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1.
Recurso na Internet em Português | LIS | ID: lis-49812

RESUMO

Uma pesquisa sobre a mortalidade por suicídio no Brasil revelou que a probabilidade de casos entre adolescentes tem crescido de forma mais intensa do que em outras faixas etárias. O estudo de tendência temporal realizado por pesquisadores da Escola Nacional de Saúde Pública (Ensp/Fiocruz) mostra que, entre 2000 e 2022, há indicativo de alta da proporção de suicídios em relação ao total de mortes em todos os grupos estudados.


Assuntos
Suicídio/etnologia , Adulto Jovem , Mortalidade , Probabilidade
2.
MMWR Morb Mortal Wkly Rep ; 73(37): 810-818, 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39298366

RESUMO

Introduction: Approximately 49,000 persons died by suicide in the United States in 2022, and provisional data indicate that a similar number died by suicide in 2023. A comprehensive approach that addresses upstream community risk and protective factors is an important component of suicide prevention. A better understanding of the role of these factors is needed, particularly among disproportionately affected populations. Methods: Suicide deaths were identified in the 2022 National Vital Statistics System. County-level factors, identified from federal data sources, included health insurance coverage, household broadband Internet access, and household income. Rates and levels of factors categorized by tertiles were calculated and presented by race and ethnicity, sex, age, and urbanicity. Results: In 2022, the overall suicide rate was 14.2 per 100,000 population; rates were highest among non-Hispanic American Indian or Alaska Native (AI/AN) persons (27.1), males (23.0), and rural residents (20.0). On average, suicide rates were lowest in counties in the top one third of percentage of persons or households with health insurance coverage (13.0), access to broadband Internet (13.3), and income >100% of the federal poverty level (13.5). These factors were more strongly associated with lower suicide rates in some disproportionately affected populations; among AI/AN persons, suicide rates in counties in the highest tertile of these factors were approximately one half the rates of counties in the lowest tertile. Conclusions and Implications for Public Health Practice: Higher levels of health insurance coverage, household broadband Internet access, and household income in communities might play a role in reducing suicide rates. Upstream programs, practices, and policies detailed in CDC's Suicide Prevention Resource for Action can be implemented by decision-makers, government agencies, and communities as they work together to address community-specific needs and save lives.


Assuntos
Suicídio , Humanos , Estados Unidos/epidemiologia , Masculino , Adulto , Feminino , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , Estatísticas Vitais , População Rural/estatística & dados numéricos , Fatores de Risco
3.
JAMA Pediatr ; 178(10): 1076-1078, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39158891

RESUMO

This cross-sectional study examines suicide mortality rates among Asian American youths and young adults overall and by ethnic subgroup from 2018 to 2021.


Assuntos
Asiático , Suicídio , Humanos , Adolescente , Asiático/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Estados Unidos/epidemiologia , Adulto Jovem , Masculino , Feminino , Criança , Adulto
4.
MMWR Surveill Summ ; 73(5): 1-44, 2024 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-38980822

