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Wang JJ, Lai DWL, Yu W. Social Capital and Mental Wellbeing of Older People Migrating along with Adult Children in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6857. [PMID: 37835127 PMCID: PMC10572125 DOI: 10.3390/ijerph20196857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/14/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023]
Abstract
The phenomenon of 'older people migrating along' (OPMA) with adult children is a unique outcome of social changes that have occurred in China. These individuals generally experience different challenges and needs associated with mental wellbeing. However, there is limited research on the relationship between the social capital and mental health of OPMA in China. This study aims to examine the mental health status of OPMA and the effects of bonding social capital and bridging social capital on their mental wellbeing in China by conducting a quantitative research survey among 399 OPMA participants. We found that bonding social capital correlated to only one indicator of mental wellbeing, subjective happiness. Bridging social capital had significant relationships with four mental health indicators, namely, the 12-item General Health Questionnaire (GHQ-12), Geriatric Depression Scale (GDS), subjective happiness, and life satisfaction. Through strengthening bridging social capital, these older adults can benefit from more opportunities for participation in formal or informal organizations in their communities and improve their mental wellbeing.
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Affiliation(s)
- Julia Juan Wang
- Elderly Healthcare College, Shenzhen Polytechnic University, Shenzhen 518055, China;
| | - Daniel W. L. Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China
| | - Wenqing Yu
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China;
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2
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Zhao S, Yan W, Tao L, Zhang J. The Association Between Relative Deprivation, Depression, and Youth Suicide: Evidence From a Psychological Autopsy Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231190595. [PMID: 37462026 DOI: 10.1177/00302228231190595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE Suicide is a serious public health concern in China. In the present study, we investigated the specific mechanisms underlying relative deprivation and suicide in rural China. METHODS A large psychological autopsy study was conducted in rural China, in which 392 suicides and 416 community-living controls were consecutively recruited. Multiple logistic regression analysis was used to assess the relationship between relative deprivation and suicide, with depression as a potential mediator. RESULTS Young people who experienced relative deprivation were at a greater risk of suicide and depression. Depression plays a mediating role in the relationship between relative deprivation and suicide. LIMITATIONS Due to the limitations of the data, we cannot know whether there is mutual causation between relative deprivation and depression. The self-reported relative deprivation may also produce some influence on the results. CONCLUSIONS The current findings demonstrate the importance of relative deprivation as one of the four sources of psychological strain to explain how relative status is associated with suicide. The findings also can be translated into the clinical and preventive practice for suicide.
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Affiliation(s)
- Sibo Zhao
- Central University of Finance and Economics, Beijing, China
| | - Wenqun Yan
- Central University of Finance and Economics, Beijing, China
| | - Lifan Tao
- Central University of Finance and Economics, Beijing, China
| | - Jie Zhang
- Central University of Finance and Economics, Beijing, China
- State University of New York Buffalo State University, Buffalo, NY, USA
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3
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Liu Y, Zhang D, Wang R, Wang P, Su Y. Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience. Aging Ment Health 2023; 27:263-271. [PMID: 35081837 DOI: 10.1080/13607863.2022.2032595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study aimed to investigate the mediating role of self-esteem in the relationship between physical disability and suicidal ideation, and whether the mediation effect was moderated by resilience among nursing home residents. METHODS Participants were 538 nursing home residents recruited from 37 nursing homes in Jinan, China (mean age = 78.13 years, SD = 8.72). The Lawton and Brody Activities of Daily Living Scale, Rosenberg Self-Esteem Scale, 10-item version of the Connor-Davidson Resilience Scale, and Beck Suicidal Ideation Inventory-Chinese Version were used. Mediation and moderated mediation analyses were performed using Models 4 and 15 of the PROCESS macro for SPSS. RESULTS The prevalence of suicidal ideation among the nursing home residents was 14.90%. The mediation analysis showed that self-esteem partially mediated the association between physical disability and suicidal ideation. Resilience was a protective factor for suicidal ideation and moderated the relationship between physical disability and suicidal ideation, and between self-esteem and suicidal ideation. CONCLUSION Both physical disability and lower self-esteem are important in understanding the development of suicidal ideation among nursing home residents. Improving resilience may be crucial for suicide prevention.
