O suicídio na região sul do Brasil: um estudo ecológico com ênfase na faixa de fronteira

• Autor(a) principal: Arruda, Leandro Ricardo de
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do UNIOESTE
• Texto Completo: https://tede.unioeste.br/handle/tede/6727
• topic: Áreas de fronteira; Estudos de séries temporais; Sistemas de informação em saúde; Epidemiologia; Time series studies; Health information systems; Epidemiology; Border areas; Zonas Fronterizas; Estudios de series de tiempo; Sistemas de información de salud; Epidemiología; SAUDE COLETIVA::SAUDE PUBLICA

Suicide is a multifactorial and complex phenomenon indicated as one of the ten leading causes of death in the world and the third in the 15-34 age group. The study aimed to perform a spatialtemporal analysis of suicide cases in the municipalities of the Southern region of Brazil and its relationship with the border, in the period from 2010 to 2020. This is an ecological study of retrospective time series, descrip tive in nature and with a quantitative approach. From data collected in the Mortality Information System (SIM) database, we extracted the rates in people over five years of age, according to the municipality of residence, we calculated the rates per municipality, comparing them among the states of the Southern region, whether they belong to the borderland strip or not, and the year of occurrence. The global (global Moran's I) and local (LISA - Local Spatial Association Index) spatial dependence was analyzed. Purely spatial, spatio-temporal, and spatial isotonic scanning statistical techniques were applied, subsequently ARIMA temporal regression analysis was performed. A total of 28,468 suicide cases were found during the 11-year period in the Southern region, with Rio Grande do Sul (RS) standing out, with 13,250 cases and an average of 15.40 deaths/100,000 inhabitants. The spatial dependence analysis showed positive spatial autocorrelation for suicide cases in the southern region of Brazil, with a value of 0.3403 (p<0.001) and the local analysis showed an association of low values in municipalities in the north of the state of Paraná (PR), while the association of high values was seen in municipalities in the interior of Santa Catarina (SC) and RS. The spatial statistics found seven clusters, being cluster 1 with the largest radius with 211.82 km, comprising municipalities in SC and RS and border with RR of 1.84 (p<0.001). In the spatiotemporal analysis high RR was found for suicide in all localities, with two large RR clusters in the state of RS, however cluster of highest spatio-temporal RR was found in PR (Cluster 7, RR = 2.82, p>0.008). In the isotonic spatial scan, both the largest cluster and the highest RR was cluster 1, involving RS and SC (RR = 1.84, p<0.001). In much of the southern border range, areas of relative risk above 1 and statistical significance were found, indicating high probability of risk for the outcome, according to space and period. Considering the temporal regression analysis, there is predictability of suicide growth for the next five years in border and nonborder areas. The results of this study can support future research on spatial-temporal analysis for a better understanding of the theme and help public health managers make decisions to raise awareness and prevent the fatal outcome.