区域社会经济不平等和自杀死亡率:使用国家暴力死亡报告系统和相关行政数据对比常见措施
Viktoryia A Kalesnikava1,2, Eskira Kahsay1, Chuwen Zhong1
1Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
American journal of epidemiology
|February 2, 2025
概括
经济不平等影响了自杀率. 贫困地区面临更高的自杀风险,特别是那些贫困集中地区. 了解这些差异需要仔细衡量社会经济因素.
科学领域:
- 公共卫生 公共卫生
- 社会学 社会学 社会学
- 流行病学 流行病学
背景情况:
- 自杀死亡率 (SM) 的社会差异可能源于经济不平等.
- 经验证据的变化与衡量不平等的不同方法有关.
- 社会经济因素显著影响公共卫生结果,包括自杀率.
研究的目的:
- 为了对比共同的收入指标:绝对贫困,吉尼不平等指数和极端集中度指数 (ICE).
- 检查这些不平等措施与美国各县的年龄和性别标准化SM之间的关联.
- 为社会经济边缘化在自杀差异中的作用提供细微的理解.
主要方法:
- 利用了2006-2019年国家暴力死亡报告系统的数据,与2006-2010年行政社会经济数据联系在一起.
- 采用贝叶斯空间多层建模方法进行分析.
- 分析了1381个美国县,比较社会经济因素和自杀死亡率.
主要成果:
- 与富裕地区相比,较贫困地区的SM相对风险 (RR) 是最高的 (ICE RR: 1.24,绝对贫困RR: 1.33).
- 吉尼不平等指数显示,与SM没有线性关联.
- 贫困集中 (高ICE) 但基尼不平等差异较高的地区自杀风险最高,通常以医疗服务不足,低人口密度和高失业率为特征.
结论:
- 经济不平等衡量的选择显著影响了关于自杀死亡率的社会差异的结论.
- 集中贫困,特别是在医疗服务不足的地区,是与更高的自杀风险相关的关键因素.
- 衡量不平等的比较方法提供了对社会经济边缘化及其对自杀差异的影响更细致的理解.
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