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Affiliation(s)
- Yuqi Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Dan Zhang
- School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Peng Wang
- Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China.,Shandong Provincial Key Laboratory of Mental Disorders, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
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4
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Ma G, Xu K. Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:192. [PMID: 36612515 PMCID: PMC9819384 DOI: 10.3390/ijerph20010192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Long-term care insurance (LTCI) is a significant approach in the effort to actively manage aging and the currently unmet need for aged care in China. Based on data from the 2011, 2013, 2015, and 2018 phases of the China Health and Retirement Longitudinal Study, we used the propensity score matching-difference in difference (PSM-DID) approach to explore the impact of LTCI on out-of-pocket medical expenses and self-rated health. Results showed that LTCI can significantly reduce out-of-pocket medical expenses by 37.16% (p < 0.01) per year and improve self-rated health by 5.73% (p < 0.01), which conforms to the spirit of “value-based health care”. The results were found to be stable in the robustness tests conducted. Currently, China is at the intersection of “low-value-based health care” and “value-based health care”. Improving the health level of aged individuals while keeping medical costs under reasonable control is crucial for formulating and implementing a new round of healthcare reform in China.
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Affiliation(s)
| | - Kun Xu
- Correspondence: ; Tel.: +86-198-1075-0586
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5
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Kim JM, Bae YJ. Regional Differences in Metabolic Risk in the Elderly in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11675. [PMID: 36141947 PMCID: PMC9517405 DOI: 10.3390/ijerph191811675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Lifestyle and dietary differences in urban and rural environments have different impacts on elderly health. We aimed to evaluate the nutritional intakes and metabolic risks in the urban and rural elderly. We analyzed 3018 elderly individuals (1358 men, 1660 women) who were aged 65 years and older using the Korea National Health and Nutrition Examination Survey data (2013-2016). Anthropometric data, blood pressure, and blood profiles were collected using health examinations. Daily dietary intakes were analyzed by the 24-h dietary recall method. Rural elderly women had significantly higher triglycerides (TG) levels and lower high-density lipoprotein (HDL)-cholesterol levels than urban elderly women (p = 0.014, p = 0.005). The rural elderly had higher carbohydrate intake and percentage of carbohydrate energy intake and lower intakes of fat, vitamin A, vitamin B2, and vitamin C and percentage of fat energy intake than the urban elderly for both men and women (p < 0.05). The odds of high TG and low HDL-cholesterol were 1.66 (95% confidence interval [CI] 1.23-2.23) and 1.33 (95% CI 1.01-1.77), respectively, in elderly women living in rural areas compared to their urban counterparts, after adjusting for confounding factors. Therefore, nutritional intervention might be needed to improve the nutritional status of the elderly in rural areas and to manage low HDL-cholesterol in rural women.
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Affiliation(s)
- Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science & Culinary Arts, Shinhan University, Uijeongbu 11644, Korea
| | - Yun-Jung Bae
- Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Korea
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6
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Shiraly R, Mahdaviazad H, Zohrabi R, Griffiths MD. Suicidal ideation and its related factors among older adults: a population-based study in Southwestern Iran. BMC Geriatr 2022; 22:371. [PMID: 35484508 PMCID: PMC9046067 DOI: 10.1186/s12877-022-03049-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/11/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Suicidal ideation is a major risk factor for suicide and can negatively affect self-care and health behaviors among the older adults. There are limited data on the prevalence and risk factors of suicidal ideation among the older population during the COVID-19 pandemic. The aim of the present study was to examine the prevalence and risk factors of suicidal ideations among Iranian older adults during the COVID-19 pandemic. Methods A total of 803 older community adults in Shiraz (Southwestern Iran) were surveyed to determine potential factors influencing suicidal ideation, including demographic factors, physical health status, access to healthcare, current depression status, fear of COVID-19, perceived social support, and social engagement. Data were collected utilizing face-to-face interviews between November and December 2020. Multivariate logistic regression analysis was used to identify independent variables associated with suicidal ideations. Results Among the 803 participants, 69 reported suicidal ideations (8.6%). Individuals with suicidal ideations were more likely to have greater fear of COVID-19. However, based on the results of multivariate logistic regression analysis, current depression (OR: 2.07, CI 95%: 1.18–3.65), not being married (OR: 1.82, CI 95%: 1.06–3.13), inability to pay for medical bills (OR: 2.16, CI 95%: 1.23–3.79), low perceived social support (OR: 2.03, CI95%: 1.11–3.71), and having limited social network (OR:1.77, CI 95%: 1.02–3.10) appeared to be more powerful influencing factors. Conclusion Suicidal ideation appears to be relatively common among Iranian older adults during the COVID-19 pandemic. A lack of longitudinal data makes it difficult to establish an association between suicidal ideations and the COVID-19 pandemic. Systematic monitoring of suicidal ideation is recommended among high-risk groups, particularly the older population.
