Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1S 5H4, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
BMC Public Health. 2023 Aug 2;23(1):1469. doi: 10.1186/s12889-023-16285-4.
Sexual and gender minority populations experience elevated risks for suicidality. This study aimed to assess prevalence and disparities in non-fatal suicidality and potential protective factors related to social support and health care access among sexual and gender minority youth and adults and their heterosexual and cisgender counterparts in Canada. The second objective was to examine changes in the prevalence of suicidal ideation and protective factors during the COVID-19 pandemic.
Pooled data from the 2015, 2016 and 2019 Canadian Community Health Surveys were used to estimate pre-pandemic prevalence of suicidal ideation, plans and attempts, and protective factors. The study also estimated changes in the prevalence of recent suicidal ideation and protective factors in fall 2020, compared with the same period pre-pandemic.
The prevalence of suicidality was higher among the sexual minority populations compared with the heterosexual population, and the prevalence was highest among the bisexual population, regardless of sex or age group. The pre-pandemic prevalence of recent suicidal ideation was 14.0% for the bisexual population, 5.2% for the gay/lesbian population, and 2.4% for the heterosexual population. The prevalence of lifetime suicide attempts was 16.6%, 8.6%, and 2.8% respectively. More than 40% of sexual minority populations aged 15-44 years had lifetime suicidal ideation; 64.3% and 36.5% of the gender minority population had lifetime suicidal ideation and suicide attempts. Sexual and gender minority populations had a lower prevalence of protective factors related to social support and health care access. The prevalence of recent suicidal ideation among sexual and gender minority populations increased in fall 2020, and they tended to experience longer wait times for immediate care needed.
Sexual and gender minority populations had a higher prevalence of suicidality and less social support and health care access compared to the heterosexual and cisgender populations. The pandemic was associated with increased suicidal ideation and limited access to care for these groups. Public health interventions that target modifiable protective factors may help decrease suicidality and reduce health disparities.
性少数群体和跨性别群体的自杀风险较高。本研究旨在评估加拿大性少数群体和跨性别青年和成年人与异性恋和顺性别群体相比，非致命性自杀倾向的流行率和差异，以及与社会支持和获得医疗保健相关的潜在保护因素。第二个目标是研究 COVID-19 大流行期间自杀意念和保护因素的流行率变化。
使用 2015 年、2016 年和 2019 年加拿大社区健康调查的汇总数据，估计自杀意念、计划和尝试的流行率以及保护因素。该研究还估计了 2020 年秋季与大流行前同期相比，最近自杀意念和保护因素的流行率变化。
性少数群体的自杀率高于异性恋群体，无论性别或年龄组，双性恋群体的自杀率最高。双性恋群体最近自杀意念的流行率为 14.0%，同性恋/女同性恋群体为 5.2%，异性恋群体为 2.4%。终身自杀企图的流行率分别为 16.6%、8.6%和 2.8%。超过 40%的 15-44 岁的性少数群体有过自杀意念；64.3%和 36.5%的性别少数群体有过自杀意念和自杀企图。性少数群体和跨性别群体获得与社会支持和医疗保健获取相关的保护因素的比例较低。2020 年秋季，性少数群体和跨性别群体最近自杀意念的流行率增加，他们往往需要更长的时间才能获得所需的即时护理。
与异性恋和顺性别群体相比，性少数群体和跨性别群体的自杀率较高，社会支持和获得医疗保健的机会较少。大流行与这些群体自杀意念增加和获得护理受限有关。针对可改变的保护因素的公共卫生干预措施可能有助于降低自杀率和减少健康差距。
