spatial clusters of suicide in the municipality of s？o paulo 1996–2005 an ecological study直辖市的空间集群自杀的年代圣保罗,1996 - 2005年生态研究.pdfVIP

Bando et al. BMC Psychiatry 2012, 12:124 /1471-244X/12/124 RESEARCH ARTICLE Open Access Spatial clusters of suicide in the municipality of São Paulo 1996–2005: an ecological study 1 2 3 4* Daniel H Bando , Rafael S Moreira , Julio CR Pereira and Ligia V Barrozo Abstract Background: In a classical study, Durkheim mapped suicide rates, wealth, and low family density and realized that they clustered in northern France. Assessing others variables, such as religious society, he constructed a framework for the analysis of the suicide, which still allows international comparisons using the same basic methodology. The present study aims to identify possible significantly clusters of suicide in the city of São Paulo, and then, verify their statistical associations with socio-economic and cultural characteristics. Methods: A spatial scan statistical test was performed to analyze the geographical pattern of suicide deaths of residents in the city of São Paulo by Administrative District, from 1996 to 2005. Relative risks and high and/or low clusters were calculated accounting for gender and age as co-variates, were analyzed using spatial scan statistics to identify geographical patterns. Logistic regression was used to estimate associations with socioeconomic variables, considering, the spatial cluster of high suicide rates as the response variable. Drawing from Durkheim’s original work, current World Health Organization (WHO) reports and recent reviews, the following independent variables were considered: marital status, income, education, religion, and migration. Results: The mean suicide rate was 4.1/100,000 inhabitant-years. Against this baseline, two clusters were identified: the first, of increased risk (RR = 1.66), co