Institute for Philosophy, Diversity and Mental Health, International School for Communities, Rights and Inclusion, University of Central Lancashire, Preston and West London Mental Health NHS Trust, London, U.K.
Int Psychogeriatr. 2010 Mar;22(2):219-26. doi: 10.1017/S104161020999130X. Epub 2009 Nov 30.
An epidemiological transition hypothesis has been developed to explain simultaneously wide cross-national variations in elderly suicide rates, trends over time for elderly suicide rates and age-associated trends in suicides rates. This speculative hypothesis suggests that there is a curvilinear (inverted U-shaped curve) relationship between elderly suicide rates and socioeconomic status fitting the quadratic equation y = a + bx - cx2 (where y is the suicide rate, x is the socioeconomic status, and a, b and c are constants).
The predicted curvilinear relationship between elderly suicide rates and gross national domestic product (GDP), a measure of socioeconomic status, fitting the above quadratic equation was examined with a curve estimation regression model using data from the World Health Organization.
The relationship between suicide rates in both sexes in the age-bands 65-74 and 75+ years and the GDP was curvilinear (inverted U-shaped curve) and fitted the above quadratic equation, and was statistically significant (at least p<0.05) in all four groups.
Caution should be exercised in accepting this model of the epidemiological transition hypothesis for elderly suicide rates because it is generated from cross-sectional data using an ecological design. Ideally, this model requires rigorous testing by following selected countries of low socioeconomic status over time as they develop socioeconomically.
为了解释老年人自杀率的广泛跨国差异、老年人自杀率随时间的变化趋势以及与年龄相关的自杀率趋势，提出了一种流行病学转移假说。这个推测性的假说表明，老年人自杀率与社会经济地位之间存在着曲线（倒 U 形曲线）关系，符合二次方程 y = a + bx - cx2（其中 y 是自杀率，x 是社会经济地位，a、b 和 c 是常数）。
利用世界卫生组织的数据，采用曲线估计回归模型，检验了老年人自杀率与国内生产总值（GDP）之间的预测曲线关系，这是衡量社会经济地位的一个指标，符合上述二次方程。
在 65-74 岁和 75 岁以上两个年龄组中，两性自杀率与 GDP 的关系呈曲线（倒 U 形曲线）关系，符合上述二次方程，在所有四个组中均具有统计学意义（至少 p<0.05）。
由于该模型是使用生态设计从横截面上的数据得出的，因此在接受老年人自杀率的这种流行病学转移假说模型时应谨慎。理想情况下，需要通过随着时间的推移跟踪选定的低社会经济地位国家来严格测试该模型，以观察它们的社会经济发展情况。
