Ten-year evolution of suicide rates and economic indicators in large Brazilian urban centers (original) (raw)
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SSM - Population Health, 2021
Global suicide rates have increased in recent decades becoming a serious social and public health problem. In Brazil, rates have been increasing annually. We aimed to analyze the correlation between suicide mortality rates and global economic and political crisis periods of 2008 and 2014 in Brazil. The analysis of suicide mortality in Brazil was done using a time-series segmented linear regression model that estimated the trend of rates over time. To obtain the model, changes in the trend of both abrupt and gradual suicide rates were investigated. The results indicate statistically significant changes showing an upward trend of suicide rates during the world economic crisis (2008-2013) and during the economic and political crisis in Brazil (2014-2017) compared to previous periods, especially at the extremes of schooling (3 < years and > 8 years). Among white and parda, there were significant trend rates increases in both periods and in different regions. In the Northeast and South regions, we observed a significant increase in the trend rate for males after the Brazilian economic and political crisis (2014 to 2017). We can conclude that the national suicide rates were influenced by the economic and political instability that our country has been going through since 2008, affecting each region differently. Further studies are needed to explore the reasons for interregional differences and the relation of suicide with unemployment rates and possible economic predictors.
Suicide time trends in Brazil from 1980 to 2005
Cadernos De Saude Publica, 2010
The aim of this study was to describe suicide time trends in Brazil from 1980Brazil from to 2005. The data were obtained from the National Mortality Information System and the Brazilian Institute of Geography and Statistics (IBGE). Suicides rates were calculated for the entire period for the country as a whole and the 26 States and Federal District. Annual increases or decreases in mortality rates were also estimated using Prais-Winsten generalized linear regression. The mean suicide rate was 4.12 per 100,000 inhabitants (6.45/100,000 in men and 1.80/100,000 in women). The study showed an increasing suicide trend in men (+1.41% per year, 95%CI: 1.00;1.23) and a decreasing trend in women (-0.53% per year, 95%CI: -0.04;-1.02). Suicide rates increased with age. In general, for all age groups and for both genders, the highest rates were in São Paulo and in the States of the South and Central-West regions. Temporal Distribution; Mortality Rate; Suicide
Impact of Income Inequality and Other Social Determinants on Suicide Rate in Brazil
PLOS ONE, 2015
To analyze whether income inequality and other social determinants are associated with suicide rate in Brazil. This study used panel data from all 5,507 Brazilian municipalities from 2000 to 2011. Suicide rates were calculated by sex and standardized by age for each municipality and year. The independent variables of the regression model included the Gini Index, per capita income, percentage of individuals with up to eight years of education, urbanization, average number of residents per household, percentage of divorced people, of Catholics, Pentecostals, and Evangelicals. A multivariable negative binomial regression for panel data with fixed-effects specification was performed. The Gini index was positively associated with suicide rates; the rate ratio (RR) was 1.055 (95% CI: 1.011-1.101). Of the other social determinants, income had a significant negative association with suicide rates (RR: 0.968, 95% CI: 0.948-0.988), whereas a low-level education had a positive association (RR: 1.015, 95% CI: 1.010-1.021). Income inequality represents a community-level risk factor for suicide rates in Brazil. The decrease in income inequality, increase in income per capita, and decrease in the percentage of individuals who did not complete basic studies may have counteracted the increase in suicides in the last decade. Other changes, such as the decrease in the mean residents per household, may have contributed to their increase. Therefore, the implementation of social policies that may improve the population&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s socioeconomic conditions and reduce income inequality in Brazil, and in other low and middle-income countries, can help to reduce suicide rates.
Brazilian Journal of Psychiatry
Objective: To examine suicide rates among adolescents from six large cities in Brazil and to analyze the relationship between adolescent suicide rates and socioeconomic indicators between 2006 and 2015. Methods: Generalized estimating equation models were used to assess the impact of socioeconomic factors-including social inequality and unemployment rates-on adolescent suicide rates. Results: The rate of adolescent suicide increased by 24% over the course of the study period. Social inequality (assessed using the Gini index), was positively associated with overall adolescent suicide rates (b = 10.68; 95%CI = 2.32-19.05; p p 0.012). After disaggregating the findings by age (10-14 and 15-19 years), social inequality was associated with suicide rate only for adolescents aged 15-19 years (b = 9.63; 95%CI = 2.31-16.96; p p 0.005). Disaggregating these findings by sex, the association with economic variables became significant only among females. Males had a higher overall suicide rate than females, and the highest rate was observed in male adolescents aged 15-19 years. Higher levels of unemployment were associated with higher suicide rates. Conclusion: Our findings suggest that socioeconomic indicators, particularly unemployment and social inequality, are relevant social determinants of suicide in adolescence.
International Journal of Environmental Research and Public Health, 2021
Suicide and suicide attempts are considered global health problems. With regard to the main causes of unnatural deaths, Brazil ranks as the eighth country with the highest absolute number of suicides. The aim of this study was to analyze the factors associated with the risk of suicide in a metropolitan city in Brazil. This was a cross-sectional study carried out in Recife, in the northeast region of Brazil. Epidemiological surveillance was conducted on the information systems regarding attempted suicide, suicide, and undetermined deaths in the period from 2007 to 2017. A record linkage between the information systems was performed. Descriptive statistics, bivariate analysis, and logistic regression were performed with an adopted a significance level of 5%. In the city of Recife, there were 4495 suicide attempts in the period, and the most frequent suicide attempts were by single females, aged between 20 and 39 years old, and who used either medication or poison to die by suicide. A ...
