Department of Preventive Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil.
Rev Panam Salud Publica. 2012 Nov;32(5):351-9. doi: 10.1590/s1020-49892012001100005.
To describe suicide rates by county size in the five geopolitical areas of Brazil.
This was an ecological, descriptive study of suicide deaths in Brazil that occurred among the population 10 years of age and older in 2004-2010. Data were obtained from the National Mortality Information System of Brazil. Counties were defined by size as: very large (200,000+), large (< 200,000-100,000), medium (< 100,000-50,000), small (< 50,000-20,000), very small (< 20,000-10,000, and micro (< 10,000). Age-adjusted suicide rates were calculated for all counties and for population-size groups in each geopolitical area. Rate ratio and 95% confidence interval were used to compare suicide risk between groups and the reference.
The national, average suicide mortality rate was 5.7 deaths/100,000 inhabitants. Except in the North and North-East, suicide mortality rates increased from the very large (> 200,000) to the micro counties (< 10,000 population). Very high rates were scattered in the North and Mid-West among the indigenous peoples (> 30 deaths per 100,000). At highest risk were micro counties in the South (13.6 deaths per 100,000), with elderly males (60+ years, 31.4) and males 40-59 years (31.3) being the sex/age group with the highest rates.
To reduce suicide mortality in Brazil, public health authorities must support mental health training in small cities and multi-professional interventions among the indigenous peoples. In addition, the causes behind underreporting of suicide deaths must be resolved in several areas.
描述巴西五个地缘政治区域按县规模划分的自杀率。
这是一项关于巴西 2004-2010 年期间 10 岁及以上人群自杀死亡的生态、描述性研究。数据来自巴西国家死亡信息系统。县按大小定义为：特大型（20 万+）、大型（<20 万-10 万）、中型（<10 万-5 万）、小型（<5 万-2 万）、特小型（<2 万-1 万）和微型（<1 万）。计算了所有县和每个地缘政治区域人口规模组的年龄调整后自杀率。率比和 95%置信区间用于比较组间和参照的自杀风险。
全国平均自杀死亡率为 5.7 人/10 万居民。除北部和东北部外，自杀死亡率从特大型（>20 万）到微型（<10000 人口）增加。在北部和中西部，土著人民的自杀死亡率非常高（>30 人/10 万）。风险最高的是南部的微型县（每 10 万人 13.6 人死亡），60 岁以上的老年男性（31.4）和 40-59 岁的男性（31.3）是自杀率最高的性别/年龄组。
为了降低巴西的自杀死亡率，公共卫生当局必须支持小城市的心理健康培训和土著人民的多专业干预。此外，必须解决几个地区自杀死亡漏报的原因。
