背景:暴力死亡,包括自杀和凶杀,在美国构成了重大的公共卫生挑战。了解趋势并确定相关的风险因素对于有针对性的干预策略至关重要。
目的:使用疾病控制和预防中心的基于Web的伤害统计查询和报告系统在线数据库,研究过去二十年中自杀和凶杀的趋势,并确定人口统计学和背景预测因素。
方法:对2000年至2020年的死亡记录进行回顾性分析,利用多元回归分析。协变量包括年龄,种族,性别,教育,心理健康状况,和时间段。采用年龄调整率评估趋势。
结果:在过去的20年里,自杀率呈上升趋势,从大约10/100,000增加到14/100,000以上的个人,在美洲印第安人(100.8%的增长)和25岁及以下的个人(45.3%的增长)中,这是一个显着的增长。凶杀率,虽然相对稳定,在2019-2020年表现出显着增长,非洲裔美国人的比例一直最高,美洲印第安人的比例显着增加(73.2%的增长)。在多元回归分析中,受过高等教育的个人(OR=1.74,95%CI=1.70-1.78),抑郁症(OR=13.47,95%CI=13.04-13.91),和双相情感障碍(OR=2.65,95%CI=2.44-2.88)的自杀几率更高。凶杀的危险因素包括非洲裔美国人(OR=4.15,95%CI=4.08-4.23),拉丁裔(OR=2.31,95%CI=2.26-2.37),25岁及以下的人,以及那些受教育程度较低的人。
结论:这项研究强调了美国自杀和凶杀案人口结构的变化,以及有针对性的公共卫生对策的必要性。意味着限制,普遍的自杀筛查,解决心理健康的耻辱,实施广泛的干预措施,改变社会对自杀和凶杀的态度,是全面战略的重要组成部分。
BACKGROUND: Violent deaths, including suicides and homicides, pose a significant public health challenge in the United States. Understanding the trends and identifying associated risk factors is crucial for targeted intervention strategies.
OBJECTIVE: To examine the trends in suicides and homicides over the past two decades and identify demographic and contextual predictors using the Center for Disease Control and Prevention\'s Web-based Injury Statistics Query and Reporting System online database.
METHODS: A retrospective analysis of mortality records from 2000 to 2020 was conducted, utilizing multivariate regression analyses. Covariates included age, race, sex, education, mental health conditions, and time period. Age-adjusted rates were employed to assess trends.
RESULTS: Over the 20 years, there was an upward trajectory in suicide rates, increasing from approximately 10/100,000 to over 14/100,000 individuals, which is a notable increase among American Indians (100.8% increase) and individuals aged 25 years and younger (45.3% increase). Homicide rates, while relatively stable, exhibited a significant increase in 2019-2020, with African Americans consistently having the highest rates and a significant increase among American Indians (73.2% increase). In the multivariate regression analysis, Individuals with advanced education (OR= 1.74, 95% CI= 1.70 - 1.78), depression (OR = 13.47, 95% CI = 13.04 - 13.91), and bipolar disorder (OR = 2.65, 95% CI = 2.44 - 2.88) had higher odds of suicide. Risk factors for homicide include African Americans (OR = 4.15, 95% CI = 4.08 - 4.23), Latinx (OR = 2.31, 95% CI = 2.26 - 2.37), people aged 25 years and younger, and those with lower educational attainment.
CONCLUSIONS: This study highlights the changing demographic pattern in suicides and homicides in the United States and the need for targeted public health responses. Means restriction, universal suicide screening, addressing mental health stigma, and implementing broad interventions that modify societal attitudes toward suicide and homicides are essential components of a comprehensive strategy.