Urban-Rural Differences in Suicide in the State of Maryland: The Role of Firearms
Urban-Rural Differences in Suicide in the State of Maryland: The Role of Firearms
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DOI：
10.2105/ajph.2017.303865
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发表时间：
2017-10-01
影响因子：
12.7
通讯作者：
Mojtabai, Ramin
中科院分区：
文献类型：
--
作者：
Nestadt, Paul S.;Triplett, Patrick;Mojtabai, Ramin
目标。评估枪支的使用是否可以解释城乡自杀率的差异。我们对2003年至2015年马里兰州所有6196起具有良好特征的成年人自杀事件进行了回顾性分析。我们利用人口普查数据计算比率，然后按性别分层，并根据年龄和种族进行调整。农村的自杀率高于城市县。然而，较高的农村自杀率仅限于枪击自杀(发生率比[IRR]=1.66；95%可信区间[CI]=1.20，2.31)。在农村环境中，非枪支自杀率并不明显更高。此外，89%的枪支自杀发生在男性，农村枪支自杀率较高的仅限于男性(IRR=1.36；95%CI=1.09，1.69)。无论采用何种方法，农村女性完全自杀的可能性显著降低(IRR=0.63；95%CI=0.43，0.94)。男性枪械的使用导致农村地区自杀率的上升。在男性和女性中，城市化与自杀之间的相反关联可能是因为男性倾向于将枪支作为自杀的一种方法。
Objectives. To assess whether the use of firearms explains rural-urban differences in suicide rates.Methods. We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race.Results. Suicide rates were higher in rural compared with urban counties. However, the higher rural suicide rates were limited to firearm suicides (incident rate ratio [IRR] = 1.66; 95% confidence interval [CI] = 1.20, 2.31). Nonfirearm suicide rates were not significantly higher in rural settings. Furthermore, 89% of firearm suicides occurred in men and the higher rural firearm suicide rate was limited to men (IRR = 1.36; 95% CI = 1.09, 1.69). Women were significantly less likely to complete suicide in rural areas (IRR = 0.63; 95% CI = 0.43, 0.94), regardless of method.Conclusions. Malefirearmuse drives the increased rate of suicide in rural areas. The opposite associations between urbanicity and suicide in men and women may be driven by the male preference for firearms as a method for committing suicide.