Association Between Adolescent Suicide and Sociodemographic Factors in Chile
Cross-Sectional Ecological Study
Abstract
Abstract.Background: Adolescent suicide rates (ASR) are a matter of concern worldwide. Causes of this trend are not understood and could correspond to socioeconomic factors such as inequality. Aim: To investigate sociodemographic variables related to ASR, particularly the potential association with indicators of socioeconomic inequality. Method: Cross-sectional ecological study analyzing data from 29 health districts with univariate and multivariable multilevel Poisson models. Results: ASR were higher in male adolescents and at increasing age. No association was found between ASR and inequality (Gini coefficient and 20/20 ratio). Analysis revealed that living in a single-parent family is associated with ASR. Conclusions: The usual demographic patterns of adolescent suicide apply in Chile. An emerging variable of interest is single-parent family. No cross-sectional association between social inequality and ASR was found based on conflicting evidence. These results should be explored in future prospective population studies to further understand associated social factors.
References
(2004). Impact of gender and parents' marital status on adolescents' suicidal ideation. International Journal of Social Psychiatry, 50(4), 351-360. 10.1177/0020764004050335
(2003). No association of income inequality with adult mortality within New Zealand: A multi-level study of 1.4 million 25-64 year olds. Journal of Epidemiology and Community Health, 57(4), 279-284. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1732433&tool=pmcentrez&rendertype=abstract
(2010). Socio-economic inequalities in suicide attempts and suicide mortality in Québec, Canada, 1990-2005. Public Health, 124(2), 78-85. 10.1016/j.puhe.2010.01.008
(2009). Suicide in Italian children and adolescents. Journal of Affective Disorders, 113(3), 291-295. 10.1016/j.jad.2008.05.019
(2007). Suicide and unemployment: What are the missing links? Archives of Suicide Research, 11(4), 327-335. 10.1080/13811110701541905
(2010). Association of secular trends in unemployment with suicide in Taiwan, 1959-2007: A time-series analysis. Public Health, 124(1), 49-54. 10.1016/j.puhe.2009.11.005
Commission on Social Determinants of Health . (2008). Closing the gap in a generation: Health equity trough action on the social determinants of health. Final Report of the Commission on Social Determinants of Health (pp. 1-256). Geneva, Switzerland: World Health Organization.Department of Health Information and Statistics . (n.d.). Proyección de población INE 2005-2020, por Servicio de Salud, Santiago de Chile[Population estimates of the National Institute of Statistics 2005-2020, by the health service, Santiago de Chile] . Retrieved from http://www.deis.cl/wp-content/uploads/2011/06/POB_SS_COMUNA_2005_2020_RegNueva.rar(2010). Suicide: A study in sociology (Vol. 3, p. 416). New York, NY: The Free Press.
Eurostat . (2013). Equivalised income - statistics explained. Retrieved from http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/Glossary:Equivalised_income.(2007). Exposure to single parenthood in childhood and later mental health, educational, economic, and criminal behavior outcomes. Archives of General Psychiatry, 64(9), 1089-1095. 10.1001/archpsyc.64.9.1089
Free Software Foundation's GNU General Public License . (2014). R (version 2.15.0) [statistical software]. Vienna, Austria: The R Foundation for Statistical Computing.(2003). Youth suicide risk and preventive interventions: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 42(4), 386-405. 10.1097/01.CHI.0000046821.95464.CF
(2011). Income-related inequalities in the prevalence of depression and suicidal behaviour: A 10-year trend following economic crisis. World Psychiatry, 10(1), 40-44. Retrieved from http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3048505&tool=pmcentrez&rendertype=abstract
(2010). Income inequality and the suicide rate in Japan: Evidence form cointegration and LA-VAR. Journal of Applied Economics, XIII(1), 113-133.
(2012). A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour - the mediating role of school performance. BMC Public Health, 12(1), 17. 10.1186/1471-2458-12-17
(2002). A glossary for health inequalities. Journal of Epidemiology and Community Health, 56, 647-652. Retrieved from http://jech.bmj.com/content/56/9/647.short
(2010). Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea. Social Science & Medicine (1982), 70(8), 1254-1261. 10.1016/j.socscimed.2010.01.004
(2011). Changes in associations between psychosocial factors and suicide attempts by adolescents in Greece from 1984 to 2007. European Journal of Public Health, 21(6), 694-698. 10.1093/eurpub/ckq160
(2012). Income inequality and health: The role of population size, inequality threshold, period effects and lag effects. Journal of Epidemiology and Community Health, 66(6), e11. 10.1136/jech-2011-200321
(2009). Inequality, poverty and social policy: Recent trends in Chile. OECD Social, Employment and Migration Working Papers (no. 85), 1-35. Retrieved from http://www.oecd-ilibrary.org/social-issues-migration-health/inequality-poverty-and-social-policy-recent-trends-in-chile_224516554144
(2005). Socio-economic inequalities in suicide: A European comparative study. The British Journal of Psychiatry: The Journal of Mental Science, 187, 49-54. 10.1192/bjp.187.1.49
(2008). Economic correlates of suicide rates in OECD countries. SCALA Disussion Paper, 6, 1-46. University of St Gallen, Switzerland.
