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2014 年至 2020 年印度自杀死亡女性的社会人口学特征:监测数据结果。

Sociodemographic characteristics of women who died by suicide in India from 2014 to 2020: findings from surveillance data.

机构信息

Public Health Foundation of India, Gurugram, India; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.

Public Health Foundation of India, Gurugram, India.

出版信息

Lancet Public Health. 2023 May;8(5):e347-e355. doi: 10.1016/S2468-2667(23)00028-2.

Abstract

BACKGROUND

Women in India have twice the suicide death rate (SDR) compared with the global average for women. The aim of this study is to present a systematic understanding of sociodemographic risk factors, reasons for suicide deaths, and methods of suicide among women in India at the state level over time.

METHODS

Administrative data on suicide deaths among women by education level, marital status, and occupation, and reason for and method of suicide were extracted from the National Crimes Record Bureau reports for years 2014 to 2020. We extrapolated SDR at the population level for Indian women by education, marital status, and occupation to understand the sociodemography of these suicide deaths for India and its states. We reported the reasons for and methods of suicide deaths among Indian women at the state level over this period.

FINDINGS

SDR was higher among women with education of class 6 or more (10·2; 95% CI 10·1-10·4) than those with no education (3·8; 3·7-3·9) or education until class 5 (5·4; 5·2-5·5) in India in 2020, with similar patterns in most states. SDR declined between 2014 and 2020 for women with education until class 5. Women currently married accounted for 28 085 (63·1%) of 44 498 suicide deaths in India, 8336 (56·2%) of 14 840 in less developed states, and 19 661 (66·9%) of 29 407 in more developed states in 2020. For India, women currently married had a significantly higher SDR (8·1; 8·0-8·2) than those never married in 2014. However, women who never married had a significantly higher SDR (8·4; 8·2-8·5) in 2020 than those who were currently married. Many individual states in 2020 had similar SDR for women who never married and those who are currently married. Housewife as an occupation accounted for 50% or more of suicide deaths from 2014 to 2020 in India and its states. Family problems was the most common reason for suicide from 2014 to 2020, accounting for 16 140 (36·3%) of 44 498 suicide deaths in India, 5268 (35·5%) of 14 840 in less developed states, and 10 803 (36·7%) of 29 407 in more developed states in 2020. Hanging was the leading mean of suicide from 2014 to 2020. Insecticide or poison consumption was the second leading cause of suicide, accounting for 2228 (15·0%) of all 14 840 suicide deaths in less developed states and 5753 (19·6%) of 29 407 in more developed states, with a near 70·0% increase in the use of this method from 2014 to 2020.

INTERPRETATION

The higher SDR among women who have received an education, similar SDR between women currently married and never married, and variations in the reasons for and means of suicide at the state level highlight the need to incorporate sociological insights into how the external social environment can matter for women to better understand the complexity of suicide and determine how to effectively intervene.

FUNDING

Bill & Melinda Gates Foundation.

摘要

背景

与全球女性平均水平相比,印度女性的自杀死亡率(SDR)是其两倍。本研究旨在系统地了解印度女性在不同时间点的社会人口学风险因素、自杀死亡原因和自杀方式。

方法

从 2014 年至 2020 年国家犯罪记录局报告中提取了关于女性按教育水平、婚姻状况和职业、自杀原因和方式的自杀死亡行政数据。我们根据教育、婚姻状况和职业对印度女性的人口水平 SDR 进行了外推,以了解印度及其各州这些自杀死亡的社会人口学特征。我们报告了印度各州在这段时间内女性自杀死亡的原因和方式。

结果

2020 年,与没有教育或仅接受过 5 年级以下教育的女性(分别为 3.8;3.7-3.9)相比,印度拥有 6 年级或以上教育程度的女性的 SDR 更高(10.2;10.1-10.4),在大多数州都呈现出类似的模式。2014 年至 2020 年间,接受过 5 年级以下教育的女性的 SDR 有所下降。目前已婚的女性占印度 2020 年 44498 例自杀死亡人数的 28085 例(63.1%),占欠发达州 14840 例自杀死亡人数的 8336 例(56.2%),占发达州 29407 例自杀死亡人数的 19661 例(66.9%)。在印度,目前已婚的女性 SDR(8.1;8.0-8.2)显著高于 2014 年从未结婚的女性。然而,从未结婚的女性在 2020 年的 SDR(8.4;8.2-8.5)显著高于目前已婚的女性。2020 年,许多州的女性无论已婚还是未婚,其 SDR 相似。作为职业的家庭主妇在 2014 年至 2020 年期间占印度及其各州自杀死亡人数的 50%或以上。家庭问题是 2014 年至 2020 年期间自杀的最常见原因,占印度 44498 例自杀死亡人数的 16140 例(36.3%),占欠发达州 14840 例自杀死亡人数的 5268 例(35.5%),占发达州 29407 例自杀死亡人数的 10803 例(36.7%)。2014 年至 2020 年期间,上吊是自杀的主要手段。杀虫剂或毒药的使用是自杀的第二大原因,占欠发达州 14840 例自杀死亡人数的 2228 例(15.0%)和发达州 29407 例自杀死亡人数的 5753 例(19.6%),自 2014 年以来,这种方法的使用率增长了近 70.0%。

解释

受教育程度较高的女性的 SDR 较高,目前已婚和未婚女性的 SDR 相似,以及各州自杀原因和方式的变化,突出了需要将社会学见解纳入外部社会环境如何影响女性的研究中,以便更好地了解自杀的复杂性,并确定如何有效地进行干预。

资金

比尔及梅琳达·盖茨基金会。

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