Method-specific suicide mortality and its spatial autocorrelation among residents in Hubei province, 2019: a vital registry-based analysis
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摘要:
目的 了解湖北省居民2019年自杀死亡方式及其空间分布特征，为有针对性地制定自杀防控措施提供参考依据。 方法 收集中国疾病预防控制中心人口死亡信息登记管理系统中2019年1月1日 — 12月31日湖北省 ≥ 10岁居民自杀死亡数据，应用SAS 9.4和ArcGis 10.6统计软件分析湖北省居民2019年的自杀死亡方式及其空间分布特征。 结果 湖北省2019年 ≥ 10岁居民自杀死亡者7868例，自杀死亡率为14.88/10万，标化自杀死亡率为12.56/10万；居于前3位的自杀死亡方式依次为杀虫剂中毒（3481例）、悬吊（2497例）和从高处跳下（709例），死亡率依次为6.58/10万、4.72/10万和1.34/10万，标化死亡率依次为5.36/10万、3.87/10万和1.33/10万，此3种自杀死亡方式者占全部自杀死亡者的84.99 %。男性和女性居民居于前3位的自杀死亡方式均为杀虫剂中毒、悬吊和从高处跳下；城市居民居于前3位的自杀死亡方式亦为杀虫剂中毒、悬吊和从高处跳下，但农村居民则为杀虫剂中毒、悬吊和其他物质中毒。10～24岁和25～44岁居民的主要自杀死亡方式均为从高处跳下，45～64岁和 ≥ 65岁居民的主要自杀死亡方式则均为杀虫剂中毒。全局空间自相关分析结果显示，2019年湖北省居民自杀死亡以及主要方式包括杀虫剂中毒、悬吊、从高处跳下均在空间上存在一定的聚集性，全局Moran′s I指数分别为0.473、0.387、0.482、0.244（均P < 0.001）。局部空间自相关分析显示，自杀死亡高 – 高聚集的地区为恩施州、宜昌市、荆州市、荆门市的一些县（市、区）以及直辖市神农架林区、天门市、潜江市，低 – 低聚集的地区为武汉市和黄石市的一些城区，高 – 低聚集的地区为黄冈麻城市，低 – 高聚集的地区为孝感应城市、荆州市的荆州区和沙市区；杀虫剂中毒自杀死亡方式高 – 高聚集的地区为巴东县、秭归县、五峰土家族自治县、公安县、石首市、监利县、仙桃市、潜江市、天门市和钟祥市，悬吊自杀死亡方式高 – 高聚集的地区为鄂西部的一些县（市、区），杀虫剂中毒和悬吊自杀死亡方式低 – 低聚集的地区均为武汉市和黄石市的一些城区，而从高处跳下自杀死亡方式高 – 高聚集的地区则为武汉市和黄石市的9个城区。 结论 杀虫剂中毒、悬吊和从高处跳下为湖北省2019年居民的主要自杀死亡方式，各自杀死亡方式均存在性别、地区、年龄差异以及明显的空间聚集性。 Abstract:Objective To analyze method-specific suicide mortality and its spatial distribution among residents in Hubei province in 2019 for providing evidences to the development of effective measures on suicide prevention. Methods The data on suicide deaths among permanent residents over 10 years old in Hubei province during 2019 were extracted from the Death Reporting System of Chinese Center for Disease Control and Prevention. SAS software and ArcGis 10.6 were utilized in analyses on suicide methods and its spatial autocorrelation. Results During the year in the residents, the number of suicide deaths, mortality and standardized mortality rate (SMR) were 7 868, 14.88/100000 and 12.56/100 000, respectively. The top three methods for all the registered suicide mortalities were pesticide poisoning (with the death number of 3 481, the mortality rate of 6.58/100 000, and the SMR of 5.36/100 000), hanging (2 497, 4.72/100 000, and 3.87/100 000), jumping from a high place (709, 1.34/100 000, 1.33/100 000) and the deaths attributed to the three methods accounting for 84.99% of all suicide deaths. The top three methods for the male, female and urban suicide mortalities among residents were the same as for all the suicide mortalities; while for the rural suicide mortalities, the top two methods were the same but the third method was other substances poisoning. Jumping from a high place was the major suicide method for the suicide mortalities aged 10 – 24 and 25 – 44 years; whereas, for the suicide mortalities aged 45 – 64 years and 65 years and above, the major suicide method was pesticide poisoning. Global spatial autocorrelation analysis showed that there were spatial clustering in suicide mortality, the main suicide methods of