预测限制经济手段对美洲地区自杀死亡率的影响:生态模型研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES
Shannon Lange , Kawon V. Kim , Huan Jiang , Kevin D. Shield , Jürgen Rehm , Anselm J.M. Hennis , Renato Oliveira e Souza
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引用次数: 0

摘要

背景世界卫生组织(WHO)所有其他地区的自杀死亡率都在下降,而美洲地区的自杀死亡率却在上升。经济限制是一种有效的预防自杀的循证干预措施。本研究旨在估算实施国家级手段限制政策(即枪支和杀虫剂限制)对美洲地区自杀死亡率的影响。方法在这项生态建模研究中,我们使用世界卫生组织全球健康估计数据库中 2000 年至 2019 年按性别分列的自杀死亡率数据,对两种反事实情景进行了调查。然后对每个国家 2020 年至 2030 年的性别年龄标准化自杀死亡率进行了预测。反事实情景 1 包括模拟 2020 年实施的枪支或杀虫剂限制措施对这些国家的影响,这些国家在 2019 年至少有一种性别的自杀人数中,枪支或杀虫剂占 40% 或以上,而在反事实情景 2 中,这一门槛降低到 20% 或以上。研究结果据估计,如果在 2020 年对 2019 年至少有一种性别的自杀率达到或超过 40% 的国家实施枪支或杀虫剂限制,那么到 2030 年,美洲地区的男性和女性自杀死亡率将为 20.5%(从 14.5 [95% 置信区间 [CI]:14.1, 15.0]):到 2030 年,美洲地区男性和女性自杀死亡率将分别比不实施此类限制的情况下低 20.5%(从每 10 万名男性 14.5 [95% 置信区间 [CI]:14.1,15.0] 降至每 10 万名男性 11.5 [95% CI:11.1,12.0])和 11.1%(从每 10 万名女性 4.5 [95% CI:4.4,4.7] 降至每 10 万名女性 4.0 [95% CI:3.9,4.2])。当阈值降低到 20% 或更高时,在避免自杀人数和降低自杀死亡率方面所取得的额外收益将微乎其微。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Forecasting the impact of means restriction on the suicide mortality rate in the Region of the Americas: an ecological modeling study

Background

The suicide mortality rate has been increasing in Region of the Americas, despite decreasing in all other World Health Organization (WHO) regions. Means restriction is an effective evidence-based intervention for suicide prevention. The objective of the current study was to estimate the impact of implementing national-level means restriction policies (i.e., firearm and pesticide restrictions) on the suicide mortality rate in the Region of the Americas.

Methods

In this ecological modeling study, two counterfactual scenarios were investigated using sex-specific suicide mortality data from the WHO Global Health Estimates database for 2000 to 2019. Forecasted sex-specific age-standardized suicide mortality rates were then estimated for each country for 2020 to 2030. Counterfactual scenario 1 involved modeling the impact of a firearm or pesticide restriction implemented in 2020 for those countries where the respective means accounted for 40% or more of all suicides for at least one sex in 2019, while in counterfactual scenario 2 this threshold was reduced to 20% or more.

Findings

It was estimated that if a firearm or pesticide restriction had been implemented in 2020 in those countries where the respective means accounted for 40% or more of all suicides for at least one sex in 2019, by 2030 the male and female suicide mortality rate in the Region of the Americas would be 20.5% (from 14.5 [95% Confidence Interval [CI]: 14.1, 15.0] per 100,000 males to 11.5 [95% CI: 11.1, 12.0] per 100,000 males) and 11.1% (from 4.5 [95% CI: 4.4, 4.7] per 100,000 females to 4.0 [95% CI: 3.9, 4.2] per 100,000 females) lower than the rate if no such restrictions were implemented, respectively. When the threshold was reduced to 20% or more, minimal additional gains in terms of number of suicides avoided and suicide mortality rate reduction would be achieved.

Interpretation

The implementation of a firearm or pesticide restriction policy in countries where the respective means account for a large proportion of suicides (e.g., at least 40%) could aid the Region of the Americas in achieving the WHO target of a one third reduction in the suicide mortality rate by 2030.

Funding

This work received no funding.

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来源期刊
CiteScore
8.00
自引率
0.00%
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0
期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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