Psychiatrist availability, social disintegration, and suicide deaths in U.S. counties, 1990–1995

Abstract

Previous studies have found that primary care resources are associated with various health outcomes. The primary purpose of the study was to test for associations between psychiatrist availability, social disintegration and suicide rates. Data utilized were from the 2002 Area Resource File on U.S. counties (N 5 3080). Suicide rates were averaged over 6 years covering 1990 through 1995. Poisson and Negative binomial regression models were used to assess the association of psychiatrist availability and suicide rate ratios. Availability of psychiatrists was significantly related to suicide. Counties with greater availability of psychiatrists per 10,000 experienced a 0.12% reduction in their suicide rates (b 5 À0.0012, incidence density ratio [IDR] 5 0.9988, 95% CI 5 0.9984-0.9992). Divorce strongly elevated suicide rates (b 5 0.0724, IDR 5 1.0751, 95% CI 5 1.0664-.0858). Counties with a high percentage of men 65 years or older had significantly high suicide rates. An increase in the White population between 1980 and 1990 was also associated with a significant increase in suicide. Increases in psychiatrists reduced suicide rates, but the association was small. Psychiatrist availability may also partially reduce the effects of social disintegration at the county level. Primary care was not associated with suicide once other variables, including hospital beds were taken into account. Results provide evidence to suggest that greater mental health promotion might reduce area inequalities in suicide rates. C

Association of temporal factors and suicides in the United States, 2000–2004

“…Studies in the United States consistently show that there are substantial disparities in rates and risks of suicide by race/ethnicity [ 11 , 30 , 38 , 40 ]. Racial differences in suicide have also been reported in South Africa, with whites experiencing much higher rates than Blacks, Coloureds or Asians in major South African cities [ 9 ].…”

“…Divorce was measured as divorces per 1,000 resident population in 2000. The variable has been generally used as an indicator of social integration or social fragmentation [ 8 , 12 , 20 , 25 , 36 , 38 ]. Both percent college educated, 2000 and the Gini Index of income inequality, 2000 were used as socioeconomic controls.…”

Impact of Firearm Availability and Gun Regulation on State Suicide Rates

“…Divisional divorce rates have no significant influence on overall suicide rates in states, but they do appear to increase mortality in three of four firearm suicide models, achieving significance at the 5% level only in one, the ownership model. Many prior studies have found a more robust, consistent association, both at the individual (Kposowa, 2000(Kposowa, , 2003 and aggregate (Breault, 1986;Kposowa, 2009) levels. Perhaps our finding is due to period or historical events: our divorce data were collected during the 2008-2009 recession.…”

Family-Oriented Informed Consent

“…The high quality social relationships typical of traditional forms of family life, for example, are associated in significant ways with positive mental health, as well as with decreases in morbidity and early mortality. 2 Strong familial relations also increase social integration, social regulation and support, even reduce the risk of suicide (Kposowa 2009; see also Kunce and Anderson 2002;Neumayer 2003;Breault 1986). In part also, within the family, persons discover themselves as already sustained by and within a web of pre-existing responsibilities and moral obligations (see, e.g., Lee 2014a, b;Deng 2014;.…”