RESUMO

Problem/Condition: In 2021, approximately 75,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2021. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. This report introduces additional incident and circumstance variables, which now include child victim-specific circumstance information. This report also incorporates new U.S. Census Bureau race and ethnicity categories, which now account for more than one race and Native Hawaiian or other Pacific Islander categories and include updated denominators to calculate rates for these populations. Period Covered: 2021. Description of System: NVDRS collects data regarding violent deaths from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2021. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (31 California counties, representing 64% of its population, and 13 Texas counties, representing 63% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. Results: For 2021, NVDRS collected information on 68,866 fatal incidents involving 70,688 deaths that occurred in 48 states (46 states collecting statewide data, 31 California counties, and 13 Texas counties), and the District of Columbia. The deaths captured in NVDRS accounted for 86.5% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2021. In addition, information was collected for 816 fatal incidents involving 880 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 70,688 deaths, the majority (58.2%) were suicides, followed by homicides (31.5%), deaths of undetermined intent that might be due to violence (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (<1.0%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.Demographic patterns and circumstances varied by manner of death. The suicide rate was higher for males than for females. Across all age groups, the suicide rate was highest among adults aged ≥85 years. In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups. Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known (84.4%), suicide was most often preceded by a mental health, intimate partner, or physical health problem or by a recent or impending crisis during the previous or upcoming 2 weeks. The homicide rate was higher for males than for females. Among all homicide victims, the homicide rate was highest among persons aged 20-24 years compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group. Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Homicide most often was precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male, and the legal intervention death rate was highest among men aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in the majority of legal intervention deaths. When circumstances were known, the most frequent circumstances reported for legal intervention deaths were as follows: the victim used a weapon in the incident and the victim had a substance use problem (other than alcohol use). Other causes of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths were most frequently experienced by males, non-Hispanic White (White) persons, and persons aged 15-24 years. These deaths most frequently occurred while the shooter was playing with a firearm and were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 30-54 years. Poisoning was the most common method of injury in deaths of undetermined intent, and opioids were detected in nearly 80% of decedents tested for those substances. Interpretation: This report provides a detailed summary of data from NVDRS on violent deaths that occurred in 2021. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black males. Intimate partner violence precipitated a large proportion of homicides for females. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary precipitating circumstances for multiple types of deaths examined. Public Health Action: Violence is preventable, and data can guide public health action. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent violent deaths. NVDRS data can be used to enhance prevention efforts into actionable strategies. States or jurisdictions have used their Violent Death Reporting System (VDRS) data to guide suicide prevention efforts and highlight where additional focus is needed. For example, North Carolina VDRS program data have played a significant role in expanding activities related to firearm safety and injury prevention. The program served as a primary data source for partners, which led to the creation of the Office of Violence Prevention in the state, focusing on combatting firearm-related deaths. In Maine, the VDRS provided data on law enforcement officer suicides that were used to help support a bill mandating mental health resiliency and awareness training in the state's law enforcement training academy, along with plans for similar training addressing mental health, substance use, and alcohol problems among corrections officers. In addition, states and jurisdictions have also used their VDRS data to examine factors related to homicide in their state or jurisdiction. For example, Georgia VDRS collaborated with the City of Atlanta Mayor's Office of Violence Reduction to develop two public dashboards that not only offer comprehensive data on violent deaths but also present data on the geographic distribution of populations disproportionately affected by violence to help inform violence prevention interventions.


Assuntos
Causas de Morte , Homicídio , Vigilância da População , Suicídio , Violência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Distribuição por Idade , District of Columbia/epidemiologia , Etnicidade/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Homicídio/etnologia , Porto Rico/epidemiologia , Porto Rico/etnologia , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Estados Unidos/epidemiologia , Violência/estatística & dados numéricos , Violência/etnologia , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico , Negro ou Afro-Americano , Hispânico ou Latino , Indígena Americano ou Nativo do Alasca , Brancos
6.
Lancet Psychiatry ; 11(8): 611-619, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-39025632

RESUMO

BACKGROUND: Understanding of ethnic disparities in suicide in England and Wales is poor as ethnicity is not recorded on death certificates. Using linked data, we examined variations, by sex, in suicide rates in England and Wales by ethnicity and migrant and descendant status. METHODS: Using the Office for National Statistics 2012-19 mortality data linked to the 2011 census from the Public Health Research Database, we calculated the age-standardised suicide rates by sex for each of the 18 self-identified ethnicity groups in England and Wales. We present rates by age, sex, and methods used for suicide by ethnic group. We estimated age-adjusted and sex-adjusted incidence rate ratios (IRRs) using Poisson regression models for each minority ethnic group compared with the majority population. We involved people with lived experience in the research. FINDINGS: Overall, 31 644 suicide deaths occurred over the study period, including 3602 (11%) in people from minority ethnic backgrounds, with a mean age of death of 43·3 years (SD 17·0, range 13-96). Almost all minority ethnic groups had a lower rate of suicide than the White British majority, apart from individuals who identified as being from a Mixed heritage background or White Gypsy or Irish Travellers. In females who identified as Mixed White and Caribbean, the suicide IRR was 1·79 (95% CI 1·45-2·21) compared with the White British majority; in those who identified as White Gypsy or Irish Travellers, the IRR was 2·26 (1·42-3·58). Rates in males identifying as from these two groups and those identifying as White Irish were similar to the White British majority. Compared with the non-migrant population, migrants had a lower rate of suicide regardless of ethnicity, but in the descendant population, people from a Mixed ethnicity background had a higher risk of suicide than the White British majority. INTERPRETATION: There are ethnic disparities in suicide mortality in England and Wales, but the reasons for this are unclear. The higher rate in previously overlooked minority ethnic groups warrants further attention. FUNDING: Wellcome Trust.


