論文

査読有り 国際誌
2020年2月18日

Spatial clustering of suicide mortality and associated community characteristics in Kanagawa prefecture, Japan, 2011-2017.

BMC psychiatry
  • Kazue Yamaoka
  • ,
  • Masako Suzuki
  • ,
  • Mariko Inoue
  • ,
  • Hirono Ishikawa
  • ,
  • Toshiro Tango

20
1
開始ページ
74
終了ページ
74
記述言語
英語
掲載種別
DOI
10.1186/s12888-020-2479-7

BACKGROUND: Suicide mortality is high in Japan and early interventional strategies to solve that problem are needed. An accurate evaluation of the regional status of current suicide mortality would be useful for community interventions. A few studies in Kanagawa prefecture, located next to Tokyo and with the second largest population in Japan, have identified spatial clusters of suicide mortality at regional levels. This study examined spatial clustering and clustering over time of such events using spatial data from regional statistics on suicide deaths. METHODS: Data were obtained from regional statistics (58 regions in Kanagawa prefecture) of the National Vital Statistics of Japan from 2011 to 2017. The standardized mortality ratio (SMR) and Empirical Bayes estimator for the SMR (EBSMR) were used as measures. Spatial clusters were examined by Kulldorff's circular spatial scan statistic, Tango-Takahashi's flexible spatial scan statistic and Tango's test. Linear regression and conditional autoregressive (CAR) models were used not only to adjust for covariates but also to estimate regional effects. The analyses were conducted for each year, inclusive. RESULTS: Among male suicide deaths, being unemployed (50%) was most frequently related to suicide while among female health problem (50%) were frequent. Spatial clusters with significance detected by FlexScan, SatScan and Tango's test were few and varied somewhat according to the method used. Spatial clusters were detected in some regions including Kawasaki ward after adjustment by covariates. By the linear regression models, selected variables with significance were different between the sexes. For males, unemployment, family size, and proportion of higher education were detected for several of the years studied while for females, family size and divorce rate were detected over this period. These variables were also observed by the CAR model with 5 covariates. Regional effects were much clearer by considering the spatial parameter for both males and females and especially, Kawasaki ward was detected as a high risk region in many years. CONCLUSION: The present results detected some spatial clustering of suicide deaths within certain regions. Factors related to suicide deaths were also indicated. These results would provide important information in policy making for suicide prevention.

リンク情報
DOI
https://doi.org/10.1186/s12888-020-2479-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32070316
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029524
ID情報
  • DOI : 10.1186/s12888-020-2479-7
  • PubMed ID : 32070316
  • PubMed Central 記事ID : PMC7029524

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