Abstract
This study aimed to analyze the spatial pattern in mortality rates from suicide in Brazil from 1990 to 2015. A spatial analysis was performed for the mortality rates from suicide in municipalities (counties) in three-year periods using Bayesian inference and clusters according to risk of death adjusted by sex and age bracket. The mortality rate from suicide increased from 3.5 deaths in 1990 to 5.3 deaths/100,000 inhabitants in 2015, when there was one death from suicide every 64 minutes. There was a predominance of suicide deaths in males in all the periods, while the variables age and race/color showed some changes. High suicide mortality rates among youth and indigenous people were seen in the most recent three-year period. We observed a loss of areas without suicide reporting, a reduction in areas with low suicide mortality rates, as opposed to an increase in areas with medium rates in all the regions of Brazil. The high rates, previously concentrated in the South of Brazil, had expanded to other regions of the country. Very high rates emerged in southern Mato Grosso do Sul state. Clusters with higher likelihood in all the periods were observed in the South. Suicide mortality rates increased, with changes in the spatial during the 25-year period. Despite the initial concentration of high suicide mortality rates in the South, the deaths spread to other regions of the country with different magnitudes. There was a reduction in suicide deaths among the elderly in the South and an increase in the Northeast, and an increase in deaths in adults and black Brazilians in the Central and among youth and indigenous persons in northwestern Amazonas state.
Highlights
Foi observada redução na taxa de óbitos por suicídio entre idosos no Sul (19%) e aumento na mesma faixa etária no Nordeste (35%), mantendose essa taxa estável na região do Cerrado
Na Região Sul do país, estão localizadas áreas com taxas de mortalidade por suicídio mais elevadas e é onde se formam os clusters de maior verossimilhança em todos os períodos analisados
A spatial analysis was performed for the mortality rates from suicide in municipalities in three-year periods using Bayesian inference and clusters according to risk of death adjusted by sex and age bracket
Summary
Realizou-se análise espacial das taxas de mortalidade por suicídio dos municípios, em triênios, por meio de inferência bayesiana e análise de clusters, segundo risco de óbito ajustado por sexo e faixa etária. Foi observada redução na taxa de óbitos por suicídio entre idosos no Sul (19%) e aumento na mesma faixa etária no Nordeste (35%), mantendose essa taxa estável na região do Cerrado. Na Região Sul do país, estão localizadas áreas com taxas de mortalidade por suicídio mais elevadas e é onde se formam os clusters de maior verossimilhança em todos os períodos analisados. É importante lembrar que a formação desses clusters também é influenciada pelos óbitos de indígenas ao sul do Mato Grosso do Sul. Ali habitam os índios da etnia Guarani/Kaiowá, que correspondem a aproximadamente 60% da população indígena do estado, e apresentam uma taxa de mortalidade por suicídio 22 vezes maior em relação ao restante da população brasileira 17,18. Tabela 1 Caracterização e perfil epidemiológico dos clusters espaciais da mortalidade por suicídio no Brasil entre 1990 e 1992
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