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Affiliation(s)
- Ramin Shiraly
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Behavior Science Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamideh Mahdaviazad
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Roya Zohrabi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
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7
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Chen X, Mo Q, Yu B, Bai X, Jia C, Zhou L, Ma Z. Hierarchical and nested associations of suicide with marriage, social support, quality of life, and depression among the elderly in rural China: Machine learning of psychological autopsy data. Front Psychiatry 2022; 13:1000026. [PMID: 36226103 PMCID: PMC9548573 DOI: 10.3389/fpsyt.2022.1000026] [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] [Received: 07/21/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To identify mechanisms underpinning the complex relationships between influential factors and suicide risk with psychological autopsy data and machine learning method. DESIGN A case-control study with suicide deaths selected using two-stage stratified cluster sampling method; and 1:1 age-and-gender matched live controls in the same geographic area. SETTING Disproportionately high risk of suicide among rural elderly in China. PARTICIPANTS A total of 242 subjects died from suicide and 242 matched live controls, 60 years of age and older. MEASUREMENTS Suicide death was determined based on the ICD-10 codes. Influential factors were measured using validated instruments and commonly accepted variables. RESULTS Of the total sample, 270 (55.8%) were male with mean age = 74.2 (SD = 8.2) years old. Four CART models were used to select influential factors using the criteria: areas under the curve (AUC) ≥ 0.8, sensitivity ≥ 0.8, and specificity ≥ 0.8. Each model included a lead predictor plus 8-10 hierarchically nested factors. Depression was the first to be selected in Model 1 as the lead predictor; After depression was excluded, quality of life (QOL) was selected in Model 2; After depression and QOL were excluded, social support was selected in Model 3. Finally, after all 3 lead factors were excluded, marital status was selected in Model 4. In addition, CART demonstrated the significance of several influential factors that would not be associated with suicide if the data were analyzed using the conventional logistic regression. CONCLUSION Associations between the key factors and suicide death for Chinese rural elderly are not linear and parallel but hierarchically nested that could not be effectively detected using conventional statistical methods. Findings of this study provide new and compelling evidence supporting tailored suicide prevention interventions at the familial, clinical and community levels.
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Affiliation(s)
- Xinguang Chen
- Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | - Qiqing Mo
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China.,Guilin People's Hospital, Guilin, China.,Department of Epidemiology, Universtiy of Florida, Gaineville, FL, United States
| | - Bin Yu
- Department of Biostatistics and Epidemiology, School of Public Health, Wuhan University, Wuhan, China
| | - Xinyu Bai
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China.,People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo Medical College, Shandong University, Jinan, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Ma
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, China
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8
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Jia P, Zhuang J, Vaca Lucero AM, Osei CD, Li J. Does Participation in Local Non-agricultural Employment Improve the Mental Health of Elderly Adults in Rural Areas? Evidence From China. Front Public Health 2021; 9:746580. [PMID: 34778181 PMCID: PMC8578795 DOI: 10.3389/fpubh.2021.746580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/04/2021] [Indexed: 12/05/2022] Open
Abstract
A rising rate of suicide among the elderly in rural China has been recognized to be triggered by mental health-associated factors. This study uses 3,397 sampled rural elderly adults from China Labor-force Dynamic Survey in 2016 to explore the response mechanism through which non-agricultural employment participation by the elderly adults in rural China can influence their mental health. Utilizing the Multivariate Regression, Instrumental Variable and Propensity Score Matching methods, we find that, the rural elderly adults who participate in local non-agricultural employment significantly improve their mental health. Self-employment tends to have a greater positive contribution to the mental health of the elderly population than waged employment. Further, work income, need for belongingness and respect, and human capital development significantly mediates the influence of participation in local non-agricultural employment on the mental health of the elderly adults. Finally, we put forward relevant policy suggestions to improving the mental health of the elderly in the countryside.
