Wilkinson D, Gunnell D
South Australian Centre for Rural and Remote Health, The University of Adelaide, Whyalla, Australia.
Aust N Z J Psychiatry. 2000 Oct;34(5):822-8. doi: 10.1080/j.1440-1614.2000.00812.x.
The objective of this study was to examine trends in suicide among 15-34-year-olds living in Australian metropolitan and non-metropolitan areas between 1988 and 1997.
Suicide and population data were obtained from the Australian Bureau of Statistics. We calculated overall and method-specific suicide rates for 15-24 and 25-34-year-old males and females separately, according to area of residence defined as non-metropolitan (< or = 20,000 people) or metropolitan.
Between 1988 and 1997 suicide rates in 15-24-year-old non-metropolitan males were consistently 50% higher than metropolitan 15-24-year-olds. In 1995-1997, for example, the rates were: 38.2 versus 25.1 per 100,000 respectively (p < 0.0001). The reverse pattern was seen in 25-34-year-old females with higher rates in metropolitan areas (7.5 per 100,000) compared with non-metropolitan areas (6.1 per 100,000, p = 0.21) in 1995-1997. There were no significant differences according to area of residence in 25-34-year-old males or 15-24-year-old females. Over the years studied we found no clear evidence that suicide rates increased to a greater extent in rural than urban areas. Rates of hanging suicide have approximately doubled in both sexes and age groups in both settings over this time. Despite an approximate halving in firearm suicide, rates remain 3-fold higher among nonmetropolitan residents.
Non-metropolitan males aged 15-24 years have disproportionately higher rates of suicide than their metropolitan counterparts. Reasons for this require further investigation. Hanging is now the most favoured method of non-metropolitan suicide replacing firearms from 10 years ago. Although legislation may reduce method-specific suicide the potential for method-substitution means that overall rates may not fall. More comprehensive interventions are therefore required.
本研究旨在调查1988年至1997年间居住在澳大利亚大都市和非大都市地区的15至34岁人群的自杀趋势。
自杀和人口数据来自澳大利亚统计局。我们根据居住地区（定义为非大都市地区[人口≤20,000人]或大都市地区），分别计算了15至24岁和25至34岁男性及女性的总体自杀率和特定方法自杀率。
1988年至1997年间，15至24岁非大都市男性的自杀率始终比大都市地区的15至24岁男性高50%。例如，在1995年至1997年期间，每10万人中的自杀率分别为38.2和25.1（p<0.0001）。在25至34岁女性中则呈现相反的模式，1995年至1997年期间，大都市地区的自杀率（每10万人中有7.5人）高于非大都市地区（每10万人中有6.1人，p = 0.21）。25至34岁男性或15至24岁女性的自杀率在居住地区方面没有显著差异。在研究的这些年里，我们没有发现明确证据表明农村地区的自杀率增长幅度大于城市地区。在此期间，两个地区的男性和女性各年龄组中，上吊自杀率大约翻了一番。尽管枪支自杀率大约减半，但非大都市地区居民的枪支自杀率仍高出3倍。
15至24岁的非大都市男性自杀率比大都市地区的同龄人高得多。其原因需要进一步调查。上吊现在是非大都市地区最常用的自杀方式，取代了10年前的枪支。尽管立法可能会降低特定方法的自杀率，但方法替代的可能性意味着总体自杀率可能不会下降。因此需要更全面的干预措施。
