Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis
Autor(a) principal: | |
---|---|
Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/135190 |
Resumo: | ABSTRACT - Background: It is well established that the health of a population is highly influenced by its socioeconomic context, welfare systems, labour markets, public policies, and demographic characteristics. Thus, changes in these key determinants may be reflected in the mental health and wellbeing of a population, through risk factors such as unemployment, financial strain, debts and job-related issues, as people posed with these challenges are usually more susceptible to mental ill-health. Following the worldwide economic crisis of 2008, several studies have found contradicting results in regards to this association, with some showing an increased risk for self-harm and suicidal behaviour, be it in the form of suicides or suicide attempts (many requiring urgent hospitalization), worldwide and in Europe, and others finding the opposite association. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the deaths and hospitalization rates trends by suicide and self-inflicted injury in Portugal. Methods: A retrospective ecological study, with an interrupted time series analysis of hospitalizations and deaths by suicide and self-inflicted injury (data from the national Hospital Morbidity Database) in mainland Portugal, between 2003 and 2014, was performed. Resident population data aged 15 years old or older was retrieved from the National Statistics Institute. Binomial negative generalized linear models were used to compare rates and trends before (2003-2008) and during (2009-2014) the Portuguese economic crisis. Regression coefficients were calculated (p<0.05) along with 95% Confidence Intervals. All rates were stratified and adjusted for seasonality. Results: Globally, for the whole mainland population, the 2009-2014 economic crisis in Portugal was associated with an increase in the hospitalization and death rate trends due to suicide and self-inflicted injury, with unemployment playing a significant albeit mixed mediating role. However, in line with previous results in the literature, many differences exist in different subgroups, with males, working-age groups (25-44 and 45- 64) and the North and Centre regions being the most impacted, globally. Conclusions: Economic downturns pose considerable risks for suicidal behavior. This should be a priority area for urgent intervention, especially in the context of the COVID- 19 pandemic crisis and the economic crisis it provoked, with a potentially tremendous impact in mental health. |
id |
RCAP_13ada546f9d02f957be7ee42f3a91d98 |
---|---|
oai_identifier_str |
oai:run.unl.pt:10362/135190 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysissuicidesuicide attemptssuicidal behaviorself-inflicted injuryhospitalizationsmental healtheconomic crisisunemploymentsuicídiotentativa de suicídiocomportamento suicidáriolesão autoinfligidahospitalizaçõessaúde mentalcrise económicadesempregoDomínio/Área Científica::Ciências Sociais::Outras Ciências SociaisABSTRACT - Background: It is well established that the health of a population is highly influenced by its socioeconomic context, welfare systems, labour markets, public policies, and demographic characteristics. Thus, changes in these key determinants may be reflected in the mental health and wellbeing of a population, through risk factors such as unemployment, financial strain, debts and job-related issues, as people posed with these challenges are usually more susceptible to mental ill-health. Following the worldwide economic crisis of 2008, several studies have found contradicting results in regards to this association, with some showing an increased risk for self-harm and suicidal behaviour, be it in the form of suicides or suicide attempts (many requiring urgent hospitalization), worldwide and in Europe, and others finding the opposite association. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the deaths and hospitalization rates trends by suicide and self-inflicted injury in Portugal. Methods: A retrospective ecological study, with an interrupted time series analysis of hospitalizations and deaths by suicide and self-inflicted injury (data from the national Hospital Morbidity Database) in mainland Portugal, between 2003 and 2014, was performed. Resident population data aged 15 years old or older was retrieved from the National Statistics Institute. Binomial negative generalized linear models were used to compare rates and trends before (2003-2008) and during (2009-2014) the Portuguese economic crisis. Regression coefficients were calculated (p<0.05) along with 95% Confidence Intervals. All rates were stratified and adjusted for seasonality. Results: Globally, for the whole mainland population, the 2009-2014 economic crisis in Portugal was associated with an increase in the hospitalization and death rate trends due to suicide and self-inflicted injury, with unemployment playing a significant albeit mixed mediating role. However, in line with previous results in the literature, many differences exist in different subgroups, with males, working-age groups (25-44 and 45- 64) and the North and Centre regions being the most impacted, globally. Conclusions: Economic downturns pose considerable risks for suicidal behavior. This should be a priority area for urgent intervention, especially in the context of the COVID- 19 pandemic crisis and the economic crisis it provoked, with a potentially tremendous impact in mental health.RESUMO - Introdução: Está bem estabelecido na literatura que a saúde das populações é altamente influenciada pelo seu contexto socioeconómico, segurança social, mercado de trabalho, políticas públicas e características demográficas. Como tal, alterações nestes determinantes podem refletir-se na saúde mental e no bem-estar de uma população, através de fatores de risco como desemprego, dificuldades financeiras, dívidas ou problemas laborais, sendo que os indivíduos a eles sujeitos estão geralmente mais suscetíveis para problemas de saúde mental. Após a crise financeira global de 2008, vários estudos encontraram resultados contraditórios no que toca a esta associação, com alguns a mostrar um risco aumentado de comportamento suicidário (suicídios e tentativas de suicídio, muitas das quais requerem hospitalização), no mundo e na Europa, enquanto outros encontraram a associação inversa. Tanto quanto foi possível averiguar, não existem estudos em Portugal sobre o assunto, neste período de tempo. Assim, o objetivo deste estudo foi estimar o impacto da crise económica de 2009- 2014 nas tendências de óbitos e hospitalizações por suicídio e lesões autoinfligidas em Portugal. Métodos: Foi realizado um estudo retrospetivo ecológico, com análise de séries temporais interrompidas de hospitalizações e óbitos por suicídio e lesões autoinfligidas (dados da Base de Dados de Morbilidade Hospitalar) em Portugal Continental, em 2003- 2014. Os dados relativos à população residente em Portugal com 15 anos de idade ou mais foram retirados da base de dados do Instituto Nacional de Estatística. Através de modelos binomiais negativos, foram comparadas as tendências das taxas de mortalidade e hospitalizações por suicídio no período da crise económica (2009-2014) em comparação com o período anterior (2003-2008), em Portugal Continental. Foram calculados os coeficientes da regressão (p < 0.05), bem como os Intervalos de Confiança a 95%. Toda a análise foi estratificada e ajustada para sazonalidade. Resultados: Globalmente, para o total da população, verificou-se uma associação positiva e estatisticamente significativa entre a crise económica de 2009-2014 e as tendências das taxas de mortalidade e de hospitalização por suicídio, com o desemprego a desempenhar um papel de mediador de efeito com resultados opostos. No entanto, e em linha com a literatura, existem grandes diferenças nos resultados da análise estratificada, com homens, indivíduos em idade ativa e residentes nas regiões do Norte e Centro a sofrer o maior impacto. Conclusões: As crises económicas constituem riscos significativos para comportamento suicidário, sendo esta uma área urgente para intervenção prioritária, especialmente no contexto do grande impacto económico da crise provocada pela pandemia de COVID-19, com enorme potencial impacto na saúde mental.Nunes, BaltazarRUNPinheiro, Vera20212024-09-13T00:00:00Z2021-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10362/135190TID:202942171enginfo:eu-repo/semantics/embargoedAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:13:38Zoai:run.unl.pt:10362/135190Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:48:20.854926Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
title |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
spellingShingle |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis Pinheiro, Vera suicide suicide attempts suicidal behavior self-inflicted injury hospitalizations mental health economic crisis unemployment suicídio tentativa de suicídio comportamento suicidário lesão autoinfligida hospitalizações saúde mental crise económica desemprego Domínio/Área Científica::Ciências Sociais::Outras Ciências Sociais |
title_short |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
title_full |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
title_fullStr |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
title_full_unstemmed |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
title_sort |
Association between the 2009-2014 economic crisis, suicide and self-harm in Portugal: time series analysis |
author |
Pinheiro, Vera |
author_facet |
Pinheiro, Vera |
author_role |
author |
dc.contributor.none.fl_str_mv |
Nunes, Baltazar RUN |
dc.contributor.author.fl_str_mv |
Pinheiro, Vera |
dc.subject.por.fl_str_mv |
suicide suicide attempts suicidal behavior self-inflicted injury hospitalizations mental health economic crisis unemployment suicídio tentativa de suicídio comportamento suicidário lesão autoinfligida hospitalizações saúde mental crise económica desemprego Domínio/Área Científica::Ciências Sociais::Outras Ciências Sociais |
topic |
suicide suicide attempts suicidal behavior self-inflicted injury hospitalizations mental health economic crisis unemployment suicídio tentativa de suicídio comportamento suicidário lesão autoinfligida hospitalizações saúde mental crise económica desemprego Domínio/Área Científica::Ciências Sociais::Outras Ciências Sociais |
description |
ABSTRACT - Background: It is well established that the health of a population is highly influenced by its socioeconomic context, welfare systems, labour markets, public policies, and demographic characteristics. Thus, changes in these key determinants may be reflected in the mental health and wellbeing of a population, through risk factors such as unemployment, financial strain, debts and job-related issues, as people posed with these challenges are usually more susceptible to mental ill-health. Following the worldwide economic crisis of 2008, several studies have found contradicting results in regards to this association, with some showing an increased risk for self-harm and suicidal behaviour, be it in the form of suicides or suicide attempts (many requiring urgent hospitalization), worldwide and in Europe, and others finding the opposite association. There is no research in Portugal on the matter. Therefore, our goal was to estimate the impact of the Portuguese economic crisis of 2009-2014 on the deaths and hospitalization rates trends by suicide and self-inflicted injury in Portugal. Methods: A retrospective ecological study, with an interrupted time series analysis of hospitalizations and deaths by suicide and self-inflicted injury (data from the national Hospital Morbidity Database) in mainland Portugal, between 2003 and 2014, was performed. Resident population data aged 15 years old or older was retrieved from the National Statistics Institute. Binomial negative generalized linear models were used to compare rates and trends before (2003-2008) and during (2009-2014) the Portuguese economic crisis. Regression coefficients were calculated (p<0.05) along with 95% Confidence Intervals. All rates were stratified and adjusted for seasonality. Results: Globally, for the whole mainland population, the 2009-2014 economic crisis in Portugal was associated with an increase in the hospitalization and death rate trends due to suicide and self-inflicted injury, with unemployment playing a significant albeit mixed mediating role. However, in line with previous results in the literature, many differences exist in different subgroups, with males, working-age groups (25-44 and 45- 64) and the North and Centre regions being the most impacted, globally. Conclusions: Economic downturns pose considerable risks for suicidal behavior. This should be a priority area for urgent intervention, especially in the context of the COVID- 19 pandemic crisis and the economic crisis it provoked, with a potentially tremendous impact in mental health. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021 2021-01-01T00:00:00Z 2024-09-13T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/135190 TID:202942171 |
url |
http://hdl.handle.net/10362/135190 |
identifier_str_mv |
TID:202942171 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/embargoedAccess |
eu_rights_str_mv |
embargoedAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799138084732796928 |