiate equal access to healthcare services for older internal and foreign-born migrants in India.

Self-harm-related mental health presentations to emergency departments by children and young people from culturally and linguistically diverse groups in South Western Sydney

BACKGROUND

Rates of self-harm among children and young people (CYP) have been on the rise, presenting major public health concerns in Australia and worldwide. However, there is a scarcity of evidence relating to self-harm among CYP from culturally and linguistically diverse (CALD) backgrounds.

AIMS

To analyse the relationship between self-harm-related mental health presentations of CYP to emergency departments and CALD status in South Western Sydney (SWS), Australia.

METHOD

We analysed electronic medical records of mental health-related emergency department presentations by CYP aged between 10 and up to 18 years in six public hospitals in the SWS region from January 2016 to March 2022. A multilevel logistic regression model was used on these data to assess the association between self-harm-related presentations and CALD status while adjusting for covariates and individual-level clustering.

RESULTS

Self-harm accounted for 2457 (31.5%) of the 7789 mental health-related emergency department presentations by CYP; CYP from a CALD background accounted for only 8% (n = 198) of the self-harm-related presentations. CYP from the lowest two most socioeconomic disadvantaged areas made 63% (n = 1544) of the total self-harm-related presentations. Findings of the regression models showed that CYP from a CALD background (compared with those from non-CALD backgrounds) had 19% lower odds of self-harm (adjusted odds ratio 0.81, 95% CI 0.66-0.99).

CONCLUSIONS

Findings of this study provide insights into the self-harm-related mental health presentations and other critical clinical features related to CYP from CALD backgrounds that could better inform health service planning and policy to manage self-harm presentations and mental health problems among CYP.

Sex Differences in the Global Prevalence of Nonsuicidal Self-Injury in Adolescents: A Meta-Analysis

Importance

Nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts. The prevalence of NSSI has been increasing among female adolescents in North America and Europe, but less is known about trends in other geographical regions.

Objective

To examine sex differences in the prevalence of NSSI among adolescents within and between geographical regions.

Data Sources

MEDLINE and PsycINFO were searched using the keywords adolescents, self-injury, sex factors, and synonyms for articles published in English between January 1, 2000, and May 10, 2022.

Study Selection

Studies were included if they presented original data (any study design), included adolescents aged 10 to 19 years, reported results stratified by sex, and explicitly defined self-injury as behaviors occurring without suicidal intent.

Data Extraction and Synthesis

This meta-analysis was registered with PROSPERO and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Articles were assessed for quality by 2 independent coders (F.M. and J.A.). A random-effects model was used to calculate prevalence. Data were analyzed from July 2022 to April 2023.

Main Outcomes and Measures

The prevalence of NSSI in male and female adolescents within and between regions was the main outcome. Odds ratios (OR) with 95% CIs were calculated for community samples.

Results

Eight hundred and two studies were screened, and 38 were included (266 491 participants). Across 17 countries, the pooled prevalence of NSSI was 17.7% (female:male OR, 1.60; 95% CI, 1.29-1.98). NSSI was twice as prevalent among female adolescents compared with male adolescents in North America (OR, 2.49; 95% CI, 2.16-2.86) and Europe (OR, 2.08; 95% CI, 1.69-2.58), but not in Asia (OR, 1.00; 95% CI, 0.71-1.41).

Conclusions and Relevance

In this meta-analysis of sex differences in global prevalence of NSSI, the female predominance of NSSI observed among adolescents in North America and Europe aligned with rising rates of suicide in these populations. The comparable prevalence of NSSI among male and female adolescents in Asia also aligned with the lower male-to-female suicide ratio compared with other countries. More research is needed to characterize regional (and potentially cultural) sex differences among adolescents with NSSI to prevent and treat the behavior and to understand the possible interplay with corresponding regional trends in suicide.

Intentional self-harm in culturally and linguistically diverse communities: A study of hospital admissions in Victoria, Australia

PURPOSE

To examine the rates and profiles of intentional self-harm hospital admissions among people from culturally and linguistically diverse and non-culturally and linguistically diverse backgrounds.

METHODS

A retrospective analysis of 29,213 hospital admissions for self-harm among people aged 15 years or older in Victoria, Australia, was conducted using data from the Victorian Admitted Episodes Dataset between 2014/2015 and 2018/2019. The Victorian Admitted Episodes Dataset records all hospital admissions in public and private hospitals in Victoria (population 6.5 million). Population-based incidence of self-harm, logistic regression and percentages (95% confidence intervals) were calculated to compare between culturally and linguistically diverse groups by birthplaces and the non-culturally and linguistically diverse groups of self-harm admissions.

RESULTS

When grouped together culturally and linguistically diverse individuals had lower rates of (hospital-treated) self-harm compared with the non-culturally and linguistically diverse individuals. However, some culturally and linguistically diverse groups such as those originating from Sudan and Iran had higher rates than non-culturally and linguistically diverse groups. Among self-harm hospitalised patients, those in the culturally and linguistically diverse group (vs non-culturally and linguistically diverse group) were more likely to be older, Metropolitan Victorian residents, from the lowest socioeconomic status, and being ever or currently married. Self-harm admissions by persons born in Southern and Eastern Europe were the oldest of all groups; in all other groups number of admissions tended to decrease as age increased whereas in this group the number of admissions increased as age increased.

CONCLUSION

There was considerable heterogeneity in rates of hospital-treated self-harm in culturally and linguistically diverse communities, with some countries of origin (e.g. Sudan, Iran) having significantly higher rates. Some of this variation may be due to factors relating to the mode of entry into Australia (refugee vs planned migration), and future research needs to examine this possibility and others, to better plan for support needs in the culturally and linguistically diverse communities most affected by self-harm. Combining all culturally and linguistically diverse people into one group may obscure important differences in self-harm. Different self-harm prevention strategies are likely to be needed for different culturally and linguistically diverse populations.