Centre for Aboriginal Economic Policy Research, Australian National University, Australia.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
Addiction. 2023 Jul;118(7):1351-1358. doi: 10.1111/add.16153. Epub 2023 Feb 17.
Suicide is the tenth leading cause of death in the United States (US). Research over many decades identifies that its etiology is complex, with risk factors operating in multiple domains. One such risk factor is gambling. Over the past three decades, exposure to gambling has increased dramatically in the United States. The aim of this study was to measure the magnitude of the association between casino density and absolute risk of suicide in US counties.
DESIGN, SETTING, CASES: This spatial panel analysis used data for 3131 counties from 50 US states from 2000 to 2016, for an overall sample of 53 227 county-year units. Using Bayesian conditional autoregressive Poisson models, we measured incidence rate ratios and credible intervals for the association between the density per population of casinos and other gambling outlets and the incidence of suicide.
The outcome of interest was counts of suicides. The main exposures of interest were casinos and other gambling outlets.
A total of 527 401 suicides occurred during the study period. On average, there was a mean of 1.3 casinos (SD = 9.1) and 1.4 other gambling venues (SD = 5.9) in each county-year. After controlling for confounding, the incidence rate ratio for casinos was 1.016, and the credible interval was between 1.010 and 1.023.
The density of casinos and other gambling venues is positively associated with suicide mortality in the United States.
自杀是美国（美国）第十大主要死因。几十年来的研究表明，其病因复杂，风险因素存在于多个领域。其中一个风险因素是赌博。在过去的三十年中，美国接触赌博的人数急剧增加。本研究的目的是衡量赌场密度与美国县自杀绝对风险之间的关联程度。
设计、设置、案例：本空间面板分析使用了来自美国 50 个州的 3131 个县的数据，来自 53227 个县年单位的总体样本。使用贝叶斯条件自回归泊松模型，我们测量了赌场和其他赌博场所的人口密度与自杀发生率之间的关联的发病率比和可信区间。
感兴趣的结果是自杀人数。主要感兴趣的暴露是赌场和其他赌博场所。
在研究期间共发生 527401 例自杀。平均而言，每个县年有 1.3 家赌场（SD=9.1）和 1.4 家其他赌博场所（SD=5.9）。在控制混杂因素后，赌场的发病率比为 1.016，可信区间在 1.010 到 1.023 之间。
赌场和其他赌博场所的密度与美国的自杀死亡率呈正相关。
