Spatial patterning of self-harm rates within urban areas

Area of Science:

• Public Health
• Epidemiology
• Spatial Analysis

Background:

• Urban areas often exhibit higher self-harm rates, with socioeconomic deprivation identified as a key predictor.
• Understanding the spatial distribution of self-harm within urban environments is crucial for targeted public health interventions.

Purpose of the Study:

• To investigate the spatial patterns of self-harm admissions within South East London.
• To examine the association of self-harm rates with area-level deprivation, urbanness (proximity to city center, population density, greenspace), and ethnicity.

Main Methods:

• Utilized Bayesian hierarchical models on self-harm admission data from 725 small areas in South East London.
• Explored spatio-temporal patterns and associations with urban characteristics and ethnicity, adjusting for deprivation and social fragmentation.

Main Results:

• Self-harm admission rates varied significantly, showing a fourfold difference across the study area.
• Lower self-harm rates were observed closer to the city center (ASR 0.71).
• After adjustment, greenspace, population density, and ethnicity were not associated with self-harm rates; deprivation partially masked but did not explain the spatial pattern.

Conclusions:

• Proximity to the city center was linked to reduced self-harm rates, challenging the assumption that inner-city areas have the highest risk.
• Standard measures of urbanness, population density, and greenspace did not correlate with self-harm risk.
• The spatial patterning of self-harm within this urban area was not primarily driven by deprivation or ethnicity.