Global differences in geography, religion and other societal factors are associated with sex differences in mortality from suicide: An ecological study of 182 countries
Global differences in geography, religion and other societal factors are associated with sex differences in mortality from suicide: An ecological study of 182 countries
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DOI：
10.1016/j.jad.2019.08.093
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发表时间：
2020-01-01
影响因子：
6.6
通讯作者：
Fogarty, Andrew
中科院分区：
文献类型：
--
作者：
Alothman, Danah;Fogarty, Andrew
背景：每年有超过80万人死于自杀，其中近三分之二是男性。这项分析旨在探讨地理位置、宗教和其他社会因素在全球自杀率方面的性别差异。方法：整理了182个国家2015年按性别划分的自杀率数据。感兴趣的因素包括地理位置、主要宗教、预期寿命、总和生育率、识字率、性别发展指数和国内生产总值。结果：大陆和主要宗教与男性与女性的自杀死亡比率密切相关(P<；两个变量均为0.001)。美洲的男性和女性自杀率最高，中位数为4.0(四分位数范围：3.0-5.0)，性别自杀率最低的是非洲(2.7，IQR：2.4-3.3)和亚洲(2.7，IQR：1.8-3.9)。以下变量均与男性：女性自杀死亡率/预期寿命(斯皮尔曼相关系数r=+0.21，p=0.004)、人均国内生产总值(r=+0.26，p=0.003)、识字率(r=+0.46，p<；0.0001)和性别发展指数(r=+0.56p<；0.0001)。总自杀率与性别自杀率呈负相关(-0.3，p<；0.0001)。结论：不同大洲和不同文化的男性和女性自杀率存在显著差异。与女性相比，社会发展的标志与男性自杀的比例更高。
Background: Over 800,000 individuals die as a consequence of suicide annually, and almost two thirds of these deaths are in males. This analysis aimed to explore sex differences in global suicide rates with regards to geographic location, religion and other societal factors.Methods: Data on sex-specific suicide rates were collated for 182 countries in 2015. The exposures of interest were geographical location, majority religion, life expectancy, total fertility rate (TFR), literacy percentage, gender development index and gross domestic product.Results: Both continent and predominant religion were strongly associated with the male:female ratio for deaths from suicide (p < 0.001 for both variables). The highest male:female suicide ratio was observed in the Americas with a median value of 4.0 (interquartile range IQR: 3.0-5.0) and the lowest gender suicide ratios were observed in Africa (2.7, IQR: 2.4-3.3) and Asia (2.7, IQR: 1.8-3.9). The predominantly Christian countries revealed the highest male:female suicide ratio (3.3, IQR: 2.7-4.4) whereas the predominantly Hindu countries revealed the lowest (1.3, IQR 1.3-3.8).The following variables were all positively associated with male:female ratio of suicide mortality: Life expectancy (Spearman's correlation coefficient r = + 0.21, p = 0.004), GDP per capita (r = + 0.26, p = 0.003), literacy percentage (r = +0.46, p < 0.0001), and Gender Development Index (r = +0.56, p < 0.0001). TFR was negatively associated with sex suicide ratio (-0.30, p < 0.0001).Conclusion: There are significant differences between male and female suicide rates across continents and cultures. Markers of societal development are associated with a higher proportion of male suicides compared to females.