Dudley M J, Kelk N J, Florio T M, Howard J P, Waters B G
School of Psychiatry, University of New South Wales, Sydney.
Med J Aust. 1998 Jul 20;169(2):77-80.
(i) To compare suicide rates in 15-24 year old men and women; and (ii) for 15-24 year old men, to investigate differences in suicide rates between metropolitan and rural area, and changes in method-specific suicide rates and, in particular, firearm and hanging suicide rates in rural and metropolitan areas.
Retrospective analysis of Australian Bureau of Statistics (ABS) suicide data (1964-1993).
All Australian States.
Young women and men aged 15-24 years who died by suicide.
Male youth suicide rates rose substantially over the 30 years in all Australian States, whereas female rates did not increase. Increases in suicide rates in young men in small rural towns consistently exceeded those in metropolitan areas in all Australian States. Metropolitan rates in 1964 were higher than those in small rural towns, but by 1993 the position was reversed. Medium-sized cities were the only areas where there was no consistent interstate trend. Differences were noted in suicide base rates in different States. High car exhaust suicide rates were noted in Western Australia, and high firearm suicide rates in Tasmania and Queensland. The ratio of firearm suicide rates in small rural areas to those in metropolitan areas rose in all mainland States, but the same ratio for hanging suicide rates changed little.
All Australian States reflect national suicide trend in relation to sex and residential area. In some States, particular suicide methods predominate. A decreasing trend in overall firearm suicide rates in young men in all States from 1984 to 1993 conceals substantial increases in firearm suicide rates in small rural areas in all mainland States over the 30-year period. This, together with the marked rate ratio difference in firearm suicides between metropolitan and small rural areas, suggests that particular risk factors for suicide are operating in small rural areas. The fact that hanging rate ratios changed little suggests that more general factors in male youth suicide are also operating in all areas. A better understanding of similarities and differences in health risks faced by metropolitan and rural youth is required.
（i）比较15至24岁男性和女性的自杀率；（ii）针对15至24岁男性，调查大城市和农村地区自杀率的差异，以及特定方法自杀率的变化，特别是农村和大城市地区枪支和上吊自杀率的变化。
对澳大利亚统计局（ABS）自杀数据（1964 - 1993年）进行回顾性分析。
澳大利亚所有州。
15至24岁自杀死亡的青年男女。
在澳大利亚所有州，男性青年自杀率在30年里大幅上升，而女性自杀率没有增加。在澳大利亚所有州，小乡村城镇青年男性自杀率的增幅一直超过大城市地区。1964年大城市的自杀率高于小乡村城镇，但到1993年情况逆转。中等规模城市是唯一没有一致的州际趋势的地区。不同州的自杀基础率存在差异。西澳大利亚州汽车尾气自杀率高，塔斯马尼亚州和昆士兰州枪支自杀率高。在所有大陆州，小农村地区与大城市地区的枪支自杀率之比都有所上升，但上吊自杀率的相同比例变化不大。
澳大利亚所有州都反映了全国在性别和居住地区方面的自杀趋势。在一些州，特定的自杀方式占主导。1984年至1993年所有州青年男性总体枪支自杀率呈下降趋势，但掩盖了30年里所有大陆州小农村地区枪支自杀率的大幅上升。这一点，再加上大城市和小农村地区枪支自杀率的显著比率差异，表明小农村地区存在特定的自杀风险因素。上吊率之比变化不大这一事实表明，男性青年自杀中更普遍的因素在所有地区也都存在。需要更好地了解大城市和农村青年面临的健康风险的异同。
