Comparative analysis of death by suicide in Brazil and in the United States: descriptive, cross-sectional time series study

Abstract

CONTEXT AND OBJECTIVE: The World Health Organization recognizes suicide as a public health priority. Increased knowledge of suicide risk factors is needed in order to be able to adopt effective prevention strategies. The aim of this study was to analyze and compare the association between the Gini coefficient (which is used to measure inequality) and suicide death rates over a 14-year period (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) in Brazil and in the United States (US). The hypothesis put forward was that reduction of income inequality is accompanied by reduction of suicide rates. DESIGN AND SETTING: Descriptive cross-sectional time-series study in Brazil and in the US. METHODS: Population, death and suicide death data were extracted from the DATASUS database in Brazil and from the National Center for Health Statistics in the US. Gini coefficient data were obtained from the World Development Indicators. Time series analysis was performed on Brazilian and American official data regarding the number of deaths caused by suicide between 2000 and 2013 and the Gini coefficients of the two countries. The suicide trends were examined and compared. RESULTS: Brazil and the US present converging Gini coefficients, mainly due to reduction of inequality in Brazil over the last decade. However, suicide rates are not converging as hypothesized, but are in fact rising in both countries. CONCLUSION:The hypothesis that reduction of income inequality is accompanied by reduction of suicide rates was not verified.

Suicide mortality among older adults in Brazil between 2000 and 2019 - estimates from the Global Burden of Disease Study 2019

“…The suicide mortality rates found in this study are higher than those verified in the country to date 6 , 25 - 29 , most likely because no previous study has made any correction for the under-reporting of deaths, and only two have used any method of correction for garbage codes 32 , 34 . The decline in these rates in the period studied is compatible with the tendency already demonstrated by the GBD 2015 35 , but it is contradictory to 11 studies which identified an increase in mortality in recent decades 6 , 25 , 26 , 28 - 32 , 34 , 36 , 37 . Seven studies failed to show the proper ASMRs; therefore, the increase in these rates over time might be due only to the process of aging within the Brazilian population 6 , 25 , 28 , 30 , 31 , 34 , 37 .…”

“…Seven studies failed to show the proper ASMRs; therefore, the increase in these rates over time might be due only to the process of aging within the Brazilian population 6 , 25 , 28 , 30 , 31 , 34 , 37 . Of the four studies that used ASMRs 26 , 29 , 31 , 36 , only one implemented a correction for mortality garbage codes 31 and two refer to the periods of 1980 to 2005 and 1990 to 2015 26 , 31 .…”

Tendência de suicídio no Brasil de 2011 a 2020: foco especial na pandemia de covid-19

“…O Brasil possui um produto interno bruto (PIB) que está entre os maiores do mundo. Porém, em contrapartida, apresenta um dos maiores índices de desigualdade social e de renda, com variáveis econômicas que podem influenciar as taxas de suicídio ( 29 ).…”

Suicide cases in developed and emerging countries: an analysis using wavelets

“…Additionally, the authors detected an inverse relationship between unemployment and the suicide rate, which contradicts the expected correlation rates reported in several other scientific studies 36 . Another study using a time series comparison of suicide deaths in Brazil and the United States showed that the decreasing economic inequality in Brazil was not significantly related to a decrease in the crude suicide rate as hypothesized 37 . An additional comprehensive investigation of the trend in suicide rates conducted in Brazil using data from 1997 to 2015 reported an increase, which is alarming 38 .…”