Assuntos
Etnicidade , Suicídio , Humanos , País de Gales/epidemiologia , Inglaterra/epidemiologia , Masculino , Feminino , Adulto , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , Etnicidade/estatística & dados numéricos , Etnicidade/psicologia , Estudos de Coortes , Idoso de 80 Anos ou mais
8.
J Couns Psychol ; 71(5): 459-472, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38976441

RESUMO

Suicide is a leading cause of death among Black emerging adults. The concurrent effect of the COVID-19 pandemic and racial discrimination were projected to exacerbate suicide vulnerability for Black Americans. The purpose of the present study was to utilize a risk-resilience model to examine the effects of racial discrimination and COVID-related stress on suicide risk for Black emerging adults, as well as the moderating effect of three central components of radical healing: critical consciousness, resilience, and cultural authenticity. Study participants included 521 Black emerging adults between the ages of 18 and 29 (51.6% male; Mage = 24.6, SD = 2.6) who completed measures evaluating symptoms of racial discrimination, COVID-related stress, suicide risk, and psychological well-being. After controlling for age, gender, socioeconomic status, and general stress, structural equation modeling analyses revealed unique and interactive effects of racial discrimination, COVID-related stress, and culturally relevant protective factors on suicide risk for Black emerging adults. These findings provide preliminary insight into novel risk and protective factors that influence suicide risk for Black emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Negro ou Afro-Americano , COVID-19 , Racismo , Sindemia , Humanos , COVID-19/psicologia , COVID-19/etnologia , Masculino , Feminino , Racismo/psicologia , Racismo/estatística & dados numéricos , Adulto , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Adulto Jovem , Adolescente , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Resiliência Psicológica , Estresse Psicológico/psicologia , SARS-CoV-2 , Fatores de Risco , Pandemias , Estados Unidos/epidemiologia , Estados Unidos/etnologia
9.
Acad Pediatr ; 24(5S): 25-31, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991798

RESUMO

Migrant youth who face forced displacement from their home countries have an emergent mental health burden, placing them at increased suicide risk. As such, it is crucial for pediatric providers to include suicide screening and assessment in their care for this population. Migrant families seek safety but, in many cases, encounter adverse events and psychosocial inequities in the migration journey and in the host community. Factors such as trauma, acculturative stress, and intersectionality influence suicide risk in migrants. Summative traumatic events contribute to the mental health load and worsen suicidal outcomes in migrant youth. Acculturative stress can lead to social marginalization in the host country, further adding to the existing mental health burden. Finally, intersectionality encompasses complex sociocultural influences, which shape the development of cultural identity in migrant youth and influence suicide risk. By examining these factors, the author advances cultural considerations in screening and assessment for suicide risk in migrant youth through evidence-based tools in pediatric clinical practice. Barriers to access to mental health services, stigma, and distrust of the health care system within the host community are also addressed. The author establishes recommendations for early suicide screening and prevention within this population through trauma-informed care, active advocacy, and cultural sensitivity.


Assuntos
Refugiados , Prevenção do Suicídio , Adolescente , Criança , Feminino , Humanos , Aculturação , Acessibilidade aos Serviços de Saúde , Serviços de Saúde Mental , Refugiados/psicologia , Medição de Risco , Estigma Social , Suicídio/psicologia , Suicídio/etnologia , Migrantes/psicologia
11.
Arch Psychiatr Nurs ; 51: 259-267, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-39034087

RESUMO

Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.


Assuntos
Indígena Americano ou Nativo do Alasca , Apoio Social , Ideação Suicida , Prevenção do Suicídio , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indígena Americano ou Nativo do Alasca/psicologia , Estudos Transversais , Depressão/psicologia , Depressão/etnologia , Fatores de Proteção , Suicídio/psicologia , Suicídio/etnologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/etnologia
12.
J Community Health ; 49(6): 1054-1061, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38853209

RESUMO

Each year millions of females develop serious mental illnesses (SMI), which are major risk factors for suicides. Using the Web-Based Injury Statistics Query and Reporting System (WISQARS) for the years 2000, 2010 and 2020, we found in 2020 9,428 females (almost 190/week) committed suicide, losing 328,653 years off potential life before age 80 years. There were pronounced increases in female suicides from 2000 to 2020 across all racial and ethnic groups. The greatest number of suicides were in non-Hispanic white females, but the highest rate of suicides was in non-Hispanic American Indians /Alaska Natives, and in females 15-24 years of age. The West had the highest female suicide rates, with methods used to commit suicides varying by census regions and race and ethnicity. Suffocation to commit suicide increased for most racial and ethnic groups and poisonings decreased for most groups between 2000 and 2020, These underscore the need for targeted primary prevention of suicides for females based on age, geographic location and method of suicide, to mitigate female suicides improved access (e.g. geographically and financially) to mental health care services is essential.


