School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
Health Place. 2011 Mar;17(2):641-50. doi: 10.1016/j.healthplace.2011.01.003. Epub 2011 Jan 14.
In industrialised Western nations suicide rates tend to be high in inner city areas and socially fragmented neighbourhoods. Few studies have investigated spatial variations in suicide in non-Western settings. We estimated smoothed standardised mortality ratios (1999-2007) for suicide for each of the 358 Taiwanese districts (median population aged 15+: 27,000) and investigated their associations with area characteristics using Bayesian hierarchical models. The geographic distribution of suicide was similar in men and women; young people showed the greatest spatial variation in rates. Rates were highest in East Taiwan, a mostly mountainous rural area. There was no evidence of above average rates in large cities. Spatial patterns of method-specific suicide rates varied markedly, with solids/liquids poisonings showing the greatest geographic variation and hangings the least. Factors most strongly associated with area suicide rates were median household income, population density and lone-parent households. Spatial patterning of suicide in Taiwan differed from that observed in Western nations. Suicide prevention strategies should take into account unique local patterns.
在工业化的西方国家，自杀率往往在市中心地区和社会分裂的社区较高。很少有研究调查过非西方环境中自杀的空间变化。我们估计了台湾 358 个地区（年龄在 15 岁以上的中位数人口：27,000 人）每一个地区的自杀标准化死亡率（1999-2007 年），并使用贝叶斯层次模型调查了这些死亡率与地区特征的关联。男性和女性的自杀地理分布相似；年轻人的自杀率变化最大。东部台湾的自杀率最高，那里主要是山区农村地区。大城市没有证据表明自杀率偏高。特定自杀方法的死亡率的空间模式变化显著，固体/液体中毒的地理变化最大，而上吊的变化最小。与地区自杀率最密切相关的因素是家庭收入中位数、人口密度和单亲家庭。台湾的自杀空间模式与西方国家观察到的模式不同。自杀预防策略应考虑到当地独特的模式。