(2005). Social determinants of health inequalities. The Lancet, 365, 1099-1104. Retrieved from http://www.sciencedirect.com/science/article/pii/S0140673605711466
(2007). Achieving health equity: From root causes to fair outcomes. Lancet, 370(9593), 1153-1163. 10.1016/S0140-6736(07)61385-3
(2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Lancet, 372(9650), 1661-1669. 10.1016/S0140-6736(08)61690-6
(2005). Income inequality and risk of suicide in new york city neighborhoods: A multilevel case-control study. Suicide and Life-Threatening Behavior, 35(4), 448-459.
(2013). Social-environmental factors and suicide mortality: A narrative review of over 200 articles. Sociology Mind, 3(2), 137-148. 10.4236/sm.2013.32021
(2013). Long-term unemployment and suicide: A systematic review and meta-analysis. PloS One, 8(1), e51333. 10.1371/journal.pone.0051333
Ministry of Social Development . (2010). Encuesta CASEN - definiciones de pobreza[CASEN Survey - Poverty definitions] . Retrieved from http://www.ministeriodesarrollosocial.gob.cl/casen/definiciones/pobreza.html#1Ministry of Planning . (2009). CASEN 2009. Informe metodológico [CASEN 2009. Methodological report] . Retrieved from http://observatorio.ministeriodesarrollosocial.gob.cl/layout/doc/casen/metodologia_2009_504de6beb0fd4.pdfMinistry of Health, Government of Chile . (2012). Estrategia nacional de salud. Para el cumplimiento de los objetivos sanitarios de la década 2011-2020[Strategy for the fulfillment of the health goals of the decade 2011-2020] . Retrieved from http://www.minsal.cl/portal/url/item/c4034eddbc96ca6de0400101640159b8.pdfNational Institute of Statistics . (2004). Chile: Estimaciones y proyecciones de población por sexo y edad. País urbano-rural, 1990-2020[Estimates and projections of the population for sex and age, urban-rural, 1990-2020] . Retrieved from http://www.ine.cl/canales/chile_estadistico/demografia_y_vitales/proyecciones/Informes/MicrosoftWordInforReg_UR.pdfNational Institute of Statistics . (2010). Mortality trends in Chile from cause of death and age, 1990-2007. Santiago de Chile. Retrieved from http://www.ine.cl/canales/menu/publicaciones/calendario_de_publicaciones/pdf/010211/evo90_07_010211.pdfSocial Observatory . (2012). Metodología del diseño muestral y factores de expansión encuesta de caracterización socioeconómica nacional. Documentos metodológicos, no1[Methodology of sample design and expansion factors of the CASEN Survey. Methodological documents, no. 1] . Retrieved from http://observatorio.ministeriodesarrollosocial.gob.cl/layout/doc/casen/Informe Diseno Muestral_Revision_13sep12.pdfSocial Observatory, Ministry of Social Development, Goverment of Chile . (2014). Descripción y objetivos[Description and objectives] . Retrieved from http://observatorio.ministeriodesarrollosocial.gob.cl/casen/casen_obj.phpOrganization for Economic Cooperation and Development, OECD . (2011). Society at a glance 2011: OECD social indicators. Income inequality. Retrieved from http://dx.doi.org/10.1787/888932381874Organization for Economic Cooperation and Development . (2012). CO4.4: Teenage suicide (15-19 years old) (pp. 1-5). Retrieved from http://www.oecd.org/social/family/database(2003). Child and adolescent suicide epidemiology, risk factors, and approaches to prevention. Peaditric Drugs, 5(4), 243-263.
(2003). Un análisis del concepto de familia monoparental a partir de una investigación sobre núcleos familiares monoparentales
[An analysis of the concept of single-parent family from an investigation on single-parent family units] . Papers, 69, 59-82.(2005). Causation and causal inference in epidemiology. American Journal of Public Health, 95 Suppl 1, S144-150. doi:10.2105/AJPH.2004.059204
(2012). Self-harm and suicidal behaviors in Hong Kong adolescents: Prevalence and psychosocial correlates. The Scientific World Journal, 2012, 932540. 10.1100/2012/932540
(2012). Adolescence and the social determinants of health. Lancet, 379(9826), 1641-1652. 10.1016/S0140-6736(12)60149-4
(2003). Mortality, severe morbidity, and injury in children living with single parents in Sweden: A population-based study. Lancet, 361(9354), 289-295. 10.1016/S0140-6736(03)12324-0
(2007). The problems of relative deprivation: Why some societies do better than others. Social Science & Medicine, 65(9), 1965-1978. 10.1016/j.socscimed.2007.05.041
(2009). Income inequality and social dysfunction. Annual Review of Sociology, 35(1), 493-511. 10.1146/annurev-soc-070308-115926
World Health Organization . (2013). Suicide prevention (SUPRE). Retrieved from http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/(2008). Suicide mortality of young, middle-aged and elderly males and females in Japan for the years 1953-96: Time series analysis for the effects of unemployment, female labour force, young and aged population, primary industry and population density. Industrial Health, 46(6), 541-549. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19088406