Assuntos
Grupos Raciais , Suicídio , Humanos , Feminino , Adolescente , Adulto , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Adulto Jovem , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Idoso , Grupos Raciais/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Idoso de 80 Anos ou mais , Criança , Fatores de Risco
13.
Am J Public Health ; 114(7): 733-742, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38754064

RESUMO

Objectives. To examine changes in cause-specific pregnancy-associated deaths during the COVID-19 pandemic by race and ethnicity and assess changes in racial and ethnic inequities in pregnancy-associated deaths. Methods. We used US vital statistics mortality data from 2018 to 2021 to identify pregnancy-associated deaths among females aged 15 to 44 years. We calculated crude pregnancy-associated death rates (deaths per 100 000 live births) by year, cause, and race/ethnicity, percent change in death rate, and the inequity (difference) in rate for each racial or ethnic group compared with non-Hispanic White people. Results. The pregnancy-associated death rate for obstetric, drug-related, homicide, and other causes of death increased during 2020, and obstetric deaths continued to increase in 2021. Overall estimates mask 2021 increases in drug-related deaths among Hispanic, non-Hispanic American Indian and Alaska Native (AI/AN), and non-Hispanic Asian people; increases in homicide among most racial and ethnic groups; and increases in suicide among Hispanic, non-Hispanic AI/AN, and non-Hispanic Asian people. Conclusions. We found disproportionate increases in pregnancy-associated deaths from nonobstetric causes among minoritized racial and ethnic groups during the COVID-19 pandemic. (Am J Public Health. 2024;114(7):733-742. https://doi.org/10.2105/AJPH.2024.307651).


Assuntos
COVID-19 , Causas de Morte , Adolescente , Adulto , Feminino , Humanos , Gravidez , Adulto Jovem , COVID-19/mortalidade , COVID-19/etnologia , Etnicidade/estatística & dados numéricos , Desigualdades de Saúde , Disparidades nos Níveis de Saúde , Pandemias , Complicações na Gravidez/etnologia , Complicações na Gravidez/mortalidade , Grupos Raciais/estatística & dados numéricos , SARS-CoV-2 , Estados Unidos/epidemiologia , Hispânico ou Latino , Indígena Americano ou Nativo do Alasca , Asiático , Homicídio/etnologia , Homicídio/estatística & dados numéricos , Suicídio/etnologia , Suicídio/estatística & dados numéricos
14.
Ann Epidemiol ; 94: 91-99, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38710240

RESUMO

INTRODUCTION: Suicide deaths among Black youth in the US have increased rapidly over the past decade. Direct or vicarious racial trauma experienced through exposure to police brutality may underlie these concerning trends. METHODS: We obtained nationally aggregated monthly counts of suicides for non-Hispanic Black and White youth (age ≤ 24 years) and adults (age > 24 years) from the National Mortality Vital Statistics restricted-use data files provided by the Centers for Disease Control and Prevention, from 2013 to 2019. Monthly counts of Black youth suicides constituted our main outcome. We defined our exposure as the monthly counts of police killings of unarmed Black persons over 84 months (2013 to 2019), retrieved from the Mapping Police Violence database. We used ARIMA (AutoRegressive Integrated Moving Average) time-series analyses to examine whether Black youth suicides increased within 0 to 3 months following police killings of unarmed Black persons, controlling for autocorrelation and corresponding series of White youth suicides. RESULTS: Suicides among Black youth increase by ∼1 count three months following an increase in police killings of unarmed Black persons (exposure lag 0 coefficient = 0.16, p > 0.05; exposure lag 1 coefficient = -0.70, p > 0.05; exposure lag 2 coefficient = -0.54, p > 0.05; exposure lag 3 coefficient = 0.95, p < 0.05). The observed increase in suicides concentrates among Black male youth (exposure lag 3 coefficient = 0.88, p < 0.05).


