The geography of suicide in older adults in Hong Kong: An ecological study

Abstract

Objectives:The geography of suicide has been widely explored among the general population. However, little is known of the geographic variations in suicides among the older adults and their spatial correlates. This study aims to explore the spatial variations in the elderly suicide rates and their correlates in Hong Kong.Methods: Bayesian hierarchical models have been used to estimate smoothed standardized mortality ratios (2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) on suicide in people aged 65 years or older in each geographic unit in Hong Kong. Their associations with the Social Vulnerability Index and the accessibility of eight types of services (ie, recreational services, rehabilitation services, food services, daily necessity services, community services, and transportation services) were further analyzed. Results:The results suggested that compared with the simple "inner-city high suicide rate and suburban low" pattern in the Western studies and the "central low suicide rate and peripheral high" pattern in the Asian studies, the spatial variations of elderly suicides in Hong Kong exhibit a much more complicated pattern. In Hong Kong, higher elderly suicide clusters were found in both the lower-density areas located in the New Territories and in some inner-city areas. The spatial variations of suicide in the older adults cannot be explained by the Social Vulnerability Index.Instead, service provision such as recreational services, daily necessity resources, and community centers played a more significant role in affecting suicides in the older adults.Conclusions: Strengthening public services, providing more public spaces and activities, and making good use of the community resources might be key and efficient strategies in elderly suicide prevention in Hong Kong.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

“…So far, regional factors affecting suicide have been found to be related to the average income level of residents in the area [9,11,12], the average educational level, the employment or unemployment rate [9], socioeconimic characteristics of the region such as the financial independence of the region [7], the percentage of single-person households in the area [10], the population density [7,10], the divorce rate [7], the health and welfare budget [7], and social infrastructure such as medical institutions and leisure facilities [7]. In other words, the suicide rate was reported to be higher in economically disadvantaged regions [9,11,12] and in regions with a higher divorce rate [10]. In addition, areas with a low population density and with a high percentage single-person households were reported to have a higher rate of suicide related to loneliness [10], and the self-harm rate was higher in areas with a higher unemployment rate and a higher average age [9].…”

Socio-economic Characteristics Associated with Increased Suicide Risk Across 1887 Municipalities in Japan, 2009-2017.

“…15 An ecological study in Hong Kong indicated that neighborhood speci c features, such as recreational services, daily necessity resources, and community centers, were signi cantly associated with suicides in older adults. 39 In this study, higher levels of rurality assessed by population density were associated with an increased risk of suicide in males but not necessarily in females. Especially among males aged 0-39 years, population density was the strongest variables associated with an increased risk of suicide.…”

Associations between social fragmentation, socioeconomic deprivation and suicide risk across 1887 municipalities in Japan, 2009–2017: a spatial analysis using the Bayesian hierarchical model

“… 16 An ecological study in Hong Kong indicated that neighbourhood-specific features, such as recreational services, daily necessity resources and community centres, were significantly associated with suicide rates in older adults. 42 …”