Research Square (Research Square), 2022
Objective: Estimate the effects of age, period, and birth cohort on suicide mortality in Brazil and by major geographic region in the overall population and by sex. Methods: This was a time trend ecological study. National and regional suicide mortality data from 1981 to 2015 were analyzed for the overall population and by sex. Age, period, and cohort effects were calculated with a Poisson regression model, using estimable functions with the Epi package of the R statistical program, version 3.4.3. Results: Except for the North of Brazil and the female population in the Central-West region, the model that best ts the data was the complete model, following by the age-period model in most of the analyses. Conclusions: Suicide mortality rates have shown an upward trend with advancing age in the Brazilian population, in both men and women. However, the behavior of the period effect and cohort has depended on the population analyzed and regional distribution.
Spatial clusters of suicide in the municipality of São Paulo 1996–2005: an ecological study
BMC Psychiatry, 2012
Background: In a classical study, Durkheim mapped suicide rates, wealth, and low family density and realized that they clustered in northern France. Assessing others variables, such as religious society, he constructed a framework for the analysis of the suicide, which still allows international comparisons using the same basic methodology. The present study aims to identify possible significantly clusters of suicide in the city of São Paulo, and then, verify their statistical associations with socio-economic and cultural characteristics. Methods: A spatial scan statistical test was performed to analyze the geographical pattern of suicide deaths of residents in the city of São Paulo by Administrative District, from 1996 to 2005. Relative risks and high and/or low clusters were calculated accounting for gender and age as co-variates, were analyzed using spatial scan statistics to identify geographical patterns. Logistic regression was used to estimate associations with socioeconomic variables, considering, the spatial cluster of high suicide rates as the response variable. Drawing from Durkheim's original work, current World Health Organization (WHO) reports and recent reviews, the following independent variables were considered: marital status, income, education, religion, and migration. Results: The mean suicide rate was 4.1/100,000 inhabitant-years. Against this baseline, two clusters were identified: the first, of increased risk (RR = 1.66), comprising 18 districts in the central region; the second, of decreased risk (RR = 0.78), including 14 districts in the southern region. The downtown area toward the southwestern region of the city displayed the highest risk for suicide, and though the overall risk may be considered low, the rate climbs up to an intermediate level in this region. One logistic regression analysis contrasted the risk cluster (18 districts) against the other remaining 78 districts, testing the effects of socioeconomic-cultural variables. The following categories of proportion of persons within the clusters were identified as risk factors: singles (OR = 2.36), migrants (OR = 1.50), Catholics (OR = 1.37) and higher income (OR = 1.06). In a second logistic model, likewise conceived, the following categories of proportion of persons were identified as protective factors: married (OR = 0.49) and Evangelical (OR = 0.60). Conclusions: This risk/ protection profile is in accordance with the interpretation that, as a social phenomenon, suicide is related to social isolation. Thus, the classical framework put forward by Durkheim seems to still hold, even though its categorical expression requires re-interpretation.
Purpose There is a growing awareness of the economic and contextual factors that may play a role in the aetiology of suicide. The Programa Bolsa Família (PBF) the Brazilian conditional cash transfer programme, established in 2004, aims to attenuate the effects of poverty of Brazilians. Our study aims to evaluate the effect of Bolsa Família Programme (BFP) coverage on suicide rates in Brazilian municipalities. Methods We conducted an ecological study using 2004-2012 panel data for 5507 Brazilian municipalities. We calculated age-standardized suicide rates for each municipality and year. BFP coverage was categorized according to three levels (< 30%, ≥ 30% and < 70% and ≥ 70%) and duration (coverage ≤ 70% for all years, ≥ 70% for 1 year, ≥ 70% for 2 years, ≥ 70% for 3 or more years). We used negative binomial regression models with fixed effects, adjusting for socio-economic, demographic and social welfare co-variables. Results An increase in BFP coverage was associated with a reduction in suicide rates. The strongest effect was observed when in addition to greater municipal coverage (RR 0.942, 95% CI 0.936-0.947), the duration of the high coverage was maintained for 3 years or more (RR 0.952 95% CI 0.950-0.954).
Suicide in Brazil, 2004-2010: the importance of small counties
Revista Panamericana de Salud Pública, 2012
Brazil is known to have low suicide rates: in 2006, just 5.7 suicides per 100 000 (1). However, the country's population has grown 17.8% from 1998 to 2008, and during that time, suicide deaths have increased 33.5% (2). Epidemiological studies of the past two decades confirm higher suicide mortality rates among Brazil's males, elderly, indigenous, and in the southern part of the country, as well as rising rates among young males (1, 3-8). The underreporting of suicide mortality is a problem to be addressed mainly when studying small populations. Hidden suicide has been reported among single-vehicle, single-occupant traffic accidents, undetermined intent accidents, unintentional poisoning, and other external causes as well as ill-defined causes of death (9-14). Regarding data quality, the automaticcoding system for recording the underlying cause of death ensures national homogeneity. Legal dispositions demand that in the case of an external cause of death, the Death Certificate be completed by a doctor from the Institute of Legal Medicine in the county, after performing an autopsy to identify the cause(s) of the violence. In counties that lack such an institute, the judicial authority or the police nominate a doctor to act as an expert. Complementary toxicological laboratory exams are not widely available, thus un-Objective. To describe suicide rates by county size in the five geopolitical areas of Brazil.
SUICIDE IN CONTEMPORANEITY: COULD PUBLIC POLICIES REDUCE THE SUICIDE RATES IN BRAZIL?
Revista Direitos Humanos Fundamentais, 2018
This research seeks to make a theoretical approach regarding the phenomenon of suicide and the increase of its occurrence in Brazil. Notwithstanding, the problem is based on the following questions: Why are suicides rates growing in the world? What political and legal measures should be proposed in a try to prevent the occurrence of this phenomenon? Are public policies the most effective means of reducing suicides? Thus, the goal of this investigation is to analyze the multicausal and multifactorial aspects of the suicide phenomenon