Exeter Daniel J, Boyle Paul J
Epidemiology and Biostatistics, School of Population Health, University of Auckland, PO BOX 92019, Auckland, NZ.
J Epidemiol Community Health. 2007 Aug;61(8):731-6. doi: 10.1136/jech.2006.052365.
Suicide rose dramatically among young adults in Scotland between 1980-1982 and 1999-2001, especially among those living in deprived areas.
To determine whether there are statistically significant geographical clusters of suicide and undetermined deaths among those aged 15 to 44 years in Scotland, and whether these persist through time.
Deaths from suicide and undetermined causes by young adults in Scotland for three periods-1980 to 1982, 1990 to 1992, and 1999 to 2001-were aggregated into 10,058 small areas for Scotland. Tests for significant (p<0.05) geographical clustering of suicide were carried out for each period separately. Methods of suicide inside the identified clusters were compared with those in the rest of Scotland.
A significant geographical cluster of suicide among young adults was identified in east Glasgow in all three time periods (involving 92, 159, and 245 cases). Compared with the rest of Scotland, significantly more deaths in these clusters were caused by poisoning from liquids or solids over the entire period, but this was not the case in the most recent period (1999 to 2001). All three clusters could be explained by the concentration of socioeconomic deprivation in this part of Scotland.
One interpretation of this large, persistent, and statistically significant cluster of suicides among young adults in east Glasgow is that suicide is geographically contagious, but the present results suggest that it is explained by the concentration of deprivation in this area. Suicide prevention strategies targeting at-risk populations living in east Glasgow are necessary to reduce the suicide burden in Scotland.
1980 - 1982年至1999 - 2001年间,苏格兰年轻人的自杀率急剧上升,尤其是生活在贫困地区的年轻人。
确定苏格兰15至44岁人群中自杀和死因不明死亡是否存在具有统计学意义的地理聚集现象,以及这些现象是否随时间持续存在。
将苏格兰年轻人在三个时间段(1980年至1982年、1990年至1992年、1999年至2001年)因自杀和不明原因导致的死亡数据汇总到苏格兰的10058个小区域。分别对每个时间段进行自杀显著地理聚集(p<0.05)的检验。将已确定聚集区内的自杀方式与苏格兰其他地区的进行比较。
在所有三个时间段内,格拉斯哥东部均发现了年轻人自杀的显著地理聚集区(分别涉及92例、159例和245例)。与苏格兰其他地区相比,在整个时期内,这些聚集区内因液体或固体中毒导致的死亡显著更多,但在最近一个时期(1999年至2001年)并非如此。所有这三个聚集区都可以用苏格兰这一地区社会经济贫困的集中程度来解释。
对格拉斯哥东部年轻人中这种大规模、持续且具有统计学意义的自杀聚集现象的一种解释是自杀具有地理传染性,但目前的结果表明这是由该地区贫困的集中程度所导致的。为减轻苏格兰的自杀负担,有必要针对生活在格拉斯哥东部的高危人群制定自杀预防策略。