巴西现金转移计划对自杀率的影响：对巴西各城市的纵向分析。
Effect of the Brazilian cash transfer programme on suicide rates: a longitudinal analysis of the Brazilian municipalities.
机构信息
Centre for Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Muniz, Fundação Oswaldo Cruz (FIOCRUZ), Parque Tecnológico, Edf. Tecnocentro, Sala 315, Rua Mundo, nº 121, Salvador, Bahia, Brazil.
Institute of Collective Health, Federal University of Bahia (UFBA), Salvador, Brazil.
出版信息
Soc Psychiatry Psychiatr Epidemiol. 2019 May;54(5):599-606. doi: 10.1007/s00127-018-1627-6. Epub 2018 Nov 19.
PURPOSE
There is a growing awareness of the economic and contextual factors that may play a role in the aetiology of suicide. The Programa Bolsa Família (PBF) the Brazilian conditional cash transfer programme, established in 2004, aims to attenuate the effects of poverty of Brazilians. Our study aims to evaluate the effect of Bolsa Família Programme (BFP) coverage on suicide rates in Brazilian municipalities.
METHODS
We conducted an ecological study using 2004-2012 panel data for 5507 Brazilian municipalities. We calculated age-standardized suicide rates for each municipality and year. BFP coverage was categorized according to three levels (< 30%, ≥ 30% and < 70% and ≥ 70%) and duration (coverage ≤ 70% for all years, ≥ 70% for 1 year, ≥ 70% for 2 years, ≥ 70% for 3 or more years). We used negative binomial regression models with fixed effects, adjusting for socio-economic, demographic and social welfare co-variables.
RESULTS
An increase in BFP coverage was associated with a reduction in suicide rates. The strongest effect was observed when in addition to greater municipal coverage (RR 0.942, 95% CI 0.936-0.947), the duration of the high coverage was maintained for 3 years or more (RR 0.952 95% CI 0.950-0.954).
CONCLUSIONS
The results provide evidence that the conditional cash transfer programme may reduce suicide in Brazilian municipalities, mitigating the effect of poverty on suicide incidence.
目的
人们越来越意识到经济和环境因素可能在自杀的病因学中起作用。巴西有条件现金转移计划“家庭补助金计划”（PBF）于 2004 年设立，旨在减轻巴西人民贫困的影响。本研究旨在评估家庭补助金计划（BFP）覆盖范围对巴西市政当局自杀率的影响。
方法
我们使用 2004-2012 年 5507 个巴西市政当局的面板数据进行了一项生态学研究。我们计算了每个市政当局和年份的年龄标准化自杀率。根据三个水平（<30%、≥30%和<70%和≥70%）和持续时间（所有年份的覆盖范围≤70%、1 年的覆盖范围≥70%、2 年的覆盖范围≥70%、3 年或更长时间的覆盖范围≥70%）对 BFP 覆盖范围进行了分类。我们使用具有固定效应的负二项式回归模型，调整了社会经济、人口和社会福利协变量。
结果
BFP 覆盖范围的增加与自杀率的降低有关。当除了更大的市政覆盖范围（RR 0.942，95%CI 0.936-0.947）外，高覆盖范围的持续时间保持 3 年或更长时间时，效果最强（RR 0.952 95%CI 0.950-0.954）。
结论
这些结果表明，有条件现金转移计划可能会降低巴西市政当局的自杀率，从而减轻贫困对自杀发生率的影响。
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