Assuntos
Negro ou Afro-Americano , Polícia , Suicídio , Humanos , Polícia/estatística & dados numéricos , Masculino , Negro ou Afro-Americano/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Feminino , Suicídio/estatística & dados numéricos , Suicídio/etnologia , Adolescente , Estados Unidos/epidemiologia , Adulto Jovem , Adulto , População Branca/estatística & dados numéricos , Homicídio/estatística & dados numéricos , Homicídio/etnologia , Violência/estatística & dados numéricos , Violência/etnologia
15.
JAMA ; 331(20): 1732-1740, 2024 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-38703403

RESUMO

Importance: Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking. Objective: To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race. Design, Setting, and Participants: This cross-sectional study conducted temporal analysis (1999-2020) and comparison of aggregate mortality rates (2016-2020) for youth aged 1 to 19 years using US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Data were analyzed from June 30, 2023, to January 17, 2024. Main Outcomes and Measures: Pooled, all-cause, and cause-specific mortality rates per 100 000 youth (hereinafter, per 100 000) for leading underlying causes of death were compared. Injuries were classified by mechanism and intent. Results: Between 1999 and 2020, there were 491 680 deaths among US youth, including 8894 (1.8%) American Indian or Alaska Native, 14 507 (3.0%) Asian or Pacific Islander, 110 154 (22.4%) Black, 89 251 (18.2%) Hispanic, and 267 452 (54.4%) White youth. Between 2016 and 2020, pooled all-cause mortality rates were 48.79 per 100 000 (95% CI, 46.58-51.00) in American Indian or Alaska Native youth, 15.25 per 100 000 (95% CI, 14.75-15.76) in Asian or Pacific Islander youth, 42.33 per 100 000 (95% CI, 41.81-42.86) in Black youth, 21.48 per 100 000 (95% CI, 21.19-21.77) in Hispanic youth, and 24.07 per 100 000 (95% CI, 23.86-24.28) in White youth. All-cause mortality ratios compared with White youth were 2.03 (95% CI, 1.93-2.12) among American Indian or Alaska Native youth, 0.63 (95% CI, 0.61-0.66) among Asian or Pacific Islander youth, 1.76 (95% CI, 1.73-1.79) among Black youth, and 0.89 (95% CI, 0.88-0.91) among Hispanic youth. From 2016 to 2020, the homicide rate in Black youth was 12.81 (95% CI, 12.52-13.10) per 100 000, which was 10.20 (95% CI, 9.75-10.66) times that of White youth. The suicide rate for American Indian or Alaska Native youth was 11.37 (95% CI, 10.30-12.43) per 100 000, which was 2.60 (95% CI, 2.35-2.86) times that of White youth. The firearm mortality rate for Black youth was 12.88 (95% CI, 12.59-13.17) per 100 000, which was 4.14 (95% CI, 4.00-4.28) times that of White youth. American Indian or Alaska Native youth had a firearm mortality rate of 6.67 (95% CI, 5.85-7.49) per 100 000, which was 2.14 (95% CI, 1.88- 2.43) times that of White youth. Black youth had an asthma mortality rate of 1.10 (95% CI, 1.01-1.18) per 100 000, which was 7.80 (95% CI, 6.78-8.99) times that of White youth. Conclusions and Relevance: In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.


Assuntos
Asma , Disparidades nos Níveis de Saúde , Mortalidade , Transtornos Relacionados ao Uso de Substâncias , Suicídio , Ferimentos e Lesões , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Adulto Jovem , Causas de Morte/tendências , Estudos Transversais , Etnicidade/estatística & dados numéricos , Mortalidade/etnologia , Mortalidade/tendências , Suicídio/etnologia , Suicídio/estatística & dados numéricos , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/etnologia , Ferimentos e Lesões/mortalidade , Grupos Raciais/etnologia , Grupos Raciais/estatística & dados numéricos , Indígena Americano ou Nativo do Alasca/estatística & dados numéricos , Brancos/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Nativo Asiático-Americano do Havaí e das Ilhas do Pacífico/estatística & dados numéricos , Asma/epidemiologia , Asma/etnologia , Asma/mortalidade , Homicídio/etnologia , Homicídio/estatística & dados numéricos , Armas de Fogo/estatística & dados numéricos , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/etnologia , Ferimentos por Arma de Fogo/mortalidade , Acidentes de Trânsito/mortalidade , Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/tendências , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/mortalidade
18.
J Immigr Minor Health ; 26(4): 660-666, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38619673

