Temporal and spatial dynamics and factors related to suicide mortality among the elderly

Abstract

Objective: To analyze the temporal and spatial dynamics and factors associated with suicide mortality among the elderly (≥60 years of age) in Northeast of Brazil. Methods: This is an ecological study that analyzed deaths from suicide among elderly people in the Northeast region of Brazil, from 2010 to 2019. Temporal analysis by Joinpoint, spatial analysis according to municipality of residence and multi-variate analysis by the Ordinary Least Squares Estimation model were performed, considering p < 0.05. Results: During the analyzed period, a significant increase of 3.0% (95%CI: 1.1-4.9; p < 0.001) per year in suicide mortality was observed. Spatially, the highest rates were observed in municipalities of Piauí, Ceará and Rio Grande do Norte. Four statistically significant suicide clusters were identified (p < 0.001). The primary cluster (2010-2019) covered 141 municipalities in Ceará, Rio Grande do Norte and Paraíba, which presented a 2.3 times higher risk of suicide when compared to other municipalities in the region. The Gini index indicators (β = 14.02; p = 0.01), illiteracy rate (β = 0.20; p < 0.001) and aging rate (β = 0.36; p = 0.02) showed a positive association with suicide among the elderly, while the dependency ratio (β =-0.31; p < 0.001) and unemployment rate (β =-0.25; p < 0.001) had a negative association. Conclu-sion: There was a significant increase in suicide among the elderly in the Northeast region, with a gre-ater concentration in four spatial clusters located primarily in Ceará, Paraíba, Piauí and Rio Grande do Norte. The association with socioeconomic indicators reinforces aspects of vulnerability of the elderly to this type of injury and helps in the formulation of intervention proposals that promote its reduction.