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探索美国自杀死亡案例中创伤与物质使用的空间动态(2017 - 2021年)

Exploring spatial dynamics of trauma and substance use among suicide deaths in the United States (2017-2021).

作者信息

Smith Bianca D, Cadet Kechna, Powell Terrinieka W

机构信息

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.

出版信息

Inj Epidemiol. 2025 May 1;12(1):22. doi: 10.1186/s40621-025-00574-0.

Abstract

BACKGROUND

Suicide remains a significant cause of death in the United States. Traumatic events, such as experiences of violence, financial loss, and mental illness, significantly increase an individual's risk of suicide. Substance use, often used as a coping mechanism for trauma, frequently occurs alongside these events. Geographic patterns of trauma and substance use may reveal underlying factors that contribute to suicide rates across the nation.

METHODS

Data from the National Violent Death Reporting System (NVDRS), collected between 2017 and 2021, was used to examine spatial relationships between traumatic events and substance use among suicides. Spatial autocorrelation was used to assess global spatial dependence of traumatic events among suicide deaths. Additionally, hot spot analyses were conducted to pinpoint regions with significantly elevated or reduced experiences of trauma. Colocation analyses were conducted to identify areas where traumatic events and substance use co-occur spatially.

RESULTS

Traumatic events among suicides exhibited geographic clustering. Spatial clusters of traumatic events were identified in specific regions across the U.S. and its territories. Hot spots were predominantly observed in Western and Midwestern areas, while more cold spots were found in Southern regions. Additionally, colocation analysis revealed that Midwestern counties had a higher likelihood of experiencing traumatic events in conjunction with substance use history among suicide decedents.

CONCLUSION

Clustering patterns may provide insight on underlying mechanisms that have significant impacts on suicide outcomes. The colocation analysis helps reveal patterns of spatial clustering, shedding light on potential risk factors or shared characteristics in those areas. By examining both global and local spatial patterns, researchers gain insights into the distribution of trauma and substance use-related incidents and their association with suicide.

摘要

背景

自杀仍是美国一个重要的死亡原因。创伤性事件,如暴力经历、经济损失和精神疾病,会显著增加个人的自杀风险。物质使用常被用作应对创伤的机制,经常与这些事件同时发生。创伤和物质使用的地理模式可能揭示出导致全国自杀率的潜在因素。

方法

利用2017年至2021年期间收集的国家暴力死亡报告系统(NVDRS)的数据,研究自杀案例中创伤性事件与物质使用之间的空间关系。空间自相关用于评估自杀死亡中创伤性事件的全局空间依赖性。此外,进行热点分析以确定创伤经历显著升高或降低的地区。进行共置分析以确定创伤性事件和物质使用在空间上同时发生的区域。

结果

自杀中的创伤性事件呈现出地理聚集性。在美国及其领土的特定地区发现了创伤性事件的空间聚集。热点主要出现在西部和中西部地区,而在南部地区发现了更多的冷点。此外,共置分析显示,中西部各县的自杀死者在经历创伤性事件的同时伴有物质使用史的可能性更高。

结论

聚集模式可能有助于深入了解对自杀结果有重大影响的潜在机制。共置分析有助于揭示空间聚集模式,从而了解这些地区的潜在风险因素或共同特征。通过研究全局和局部空间模式,研究人员可以深入了解创伤和物质使用相关事件的分布及其与自杀的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0547/12046928/eb2a504b7d5e/40621_2025_574_Fig1_HTML.jpg

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