RESUMO
Background: A suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006-14. Methods: This study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran's I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide. Results: The results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females. Conclusion: The results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention.
RESUMO
Background: Proper access to health care centres and services is one of the key indicators of health justice, and it is more than ever important in slums. Objective: This aim of this research is to evaluate the accessibility of health care centres to slum residents in the Kermanshah metropolis, Iran during the period 1996-2016. Methods: In this cross-sectional study, data was obtained from the Census of Iran for the periods 1996, 2006 and 2016. Information on the number and location of health care centres was collected from the Kermanshah University of Medical Sciences. Network Analysis modelling method in Arc/GIS10.6 software was used to evaluate the accessibility of people to health centres. Results: The results show that the spatial pattern of health centres in Kermanshah was random during 1996, 2006 and 2016, but the spatial pattern of poverty in the metropolis was clustered. In addition, the distribution of health centres was not consistent with the population densities. However, the overall population with inappropriate access to health centres in the slums of Kermanshah metropolis decreased over the study period (1996-54.02%, 2006-51.09%, and 2016-34.71%). Conclusions: The findings of the study reveal that access to health care services by the slum population is not consistent with the increase of health care centres. This means that health policymakers were unsuccessful to provide the required health care services for the slums.