RESUMO

Suicide remains a major public health problem, with nearly 1 million deaths per year. The number tends to increase over time and factors leading to suicide suicidal behaviors are complex. However, there is a paucity of evidence on suicidal behaviors and the associated factors among people living with HIV (PLWH) in Indonesia. Therefore, this study aimed to estimate the prevalence and associated factors of suicidal behavior between indigenous and non-indigenous living with HIV who were on Dolutegravir and Efavirenz therapies. The cross-sectional data were collected using questionnaires. Participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Depression Anxiety Stress Scale-42 (DASS-42), HIV Stigma-Sowell Scale, and demographic information questions. The outcome was low and high self-reported suicidal behaviors, while logistic regression analyses were used to estimate adjusted odds ratios (aOR) for associated factors of high suicidal behaviors. A total of 200 PLWH were enrolled and 8.5% of the participants had high levels of suicidal behaviors. The majority of participants were Efavirenz users (84.0%), and Papuans as Indigenous (75.5%). More than half had a high school education (60.5%), were female (58%), married (54%), and unpaid (59%). The multiple logistic regression model showed that indigenous (aOR = 0.122; 95% CI = 0.029-0.514), and people who had children (aOR = 0.221; 95% CI = 0.051-0.957) were more likely to have low suicidal behaviors. Participants who were aged 18-27 years (aOR = 5.894; 95% CI = 1.336-30.579), had high self-blame (aOR = 1.342; 95% CI) = 1.004-1.792), and detectable HIV viral load (aOR = 6.177; 95%CI = 1.118-34.119) had high suicidal behavior. This study identified the risk of suicidality among PLWHs is high and routine suicide assessment is prioritized. The findings are also useful for intervention design and the development of clinical practice guidelines to manage the well-being of PLWH such as using digital intervention to cope with hindrances.


Assuntos
Benzoxazinas , Ciclopropanos , Infecções por HIV , Humanos , Feminino , Masculino , Indonésia/epidemiologia , Estudos Transversais , Adulto , Infecções por HIV/etnologia , Infecções por HIV/tratamento farmacológico , Benzoxazinas/uso terapêutico , Pessoa de Meia-Idade , Alcinos , Adulto Jovem , Fármacos Anti-HIV/uso terapêutico , Piridonas/uso terapêutico , Ideação Suicida , Adolescente , Fatores de Risco , Piperazinas/uso terapêutico , Suicídio/etnologia , Fatores Socioeconômicos , Prevalência
19.
J Am Acad Child Adolesc Psychiatry ; 63(8): 757-760, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38537735

RESUMO

Youth of color are often exposed to racism at both systemic and individual levels. Interpersonal racial/ethnic discrimination is the behavioral manifestation of individual racism.1,2 While direct individual experiences of racism (eg, comments directed at the individual) have deleterious effects for the socioemotional well-being of youth of color,3 research also points to the negative effects of broader exposure to racism (eg, viewing racist comments, images, or videos online1,2) that is not experienced directly. Now that social media (SM) has become a prominent and ubiquitous source of social interactions for adolescents, research on the influence of racism on youth must contend with this new medium. This is especially the case for youth of color, particularly Black and Hispanic/Latine youth, who report more SM use than White youth who do not identify as Hispanic/Latine.4 The unique features of SM, including its permanence, publicness, and personalized algorithms, may increase both direct and indirect experiences of online racism for youth of color, particularly due to its constant availability and highly visual nature, which likely expose and re-expose youth of color to a variety of online racist experiences. Approximately 20% of all Black adolescents sampled in a large national survey reported that they were the target of online bullying or harassment because of their racial or ethnic identity.4 Indeed, exposure to direct and indirect online racism is associated with negative mental health outcomes for youth of color,5,6 including posttraumatic symptoms, depression, and anxiety.


Assuntos
Negro ou Afro-Americano , Hispânico ou Latino , Racismo , Mídias Sociais , Humanos , Adolescente , Racismo/etnologia , Masculino , Feminino , Hispânico ou Latino/psicologia , Suicídio/etnologia , Suicídio/psicologia
20.
JAMA Netw Open ; 7(2): e2354953, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38319659

RESUMO

Importance: Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. Objective: To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. Design, Setting, and Participants: This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023. Exposures: Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting. Main Outcomes and Measures: Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors. Results: The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]). Conclusions and Relevance: In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.


Assuntos
Negro ou Afro-Americano , Exposição à Violência , Violência com Arma de Fogo , Suicídio , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Negra/psicologia , População Negra/estatística & dados numéricos , Estudos Transversais , Exposição à Violência/etnologia , Exposição à Violência/psicologia , Exposição à Violência/estatística & dados numéricos , Violência com Arma de Fogo/etnologia , Violência com Arma de Fogo/psicologia , Violência com Arma de Fogo/estatística & dados numéricos , Violência/etnologia , Violência/psicologia , Violência/estatística & dados numéricos , Suicídio/etnologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Ideação Suicida , Tentativa de Suicídio/etnologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos
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