Division of mental and physical health, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
BMC Health Serv Res. 2019 Jul 22;19(1):508. doi: 10.1186/s12913-019-4246-3.
There is an increase in studies investigating the use of healthcare services prior to suicide. Although studies generally report high usage, there are no previous studies comparing immigrants' use of primary healthcare (PHC) prior to suicide with that of majority populations. There is a strong influx of immigrants in Europe, and thus a growing demand for filling this knowledge gap and exploiting unused potential for suicide prevention.
By linking three national registers, we examine contact with PHC prior to suicide in all suicide cases in Norway from 2007 to 2014 among individuals aged 15 years and over (N = 4341). We report the percentage of individuals in personal contact within the last 6 months, 1 month and 1 week prior to suicide, and use the chi square-test for association.
Overall, immigrants have less contact with PHC prior to suicide. We find significantly lower rates of contact among immigrants, both 6 months and 1 month prior to suicide, for both sexes. The trend is similar in the last week prior to suicide, but less pronounced. The largest variance in contact with PHC prior to suicide is amongst 30-44 year olds. Young, male immigrant suicide victims have the lowest rates of contact with PHC prior to suicide. Contact rates increase with age for all men and women in the majority population, but not for female immigrant suicide victims.
There is a clear difference in rates of contact with PHC prior to suicide between the majority and immigrant populations. The rates are especially low among young males, and measures should be made to lower their threshold for consulting PHC for young males in general and young male immigrants in particular. The difference in contact due to immigrant status appears to be of equal importance as the difference due to sex, although, with few significant results, a conclusion is hard to draw.
越来越多的研究调查了自杀前使用医疗服务的情况。尽管这些研究普遍报告了高使用率，但以前没有研究比较移民在自杀前使用初级保健（PHC）的情况与大多数人群的使用情况。欧洲有大量移民涌入，因此，填补这一知识空白并挖掘预防自杀方面未被利用的潜力的需求日益增长。
通过链接三个国家登记册，我们调查了 2007 年至 2014 年期间挪威所有年龄在 15 岁及以上的自杀案例（N=4341）在自杀前 6 个月、1 个月和 1 周内与 PHC 的个人接触情况。我们报告在自杀前 6 个月和 1 个月内有个人接触的个人比例，并使用卡方检验进行关联分析。
总体而言，移民在自杀前与 PHC 的接触较少。我们发现，无论是男性还是女性，移民在自杀前 6 个月和 1 个月内的接触率都明显较低。在自杀前最后一周，这种趋势类似，但不太明显。在自杀前与 PHC 接触的最大差异发生在 30-44 岁之间。年轻的男性移民自杀受害者在自杀前与 PHC 的接触率最低。大多数人群中的所有男性和女性的接触率都随着年龄的增长而增加，但女性移民自杀受害者则不然。
在自杀前与 PHC 接触的比率在多数人群和移民群体之间存在明显差异。在年轻男性中，这一比率尤其低，应采取措施降低年轻男性，尤其是年轻男性移民对 PHC 的咨询门槛。由于移民身份而导致的接触差异与由于性别而导致的差异同样重要，尽管由于显著结果较少，因此难以得出结论。
