Geographic variation in male suicide rates in the United States

Trgovac, Andrew B.; Kedron, Peter; Bagchi‐Sen, Sharmistha

doi:10.1016/j.apgeog.2015.04.005

Cited by 30 publications

(29 citation statements)

References 85 publications

(101 reference statements)

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“…The suicide data were collected from the annual mortality files of the National Center for Health Statistics (NCHS) under the U.S. CDC throughout the Web-based Injury Statistics Query and Reporting System (WISQARS) [ 23 , 27 ]. WISQARS provides fatal injury data in all of the 3141 U.S. counties, of which 3102 are in the contiguous U.S. Age-adjusted smoothed suicide rates were downloaded and used in our study.…”

Section: Methodsmentioning

confidence: 99%

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An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States

2018

IJERPH

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Suicide is a serious but preventable public health issue. Several previous studies have revealed a positive association between altitude and suicide rates at the county level in the contiguous United States. We assessed the association between suicide rates and altitude using a cross-county ecological study design. Data on suicide rates were obtained from a Web-based Injury Statistics Query and Reporting System (WISQARS), maintained by the U.S. National Center for Injury Prevention and Control (NCIPC). Altitude data were collected from the United States Geological Survey (USGS). We employed an ordinary least square (OLS) regression to model the association between altitude and suicide rates in 3064 counties in the contiguous U.S. We conducted a geographically weighted regression (GWR) to examine the spatially varying relationship between suicide rates and altitude after controlling for several well-established covariates. A significant positive association between altitude and suicide rates (average county rates between 2008 and 2014) was found in the dataset in the OLS model (R2 = 0.483, p < 0.001). Our GWR model fitted the data better, as indicated by an improved R2 (average: 0.62; range: 0.21–0.64) and a lower Akaike Information Criteria (AIC) value (13,593.68 vs. 14,432.14 in the OLS model). The GWR model also significantly reduced the spatial autocorrelation, as indicated by Moran’s I test statistic (Moran’s I = 0.171; z = 33.656; p < 0.001 vs. Moran’s I = 0.323; z = 63.526; p < 0.001 in the OLS model). In addition, a stronger positive relationship was detected in areas of the northern regions, northern plain regions, and southeastern regions in the U.S. Our study confirmed a varying overall positive relationship between altitude and suicide. Future research may consider controlling more predictor variables in regression models, such as firearm ownership, religion, and access to mental health services.

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Section: Methodsmentioning

confidence: 99%

“…Moreover, Trgovac et al (2015) found increased county-level male suicide rates in the western U.S., small areas throughout the Appalachian Region, and the Midwest, using data from 2000 to 2006. In addition, social isolation was theorized as the major cause behind the elevated male suicide risk in high altitude regions [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States

2018

IJERPH

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“…England and Wales (Gunnell et al, 2012;Middleton et al, 2004), Germany (Helbich et al, 2017a) and the United States (Trgovac et al, 2015). More than half of the world's population now resides in urban areas (United Nations, 2014).…”

Section: Introductionmentioning

confidence: 99%

Spatial patterning, correlates, and inequality in suicide across 432 neighborhoods in Taipei City, Taiwan

Lin

Hsu

Gunnell

et al. 2019

Social Science & Medicine

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More than half of the world's population now lives in urban areas. Understanding the spatial distribution of suicide in these settings may inform prevention. Previous analyses of the spatial distribution of suicide in cities were mostly restricted to Western nations. We investigated the spatial pattern of suicide and factors associated with its spatial distribution in Taipei City, Taiwan. We estimated smoothed standardized mortality ratios for overall suicide and suicide by sex/age group across 432 neighborhoods (mean population size: 5,500) in Taipei City, Taiwan (2004-2010) using Bayesian hierarchical models. A range of area-level characteristics including socioeconomic deprivation, social fragmentation, income inequality, and linking social capital were investigated for their associations with suicide mortality. Overall suicide rates were below average in the city center, whereas above average rates were found in some suburbs. The cartogram highlighted the concentration of suicide burden in the western area of the city. Male suicides demonstrated generally similar spatial patterning across age groups, while the geographic distribution of female suicides differed by age. After adjusting for other variables, two area characteristics were found to be associated with area suicide rates: the proportion of divorced/separated adults (rate ratio [RR] per one standard deviation increase =1.08, 95% confidence interval 1.01-1.16), an indicator of social fragmentation; and median household income (RR=0.80, 0.73-0.86), an indicator of socioeconomic deprivation. There was a 1.8-fold difference in suicide rates between neighborhood quintiles with the lowest and the highest median household income, with middle-aged males showing the largest gradient (3.2-fold difference). The geography of suicide in Taipei City showed spatial patterning and socioeconomic correlates distinct from cities in Western nations. There is a need for future research to better understand the correlates of change in the geographic distribution of suicide throughout the process of urban development.

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“…While, collectively, the global literature is more robust, closer inspection reveals similarly small numbers of published papers per country. As an example, four GIS studies of suicide clusters in the general population have been published in Asia [ 12 – 15 ], six in England [ 16 – 21 ], and three in America [ 22 – 24 ]. The focus of such research to date has primarily been on mapping purely spatial distribution of suicides, or the spatial relationship between suicide deaths and area deprivation.…”

Section: Introductionmentioning

confidence: 99%

Spatial clustering of fatal, and non-fatal, suicide in new South Wales, Australia: implications for evidence-based prevention

et al. 2017

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BackgroundRates of suicide appear to be increasing, indicating a critical need for more effective prevention initiatives. To increase the efficacy of future prevention initiatives, we examined the spatial distribution of suicide deaths and suicide attempts in New South Wales (NSW), Australia, to identify where high incidence ‘suicide clusters’ were occurring. Such clusters represent candidate regions where intervention is critically needed, and likely to have the greatest impact, thus providing an evidence-base for the targeted prioritisation of resources.MethodsAnalysis is based on official suicide mortality statistics for NSW, provided by the Australian Bureau of Statistics, and hospital separations for non-fatal intentional self-harm, provided through the NSW Health Admitted Patient Data Collection at a Statistical Area 2 (SA2) geography. Geographical Information System (GIS) techniques were applied to detect suicide clusters occurring between 2005 and 2013 (aggregated), for persons aged over 5 years. The final dataset contained 5466 mortality and 86,017 non-fatal intentional self-harm cases.ResultsIn total, 25 Local Government Areas were identified as primary or secondary likely candidate regions for intervention. Together, these regions contained approximately 200 SA2 level suicide clusters, which represented 46% (n = 39,869) of hospital separations and 43% (n = 2330) of suicide deaths between 2005 and 2013. These clusters primarily converged on the Eastern coastal fringe of NSW.ConclusionsCrude rates of suicide deaths and intentional self-harm differed at the Local Government Areas (LGA) level in NSW. There was a tendency for primary suicide clusters to occur within metropolitan and coastal regions, rather than rural areas. The findings demonstrate the importance of taking geographical variation of suicidal behaviour into account, prior to development and implementation of prevention initiatives, so that such initiatives can target key problem areas where they are likely to have maximal impact.

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Geographic variation in male suicide rates in the United States

Cited by 30 publications

References 85 publications

An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States

An Ecological Study on the Spatially Varying Relationship between County-Level Suicide Rates and Altitude in the United States

Spatial patterning, correlates, and inequality in suicide across 432 neighborhoods in Taipei City, Taiwan

Spatial clustering of fatal, and non-fatal, suicide in new South Wales, Australia: implications for evidence-based prevention

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