pesticide poisoning, hanging, and jumping from a high place, with the global Moran′s indicies of 0.473, 0.387, 0.482, and 0.244 (P < 0.001). Local spatial autocorrelation analysis revealed high-high clustering of suicide mortality in some districts/prefectures of 7 municipalities, low-low clustering in some urban districts of 2 municipalities, high-low clustering in one prefectures, and low-high clustering in one prefecture and two districts of a prefecture; local spatial autocorrelation analysis also revealed various types of clustering of suicide methods as following: high-high clustering of pesticide poisoning in 5 counties and 5 prefectures, high-high clustering of hanging in some districts/counties/prefectures in western region of Hubei province, low-low clustering of pesticide poisoning and hanging in some urban districts of two municipalities, and high-high clustering of jumping from a high place in some urban districts of two municipalities. Conclusion Among suicide mortalities during 2019 in Hubei province, pesticide poisoning, hanging, and jumping from a high place were main methods and there were obvious spatial clustering and significant gender, age, and regional differences in the main suicide methods. -
Key words:
- suicide /
- suicide method /
- spatial autocorrelation analysis
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表 1 湖北省男性和女性居民不同自杀死亡方式死亡情况比较
自杀死亡方式 男性 女性 死亡数 死亡率（1/10万） 标化死亡率（1/10万） 构成比(%) 顺位 死亡数 死亡率（1/10万） 标化死亡率（1/10万） 构成比(%) 顺位 其他物质中毒 245 0.92 0.87 5.82 4 234 0.89 0.75 6.40 5 杀虫剂中毒 1796 6.73 5.83 42.67 1 1685 6.43 4.93 46.05 1 悬吊 1413 5.30 4.66 33.57 2 1084 4.14 3.15 29.63 2 淹溺 185 0.69 0.69 4.40 5 258 0.98 0.84 7.05 4 枪支和炸药 3 0.01 0.01 0.07 7 0 0 0 0.00 7 从高处跳下 410 1.54 1.55 9.74 3 299 1.14 1.10 8.17 3 其他方式 157 0.59 0.54 3.73 6 99 0.38 0.32 2.71 6 
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表 2 湖北省城市和农村居民不同自杀死亡方式死亡情况比较
自杀死亡方式 城市 农村 死亡数 死亡率（1/10万） 标化死亡率（1/10万） 构成比(%) 顺位 死亡数 死亡率（1/10万） 标化死亡率（1/10万） 构成比(%) 顺位 其他物质中毒 173 0.59 0.57 4.80 5 306 1.30 1.07 7.18 3 杀虫剂中毒 1590 5.42 4.65 44.11 1 1891 8.03 6.20 44.36 1 悬吊 1030 3.51 3.01 28.57 2 1467 6.23 4.83 34.41 2 淹溺 212 0.72 0.66 5.88 4 231 0.98 0.89 5.42 5 枪支和炸药 0 0 0 0.00 7 3 0.01 0.01 0.07 7 从高处跳下 454 1.55 1.52 12.59 3 255 1.08 1.10 5.98 4 其他方式 146 0.50 0.43 4.05 6 110 0.47 0.41 2.58 6
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表 3 湖北省不同年龄居民不同自杀死亡方式死亡情况比较
自杀死亡方式 10～24岁 25～44岁 45～64岁 ≥ 65岁 死亡数 死亡率
(1/10万)构成比(%) 死亡数 死亡率
(1/10万)构成比(%) 死亡数 死亡率
(1/10万)构成比(%) 死亡数 死亡率
(1/10万)构成比(%) 其他物质中毒 37 0.40 12.09 86 0.49 10.86 85 0.45 4.02 271 3.75 5.82 杀虫剂中毒 30 0.33 9.80 200 1.13 25.25 896 4.76 42.36 2355 32.55 50.59 悬吊 35 0.38 11.44 164 0.93 20.71 705 3.75 33.33 1593 22.01 34.22 淹溺 54 0.59 17.65 71 0.40 8.96 129 0.69 6.10 189 2.61 4.06 枪支和炸药 0 0 0.00 0 0 0.00 2 0.01 0.09 1 0.01 0.02 从高处跳下 135 1.47 44.12 213 1.21 26.89 207 1.10 9.79 154 2.13 3.31 其他方式 15 0.16 4.90 58 0.33 7.32 91 0.48 4.30 92 1.27 1.98
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