Urban/rural inequalities in suicide in Scotland, 1981-1999
Urban/rural inequalities in suicide in Scotland, 1981-1999
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DOI：
10.1016/j.socscimed.2004.11.025
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发表时间：
2005-06-01
影响因子：
5.4
通讯作者：
Leyland, AH
中科院分区：
文献类型：
--
作者：
Levin, KA;Leyland, AH
虽然自杀占苏格兰死亡人数的比例很小（1999年为1.4%），但在过去二十年中一直在稳步上升。在美国、澳大利亚、英格兰和威尔士，这一时期自杀率上升最多的是农村地区。这项研究描述了苏格兰自杀的城市/农村变化的模式和幅度，研究了不同地理区域内的自杀方法，并研究了随着时间的推移自杀的趋势。苏格兰所有地区的自杀数据（除了格兰扁在1996年经历了邮政编码部门边界的变化）进行了调查，使用标准化死亡率（SMR）和多级泊松模型，调整年龄，性别和剥夺。1981-85年、1989-93年和1995-99年的SMR是在四个地区建立的，使用1983年、1991年和1997年的苏格兰人口作为标准人口（SMR = 100）。1995- 1999年的最高比率出现在“偏远农村”地区，SMR = 125（95%置信区间107-146）。经年龄和贫困调整的模型显示，偏远农村地区男性自杀的风险明显高于城市地区，而农村地区女性自杀的风险明显低于城市地区。农村男女自杀的方式各不相同。该研究考虑了自杀和农村之间的关系如何随着时间的推移而变化，以及不同农村的自杀方法如何变化。在调整了年龄和贫困因素后，男性自杀率上升最快的地区出现在交通便利的农村地区，但偏远农村地区的自杀率仍然最高。(c)2004 Elsevier Ltd.保留所有权利。
Although suicide accounts for a small percentage of deaths in Scotland (1.4% in 1999), it has been steadily increasing over the last two decades. In the US, Australia, England and Wales the greatest rises in suicide for this time period, occurred in rural areas. This study describes the pattern and magnitude of urban/rural variation in suicide in Scotland, examines methods of suicide within differing geographies and looks at trends in suicides over time.Scotland is split into four rurality types. Suicide data for all areas of Scotland (apart from Grampian which underwent changes in postcode sector boundaries in 1996) are investigated using Standardised Mortality Ratios (SMRs) and multilevel Poisson modelling, adjusting for age, sex and deprivation. SMRs for 1981-85, 1989-93 and 1995-99 are created across the four geographies, using the populations of Scotland in 1983, 1991 and 1997 as the standard populations (SMR = 100). The highest rates in 1995-99 are seen in "remote rural" areas, SMR = 125 (95% confidence interval 107-146). Models adjusted for age and deprivation show significantly greater risk of male suicide in remote rural areas relative to urban areas and significantly lower risk of female suicide in accessible rural areas. The method of suicide varies across ruralities for both males and females. The study considers how the relationship between suicides and rurality varies over time and how methods of suicide vary across different ruralities. The steepest rises in suicide amongst men, adjusting for age and deprivation, were seen to occur in accessible rural areas, however highest rates remain in remote rural areas. (c) 2004 Elsevier Ltd. All rights reserved.