An investigation of neighborhood-level social, economic and physical factors for railway suicide in Victoria, Australia

JOURNAL OF AFFECTIVE DISORDERS

卷:183

Article

Too, Lay San¹  Spittal, Matthew J.²  Bugeja, Lynda¹  Milner, Allison³  Stevenson, Mark⁴  McClure, Roderick⁵ 

[1] Monash Univ, Monash Injury Res Inst, Clayton, Vic 3800, Australia

[2] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Mental Hlth, Melbourne, Vic 3010, Australia

[3] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Hlth Equ, Melbourne, Vic 3010, Australia

[4] Univ Melbourne, Melbourne Sch Design, Melbourne, Vic 3010, Australia

[5] Harvard Univ, Sch Publ Hlth, Harvard Injury Control Res Ctr, Boston, MA 02115 USA

关键词: Suicide;    Railway;    Neighborhood;    Socio-environment;   

DOI  :  10.1016/j.jad.2015.05.006

来源: Elsevier

【 摘 要 】

Background: This study investigates the associations between railway suicide and neighborhood social, economic, and physical determinants using postcode level data It also examines whether the associations are influenced by having high concentration of high risk individuals in a neighborhood area. Methods: Railway suicide cases from Victoria, Australia for the period of 2001-2012, their age, sex, year of death, usual residential address and suicide location were obtained from the National Coronial Information System. Univariate negative binomial regression models were used to estimate the association between railway suicide and neighborhood level social, economic and physical factors. Variables which were significant in these univariate models were then assessed in a multivariate model, controlling for age and sex of the deceased and other known confounders. Results: Findings from the multivariate analysis indicate that an elevated rate of railway suicide was strongly associated with neighborhood exposure of higher number of railway stations (IRR=1.30 95% CI=1.16-1.46). Other significant neighborhood risk factors included patronage volume (IRR=1.06, 95% CI=1.02-1.11) and train frequency (IRR=1.02, 95% CI=1.01-1.04). An increased number of video surveillance systems at railway stations and carparks was significantly associated with a modest reduction in railway suicide risk (IRR=0.93, 95% CI=0.88-0.98). These associations were independent of concentration of high-risk individuals. Limitations: Railway suicide may be under-reported in Australia. Conclusions: Interventions to prevent railway suicide should target vulnerable individuals residing in areas characterized by high station density, patronage volume and train frequency. (C) 2015 Elsevier B.V. All rights reserved.

【 授权许可】

Free