Achieving health equity in US suicides: a narrative review and commentary.
Achieving health equity in US suicides: a narrative review and commentary.
复制标题
在美国自杀中实现健康公平：叙事评论和评论。
DOI：
10.1186/s12889-022-13596-w
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发表时间：
2022-07-15
影响因子：
4.5
通讯作者：
Wilcox, Holly C.
中科院分区：
文献类型：
--
作者：
Perry, Seth W.;Rainey, Jacob C.;Allison, Stephen;Bastiampillai, Tarun;Wong, Ma-Li;Licinio, Julio;Sharfstein, Steven S.;Wilcox, Holly C.
关键词：
美国的自杀率在2018年达到峰值，并在2019年和2020年下降，年龄、性别、种族/民族、地理、退伍军人身份、性少数群体身份、社会经济地位和所采用的方法（平均差异）存在巨大且往往不断扩大的差异。在这篇叙述性评论和评论中，我们强调了美国自杀死亡的许多差异，然后研究了可能的原因和潜在的解决方案，其总体目标是减少自杀死亡的差异，以实现健康公平。这些数据表明，未经治疗、治疗不足或身份不明的抑郁症或其他精神疾病，以及获得枪支，是所有群体自杀的两个可改变的风险因素。数据还显示，随着乡村人口的增加，枪支自杀率急剧上升，而自杀率福尔斯（例如，从高楼自杀）随着乡村化程度的增加而线性下降，而其他方式的自杀率则保持相当稳定，与相对的县城市化无关。此外，在所有地区，男性的枪支自杀率明显高于女性，51-85岁以上的男性和女性的枪支自杀率最高。在1999年至2019年的所有美国自杀事件中，55%的男性自杀和29%的女性自杀是在大都市地区，而在非大都市地区，65%（男性）和42%（女性）的自杀是通过枪支自杀。枪支占71-85岁以上非都市男性自杀的89%。枪支（即，使用更致命的手段）也被认为是男性自杀率平均比女性高2-4倍的主要原因，尽管男性自杀未遂的人数仅为女性的1/4-1/2。总的来说，文献和数据强烈暗示枪支接触是所有人群自杀的风险因素，对于男性，农村和老年人群更是如此。为了在所有群体中实现自杀预防的最显著结果，我们需要1）更多地强调减少自杀行为的政策和普遍计划，以及2）加强基于人口的战略，以改善预防自杀的两个最突出的可修改目标：抑郁症和枪支。
Suicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity. The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51–85 + years old for both sexes. Of all US suicides from 1999–2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71–85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2–4 times higher suicide rates than women, despite having only 1/4—1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations. To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention: depression and firearms.
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影响因子：
4.5
作者：
Adams LB;Baxter SLK;Lightfoot AF;Gottfredson N;Golin C;Jackson LC;Tabron J;Corbie-Smith G;Powell W
通讯作者：
Powell W
影响因子：
11
作者：
Allison, S.;Bastiampillai, T.;Sharfstein, S. S.
通讯作者：
Sharfstein, S. S.
影响因子：
12.7
作者：
Anestis, Michael D.;Anestis, Joye C.
通讯作者：
Anestis, Joye C.
DOI：
10.1001/jama.2021.5469
发表时间：
2021-05-11
期刊：
JAMA
影响因子：
--
作者：
Ahmad FB;Anderson RN
通讯作者：
Anderson RN
DOI：
10.1007/s40615-020-00957-7
发表时间：
2021-01-07
影响因子：
3.9
作者：
Ali, Bina;Rockett, Ian R. H.;Leonardo, Jennifer B.
通讯作者：
Leonardo, Jennifer B.