Spatial clusters of suicide in the municipality of S？o Paulo 1996–2005 an ecological study 英文参考文献.docVIP

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Spatial clusters of suicide in the municipality of S？o Paulo 1996–2005 an ecological study 英文参考文献.doc

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Spatial clusters of suicide in the municipality of S？o Paulo 1996–2005 an ecological study 英文参考文献

Bandoetal.BMCPsychiatry2012,12:124 /1471-244X/12/124 RESEARCH ARTICLE OpenAccess Spatialclustersofsuicideinthemunicipalityof S?oPaulo1996–2005:anecologicalstudy DanielHBando1,RafaelSMoreira2,JulioCRPereira3andLigiaVBarrozo4* Abstract Background:Inaclassicalstudy,Durkheimmappedsuiciderates,wealth,andlowfamilydensityandrealizedthat theyclusteredinnorthernFrance.Assessingothersvariables,suchasreligioussociety,heconstructedaframework fortheanalysisofthesuicide,whichstillallowsinternationalcomparisonsusingthesamebasicmethodology.The presentstudyaimstoidentifypossiblesignificantlyclustersofsuicideinthecityofS?oPaulo,andthen,verifytheir statisticalassociationswithsocio-economicandculturalcharacteristics. Methods:Aspatialscanstatisticaltestwasperformedtoanalyzethegeographicalpatternofsuicidedeathsof residentsinthecityofS?oPaulobyAdministrativeDistrict,from1996to2005.Relativerisksandhighand/orlow clusterswerecalculatedaccountingforgenderandageasco-variates,wereanalyzedusingspatialscanstatisticsto identifygeographicalpatterns.Logisticregressionwasusedtoestimateassociationswithsocioeconomicvariables, considering,thespatialclusterofhighsuicideratesastheresponsevariable.DrawingfromDurkheim’ soriginal work,currentWorldHealthOrganization(WHO)reportsandrecentreviews,thefollowingindependentvariables wereconsidered:maritalstatus,income,education,religion,andmigration. Results:Themeansuicideratewas4.1/100,000inhabitant-years.Againstthisbaseline,twoclusterswereidentified: thefirst,ofincreasedrisk(RR=1.66),comprising18districtsinthecentralregion;thesecond,ofdecreasedrisk (RR=0.78),including14districtsinthesouthernregion.Thedowntownareatowardthesouthwesternregionof thecitydisplayedthehighestriskforsuicide,andthoughtheoverallriskmaybeconsideredlow,therateclimbs uptoanintermediatelevelinthisregion.Onelogisticregressionanalysiscontrastedtheriskcluster(18districts) againsttheotherremaining78districts,testingtheeffectsofsocioeconomic-culturalvariables.Thefollowing categoriesofproportionofp