ArticleBMJ open2020
Association between homicide rates and suicide rates: a countrywide longitudinal analysis of 5507 Brazilian municipalities.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- One stream, two channels? A parallel-process latent class growth model of homicide rates and suicide rates in 183 countries, between 2000 and 2019.SSM - population health · 2023Article
- Contextual factors associated with country-level suicide mortality in the Americas, 2000-2019: a cross-sectional ecological study.Lancet regional health. Americas · 2023Article
- Cross-national examination of adolescent suicidal behavior: a pooled and multi-level analysis of 193,484 students from 53 LMIC countries.Social psychiatry and psychiatric epidemiology · 2022Article
- Relationship between the Bolsa Família national cash transfer programme and suicide incidence in Brazil: A quasi-experimental study.PLoS medicine · 2022Article
- Interpersonal violence and depression in Brazil: A cross-sectional analysis of the 2019 National Health Survey.PLOS global public health · 2022Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo estimate the association between homicide and suicide rates in Brazilian municipalities over a period of 7 years.
designWe conducted a longitudinal ecological study using annual mortality data from 5507 Brazilian municipalities between 2008 and 2014. Multivariable negative binomial regression models were used to examine the relationship between homicide and suicide rates. Robustness of results was explored using sensitivity analyses to examine the influence of data quality, population size, age and sex on the relationship between homicide and suicide rates.
settingA nationwide study of municipality-level data.
participantsMortality data and corresponding population estimates for municipal populations aged 10 years and older. PRIMARY AND SECONDARY OUTCOME MEASURES: Age-standardised suicide rates per 100 000.
resultsMunicipal suicide rates were positively associated with municipal homicide rates; after adjusting for socioeconomic and demographic factors, a doubling of the homicide rate was associated with 22% increase in suicide rate (rate ratio=1.22, 95% CI: 1.13 to 1.33). A dose-response effect was observed with 4% increase in suicide rates at the third quintile, 9% at the fourth quintile and 12% at the highest quintile of homicide rates compared with the lowest quintile. The observed effect estimates were robust to sensitivity analyses.
conclusionsMunicipalities with higher homicide rates have higher suicide rates and the relationship between homicide and suicide rates in Brazil exists independently of many sociodemographic and socioeconomic factors. Our results are in line with the hypothesis that changes in homicide rates lead to changes in suicide rates, although a causal association cannot be established from this study. Suicide and homicide rates have increased in Brazil despite increased community mental health support and incarceration, respectively; therefore, new avenues for intervention are needed. The identification of a positive relationship between homicide and suicide rates suggests that population-based interventions to reduce homicide rates may also reduce suicide rates in Brazil.
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