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Affiliation(s)
- Peng Jia
- School of Management, Jiangsu University, Zhenjiang, China
| | - Jincai Zhuang
- School of Management, Jiangsu University, Zhenjiang, China
| | | | | | - Juan Li
- School of Business, Guilin University of Electronic Technology, Guilin, China
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9
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Yang Y, Wang R, Zhang D, Su Y, Zang Y. The protective effect of self-esteem on suicidal ideation among nursing home residents with limited social support in China: A cross-sectional study. Nurs Open 2021; 9:2729-2738. [PMID: 34190426 PMCID: PMC9584493 DOI: 10.1002/nop2.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 11/20/2022] Open
Abstract
Aim This cross‐sectional study aimed to assess the impact of limited social support and loneliness on suicidal ideation, under the influence of self‐esteem, an important inner resource for quality living. Design An observational cross‐sectional study conducted from September 2018–April 2019. Methods The participants comprised 538 nursing home residents selected by a stratified sampling method from all seven administrative districts in a capital city of eastern China. All the participants completed the survey that constituted the measurement of suicidal ideation, self‐esteem, social support and loneliness. Path analysis was performed using the structural equation modelling method. Results A moderating effect, with satisfactory model fit indices and significant path coefficients, was detected between self‐esteem and suicidal ideation through limited social support and loneliness, revealing the multiple protective mechanisms of this psychological characteristic on the change of suicidal ideation.
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Affiliation(s)
- Yang Yang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Rui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Dan Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yonggang Su
- School of Basic Medical Sciences, Shandong University, Jinan, China.,School of Foreign Languages and Literature, Shandong University, Jinan, China
| | - Yuli Zang
- Faculty of Medicine, The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, China
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10
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Syed Elias SM, Makhtar A, Ahmad Tarmidi NH. Factors associated with suicidal ideation among older people in medical outpatient clinic. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2020.09.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Yang Y, Wang S, Hu B, Hao J, Hu R, Zhou Y, Mao Z. Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6399. [PMID: 32887427 PMCID: PMC7504437 DOI: 10.3390/ijerph17176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Abstract
Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.
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Affiliation(s)
- Ying Yang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Shizhen Wang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Borui Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Jinwei Hao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Runhu Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Yinling Zhou
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
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12
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Nie Y, Hu Z, Zhu T, Xu H. A Cross-Sectional Study of the Prevalence of and Risk Factors for Suicidal Ideation Among the Elderly in Nursing Homes in Hunan Province, China. Front Psychiatry 2020; 11:339. [PMID: 32477170 PMCID: PMC7241427 DOI: 10.3389/fpsyt.2020.00339] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/03/2020] [Indexed: 11/30/2022] Open
Abstract
Our study aims to explore the risk factors for suicidal ideation and their interaction among the elderly in nursing homes in Hunan province, China. A cross-sectional study was conducted among the elderly in nursing homes in Hunan Province. Twenty-four nursing homes were selected by multistage cluster random sampling, and 817 elderly residents were investigated using a set of structured questionnaires. The main outcome measures included general information, suicidal ideation, depression symptoms, social support, activities of daily living (ADL), stressful life events, and sleep quality. Multivariate binary logistic regression was performed to explore the risk factors for suicidal ideation among the elderly in nursing homes, and additive interaction was used to analyze the interaction between risk factors. The prevalence of suicidal ideation among the elderly in nursing homes in Hunan province was 17.9% (95% confidence interval(CI): 15.2%, 20.6%). Living in a rural area (odds ratio(OR)=1.88, 95% CI: 1.03, 3.44), infrequent visits from relatives (OR=2.61, 95% CI: 1.42, 4.78), history of chronic disease (OR=2.34, 95% CI: 1.09, 5.01), depression symptoms (OR=8.11, 95% CI: 4.52, 14.54), lower social support (OR=3.85, 95% CI: 1.94, 7.61), and ADL disability status (OR=4.38, 95% CI: 2.10, 9.14) increased the risk of suicidal ideation. Additive interactions were detected between depression symptoms and ADL status, with a relative excess risk due to interaction (RERI) of 8.73 (95% CI: 2.04, 15.43), and between depression symptoms and social support, with an RERI of 5.98 (95% CI: 0.86, 11.10). The prevalence of suicidal ideation among the elderly in nursing homes is relatively high. Both physical conditions and psychosocial factors were associated with suicidal ideation among the elderly. These findings have significant implications for the prediction and prevention of suicidal behaviors.
