Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States of America.
Health Affairs Institute, West Virginia University, Morgantown, WV, United States of America.
PLoS One. 2024 Nov 18;19(11):e0312373. doi: 10.1371/journal.pone.0312373. eCollection 2024.
West Virginia's (WV) suicide rate is 50% higher than the national average and is the highest in the Appalachian Region. Appalachia has several social factors that have contributed to greater socioeconomic deprivation, a known contributor of suicide. Given WV's high prevalence of suicide and poverty, the current study aims to examine the relationship between socioeconomic deprivation and suicide rates in WV.
The Townsend Deprivation Index (TDI), Social Deprivation Index (SDI), and Social Vulnerability Index (SVI) measured socioeconomic deprivation. Negative binomial regression models assessed the relationship between socioeconomic deprivation scores, individual index items, and suicide rates. Model comparisons evaluated the indices' ability to assess suicide rates. A backward selection strategy identified additional key items for examining suicide rates.
There was a significant increase in suicide rates for every 10% increase in TDI (β = 0.04; p < 0.01), SDI (β = 0.03; p = 0.04), and SVI scores (β = 0.05; p < 0.01). Household overcrowding and unemployment had a positive linear relationship with suicide in TDI (β = 0.04, p = 0.02; β = 0.07, p = 0.01), SDI (β = 0.10, p = 0.02; β = 0.01, p<0.01), and the SVI (β = 0.10, p = 0.02; β = 0.03, p<0.01). The backwards selection strategy identified additional key items included by the SVI when assessing suicide.
Greater socioeconomic deprivation, measured by the TDI, SDI, and SVI, was significantly associated with higher suicide rates. Expanding unemployment benefits and increasing the availability of affordable housing, especially in rural areas, may be useful in reducing suicide rates. Our results suggest racial and ethnic minorities and adults living with a disability may benefit from targeted suicide prevention strategies.
西弗吉尼亚州（WV）的自杀率比全国平均水平高出 50%，居阿巴拉契亚地区之首。阿巴拉契亚地区有几个社会因素导致了更大的社会经济贫困，这是自杀的一个已知促成因素。鉴于 WV 自杀率和贫困率都很高，本研究旨在探讨 WV 社会经济贫困与自杀率之间的关系。
采用 Townsend 贫困指数（TDI）、社会贫困指数（SDI）和社会脆弱性指数（SVI）来衡量社会经济贫困程度。采用负二项回归模型评估社会经济贫困评分、各指数项目与自杀率之间的关系。通过比较模型评估各指数评估自杀率的能力。采用向后选择策略确定了进一步检查自杀率的关键项目。
TDI（β=0.04，p<0.01）、SDI（β=0.03，p=0.04）和 SVI 评分每增加 10%，自杀率显著增加（β=0.04，p<0.01）。家庭拥挤和失业与 TDI（β=0.04，p=0.02；β=0.07，p=0.01）、SDI（β=0.10，p=0.02；β=0.01，p<0.01）和 SVI（β=0.10，p=0.02；β=0.03，p<0.01）中的自杀呈正线性关系。向后选择策略确定了 SVI 评估自杀时包含的其他关键项目。
TDI、SDI 和 SVI 衡量的社会经济贫困程度与较高的自杀率显著相关。扩大失业救济金并增加经济适用房的供应，特别是在农村地区，可能有助于降低自杀率。我们的研究结果表明，少数民族和残疾成年人可能受益于有针对性的自杀预防策略。
