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自杀死亡率:以巴西亚马孙州自我报告的原住民比例较高的市镇为重点。

Mortality by suicide: a focus on municipalities with a high proportion of self-reported indigenous people in the state of Amazonas, Brazil.

作者信息

Orellana Jesem Douglas Yamall, Basta Paulo Cesar, de Souza Maximiliano Loiola Ponte

机构信息

Instituto Leonidas e Maria Deane, Fundacao Oswaldo Cruz, Manaus, AM, Brasil.

Escola Nacional de Saude Publica Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Bras Epidemiol. 2013 Sep;16(3):658-69. doi: 10.1590/s1415-790x2013000300010.

Abstract

OBJECTIVE

To analyze mortality rates and to describe the demographic and epidemiological characteristics of suicides recorded in the state of Amazonas.

METHODS

A descriptive and retrospective study has been carried out with emphasis on municipalities, which have shown, simultaneously, a high mortality rates and a high proportion of self-reported indigenous population, based on 2005 - 2009 data as provided by the Informatics Department of the Unified National Health System.

RESULTS

Among the general population of the state of Amazonas, the mortality rate, by suicide, of 4.2/100.000 inhabitants has been reported, similar to that of Manaus (4.6/100.000 inhabitants). In contrast, at Tabatinga (25.2/100.000 inhabitants), at São Gabriel da Cachoeira (27.6/100.000 inhabitants) and at Santa Isabel do Rio Negro (36.4/100.000 inhabitants), municipalities, where the proportion of self-reported indigenous population is high, besides the taxes being notably higher, it was observed that most of the suicides has occurred among men; among young men aged between 15 - 24 years; at home; by hanging; during "weekend" and among the indigenous population.

DISCUSSION

Our findings have unveiled that suicide comes forth as a serious public health issue in some municipalities in the state of Amazonas, further indicating that the event occurs within very specific contexts, and that the dimension and the magnitude of the problem can be even more serious among populations or in territories exclusively inhabited by indigenous people.

摘要

目的

分析死亡率,并描述亚马孙州记录的自杀事件的人口统计学和流行病学特征。

方法

基于巴西统一卫生系统信息部提供的2005 - 2009年数据,开展了一项描述性回顾性研究,重点关注那些同时呈现高死亡率和高比例自我报告的原住民人口的市镇。

结果

据报告,在亚马孙州的普通人群中,自杀死亡率为每10万居民4.2例,与玛瑙斯市(每10万居民4.6例)相似。相比之下,在塔巴廷加(每10万居民25.2例)、圣加布里埃尔-达卡舒埃拉(每10万居民27.6例)和圣伊莎贝尔-杜里奥内格罗(每10万居民36.4例)这些自我报告的原住民人口比例较高的市镇,除了自杀率明显更高外,还观察到大多数自杀事件发生在男性中;年龄在15 - 24岁的年轻男性中;在家中;通过上吊;在“周末”期间;以及在原住民人口中。

讨论

我们的研究结果表明,自杀在亚马孙州的一些市镇中是一个严重的公共卫生问题,进一步表明该事件发生在非常特定的背景下,而且在原住民专门居住的人群或地区,问题的规模和严重程度可能更加严重。

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