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Affiliation(s)
- Yu Nie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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13
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Brådvik L. Suicide Risk and Mental Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092028. [PMID: 30227658 PMCID: PMC6165520 DOI: 10.3390/ijerph15092028] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Louise Brådvik
- Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund SE 221 00, Sweden.
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14
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Gender differentials and state variations in suicide deaths in India: the Global Burden of Disease Study 1990-2016. LANCET PUBLIC HEALTH 2018; 3:e478-e489. [PMID: 30219340 PMCID: PMC6178873 DOI: 10.1016/s2468-2667(18)30138-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/20/2022]
Abstract
Background A systematic understanding of suicide mortality trends over time at the subnational level for India's 1·3 billion people, 18% of the global population, is not readily available. Thus, we aimed to report time trends of suicide deaths, and the heterogeneity in its distribution between the states of India from 1990 to 2016. Methods As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016, we estimated suicide death rates (SDRs) for both sexes in each state of India from 1990 to 2016. We used various data sources for estimating cause-specific mortality in India. For suicide mortality in India before 2000, estimates were based largely on GBD covariates. For each state, we calculated the ratio of the observed SDR to the rate expected in geographies globally with similar GBD Socio-demographic Index in 2016 (ie, the observed-to-expected ratio); and assessed the age distribution of suicide deaths, and the men-to-women ratio of SDR over time. Finally, we assessed the probability for India and the states of reaching the Sustainable Development Goal (SDG) target of a one-third reduction in SDR from 2015 to 2030, using location-wise trends of the age-standardised SDR from 1990 to 2016. We calculated 95% uncertainty intervals (UIs) for the point estimates. Findings There were 230 314 (95% UI 194 058–250 260) suicide deaths in India in 2016. India's contribution to global suicide deaths increased from 25·3% in 1990 to 36·6% in 2016 among women, and from 18·7% to 24·3% among men. Age-standardised SDR among women in India reduced by 26·7% from 20·0 (95% UI 16·5–23·5) in 1990 to 14·7 (13·1–16·2) per 100 000 in 2016, but the age-standardised SDR among men was the same in 1990 (22·3 [95% UI 14·4–27·4] per 100 000) and 2016 (21·2 [14·6–23·6] per 100 000). SDR in women was 2·1 times higher in India than the global average in 2016, and the observed-to-expected ratio was 2·74, ranging from 0·45 to 4·54 between the states. SDR in men was 1·4 times higher in India than the global average in 2016, with an observed-to-expected ratio of 1·31, ranging from 0·40 to 2·42 between the states. There was a ten-fold variation between the states in the SDR for women and six-fold variation for men in 2016. The men-to-women ratio of SDR for India was 1·34 in 2016, ranging from 0·97 to 4·11 between the states. The highest age-specific SDRs among women in 2016 were for ages 15–29 years and 75 years or older, and among men for ages 75 years or older. Suicide was the leading cause of death in India in 2016 for those aged 15–39 years; 71·2% of the suicide deaths among women and 57·7% among men were in this age group. If the trends observed up to 2016 continue, the probability of India achieving the SDG SDR reduction target in 2030 is zero, and the majority of the states with 81·3% of India's population have less than 10% probability, three states have a probability of 10·3–15·0%, and six have a probability of 25·1–36·7%. Interpretation India's proportional contribution to global suicide deaths is high and increasing. SDR in India is higher than expected for its Socio-Demographic Index level, especially for women, with substantial variations in the magnitude and men-to-women ratio between the states. India must develop a suicide prevention strategy that takes into account these variations in order to address this major public health problem. Funding Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
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