College of Nursing, University of Kentucky, Lexington, Kentucky, USA.
College of Social Work, University of Kentucky, Lexington, Kentucky, USA.
J Rural Health. 2023 Jan;39(1):30-38. doi: 10.1111/jrh.12686. Epub 2022 Jun 16.
Those factors identified to increase the risk of suicide in rural dwellers were exacerbated by the SARS-CoV-2 pandemic, specifically economic factors, substance use, access to health care, and access to lethal weapons. Because the effects of SARS-CoV-2 on suicide ideation and attempts in rural populations have not been fully characterized in published literature, this study compares: (1) the rates of suicide ideation and attempts between the 6 months affected by SARS-CoV-2 to same months of the preceding year (3/18/2020-9/18/20; 3/18/2019-9/18/19), (2) demographics (ie, age, sex, residence, race, and ethnicity), and (3) the locations in which the encounters were billed (inpatient, outpatient, and emergency department).
Deidentified claims data associated with patient encounters billed for Suicide Ideation and Suicide Attempt were grouped based on time period and analyzed using descriptive statistics, incidence rate ratio (IRR), 2-sample t-test, chi-square test of association, or Fisher's exact test.
Suicidal ideation encounters increased in the 6 months post-SARS-CoV-2 when compared to the 6 months of the prior year (IRR = 1.19; P < .001). Males (IRR = 1.27, P < .001), those residing rural areas (IRR = 1.22, P = .01), and Black, non-Hispanic (IRR = 1.24, P = .024) were found to have increased rates of suicide ideation post-SARS-Cov-2. In adults, White, non-Hispanics (IRR = 1.16; P < .001) had increased rates of post-SARS-CoV-2. In the pediatric subset, those who were aged 14-17 (IRR = 1.50; P < .001), resided in rural areas (IRR = 1.61, P = .009), and idenitifed as Hispanic (IRR = 1.89; P = .037) or Black, non-Hispanic (IRR = 1.61, P = .009) had increased rates post-SARS-CoV-2.
Our study identified rural dwellers to be at increased risk for suicide ideation.
那些被确定会增加农村居民自杀风险的因素,因 SARS-CoV-2 大流行而更加恶化,具体包括经济因素、物质使用、获得医疗保健的机会和获得致命武器的机会。由于 SARS-CoV-2 对农村人口自杀意念和自杀未遂的影响在已发表的文献中尚未完全描述,本研究比较了:(1)受 SARS-CoV-2 影响的 6 个月与前一年同期(2020 年 3 月 18 日至 9 月 18 日;2019 年 3 月 18 日至 9 月 18 日)自杀意念和自杀未遂的发生率;(2)人口统计学特征(即年龄、性别、居住地、种族和族裔);(3)计费的就诊地点(住院、门诊和急诊)。
根据时间段对与自杀意念和自杀未遂就诊相关的去识别索赔数据进行分组,并使用描述性统计、发病率比 (IRR)、2 样本 t 检验、卡方检验、关联检验或 Fisher 精确检验进行分析。
与前一年同期相比,SARS-CoV-2 后 6 个月的自杀意念就诊次数增加(IRR=1.19;P<0.001)。男性(IRR=1.27,P<0.001)、居住在农村地区(IRR=1.22,P=0.01)和非裔美国人(IRR=1.24,P=0.024)的自杀意念发生率升高。在成年人中,白人非西班牙裔(IRR=1.16;P<0.001)的 SARS-CoV-2 后自杀意念发生率增加。在儿科亚组中,年龄在 14-17 岁(IRR=1.50;P<0.001)、居住在农村地区(IRR=1.61,P=0.009)、被鉴定为西班牙裔(IRR=1.89;P=0.037)或非裔美国人(IRR=1.61,P=0.009)的儿童的 SARS-CoV-2 后自杀意念发生率增加。
我们的研究发现农村居民自杀意念的风险增加。