University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109, United States of America.
University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109, United States of America.
J Affect Disord. 2020 Dec 1;277:99-103. doi: 10.1016/j.jad.2020.07.129. Epub 2020 Aug 2.
Suicide represents a substantial public health problem in the U.S. Programs like the Supplemental Nutrition Assistance Program (SNAP)-which provides services for U.S. adults who are food insecure-could be an appropriate venue for suicide prevention strategies targeting high-risk individuals.
This cross-sectional study used multiple logistic regression to determine odds ratios (ORs) and 95% confidence intervals (CIs) for suicide ideation, planning and attempt among those who participated in SNAP vs. nonparticipants. The National Survey of Drug Use and Health provided a representative sample of U.S. adults for 2012-2018 (n = 288,730).
SNAP participants were more likely than nonparticipants to have serious suicidal thoughts (crude OR=1.89; 95% CI=1.79-1.99), to have a plan for suicide (crude OR=2.35; 95% CI=2.16-2.56) or to attempt suicide (crude OR=2.89; 95% CI=2.54-3.29). Associations remained for those aged <50 in age-stratified analyses that accounted for survey year, demographics, socioeconomic status, self-rated health and mental health service use.
SNAP was assessed at the household level; thus, those who reported suicidal thoughts and/or behaviors may not personally interact with SNAP.
Using a large, nationally-representative sample of U.S. adults, this study documented greater prevalence of suicide-related outcomes among those who participate in SNAP. Suicide prevention among SNAP participants may provide a unique means to reach individuals who are often hard to engage in other health services.
在美国,自杀是一个严重的公共卫生问题。补充营养援助计划(SNAP)等项目为面临食物不安全问题的美国成年人提供服务,该计划可以成为针对高风险个体的自杀预防策略的合适场所。
本横断面研究采用多因素逻辑回归分析确定参加与未参加 SNAP 的人群中自杀意念、计划和尝试的比值比(OR)和 95%置信区间(CI)。国家药物使用和健康调查为 2012-2018 年的美国成年人提供了具有代表性的样本(n=288730)。
与未参加者相比,参加 SNAP 的人群更有可能出现严重自杀念头(粗 OR=1.89;95%CI=1.79-1.99)、有自杀计划(粗 OR=2.35;95%CI=2.16-2.56)或尝试自杀(粗 OR=2.89;95%CI=2.54-3.29)。在按年龄分层的分析中,对于年龄<50 岁的人群,这些关联仍然存在,这些分析考虑了调查年份、人口统计学、社会经济状况、自我评估的健康状况和心理健康服务的使用情况。
SNAP 是在家庭层面评估的;因此,那些报告自杀想法和/或行为的人可能没有亲自与 SNAP 互动。
本研究使用美国成年人的大型全国代表性样本记录了参加 SNAP 的人群中与自杀相关的结果发生率更高。在 SNAP 参与者中进行自杀预防可能为接触那些通常难以参与其他健康服务的人提供了一种独特的手段。