Chien-Yu Lin1,2, Chia-Yueh Hsu3,4,5, Ying-Yeh Chen6,7, Shu-Sen Chang1,5, David Gunnell8,9. 1. Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan. 2. Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan. 3. Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 4. Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 5. Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 6. Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan. 7. Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan. 8. Centre for Academic Mental Health, Population Health Sciences, University of Bristol, UK. 9. National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK.
Abstract
Background: Few studies have investigated whether means accessibility is related to the spatial distribution of suicide. Aims: To examine the hypothesis that indicators of the accessibility to specific suicide methods were associated with method-specific suicide rates in Taipei City, Taiwan. Method: Smoothed standardized mortality ratios for method-specific suicide rates across 432 neighborhoods and their associations with means accessibility indicators were estimated using Bayesian hierarchical models. Results: The proportion of single-person households, indicating the ease of burning charcoal in the home, was associated with charcoal-burning suicide rates (adjusted rate ratio [aRR] = 1.13, 95% credible interval [CrI] = 1.03-1.25). The proportion of households living on the sixth floor or above, indicating easy access to high places, was associated with jumping suicide rates (aRR = 1.16, 95% CrI, 1.04-1.29). Neighborhoods' adjacency to rivers, indicating easy access to water, showed no statistical evidence of an association with drowning suicide rates (aRR = 1.27, 95% CrI = 0.92-1.69). Hanging and overall suicide rates showed no associations with any of these three accessibility indicators. Limitations: This is an ecological study; associations between means accessibility and suicide cannot be directly inferred as causal. Conclusion: The findings have implications for identifying high-risk groups for charcoal-burning suicide (e.g., vulnerable individuals living alone) and preventing jumping suicides by increasing the safety of high buildings.
Background: Few studies have investigated whether means accessibility is related to the spatial distribution of suicide. Aims: To examine the hypothesis that indicators of the accessibility to specific suicide methods were associated with method-specific suicide rates in Taipei City, Taiwan. Method: Smoothed standardized mortality ratios for method-specific suicide rates across 432 neighborhoods and their associations with means accessibility indicators were estimated using Bayesian hierarchical models. Results: The proportion of single-person households, indicating the ease of burning charcoal in the home, was associated with charcoal-burning suicide rates (adjusted rate ratio [aRR] = 1.13, 95% credible interval [CrI] = 1.03-1.25). The proportion of households living on the sixth floor or above, indicating easy access to high places, was associated with jumping suicide rates (aRR = 1.16, 95% CrI, 1.04-1.29). Neighborhoods' adjacency to rivers, indicating easy access to water, showed no statistical evidence of an association with drowning suicide rates (aRR = 1.27, 95% CrI = 0.92-1.69). Hanging and overall suicide rates showed no associations with any of these three accessibility indicators. Limitations: This is an ecological study; associations between means accessibility and suicide cannot be directly inferred as causal. Conclusion: The findings have implications for identifying high-risk groups for charcoal-burning suicide (e.g., vulnerable individuals living alone) and preventing jumping suicides by increasing the safety of high buildings.
Entities:
Keywords:
means accessibility; spatial analysis; suicide; suicide methods
Authors: Shu-Sen Chang; Tsung-Hsueh Lu; Jonathan Ac Sterne; Michael Eddleston; Jin-Jia Lin; David Gunnell Journal: BMC Public Health Date: 2012-04-02 Impact factor: 3.295