Gender differentials in suicide mortality

Objective: to identify gender differences in suicide mortality in Northeastern Brazil. Methods: the deaths from suicide recorded in the Mortality Information System were analyzed. The Chi-square (x2) for independence and odds ratio tests were used. The time trend was evaluated by the Joinpoint method. Results: in the period studied there were 27,101 suicide deaths in the Northeast, with a predominance of the male gender (79.5%). Adolescent women, with high schooling, widows, and divorcees are more prone to suicide than men. The male gender is more likely to use firearms and hanging, while the female gender uses more smoke, fire and flames and self-intoxication to commit the act. The most significant increase in mortality was among men (3.1%; p<0.05). Conclusion: there was a greater prevalence and tendency to increase suicide among men, as they use more lethal means to commit the act compared to women. Descriptors: Suicide; Mortality; Gender and Health; Time Series Studies; Ecological Studies. RESUMO Objetivo: identificar diferenças de gênero na mortalidade por suicídio no Nordeste brasileiro. Métodos: analisaram-se os óbitos por suicídio registrados no Sistema de Informação sobre Mortalidade. Foram empregados os testes de Qui-Quadrado (x2) para independência e razão de chances. A tendência temporal foi avaliada pelo método Joinpoint. Resultados: no período estudado ocorreram 27.101 óbitos por suicídio no Nordeste, com predominância do gênero masculino (79,5%). As mulheres adolescentes, com alta escolaridade, viúvas e divorciadas são mais propensas ao suicídio em comparação aos homens. O gênero masculino tem mais chances de utilizar armas de fogo e enforcamento, enquanto as mulheres utilizam mais fumaça, fogo e chamas e autointoxicação para cometer o ato. O aumento mais expressivo da mortalidade se deu entre os homens (3,1%; p<0,05). Conclusão: houve maior prevalência e tendência de aumento do suicídio entre os homens, pois estes utilizam meios mais letais para cometer o ato em comparação às mulheres. Descritores: Suicídio; Mortalidade; Gênero e Saúde; Estudos de Séries Temporais; Estudos Ecológicos. 1Universidade Estadual do Piauí. Parnaíba, PI, Brazil. 2Universidade Estadual do Ceará. Fortaleza, CE, Brazil. 3Universidade Federal do Piauí. Floriano, PI, Brazil. Corresponding author: Isaac Gonçalves da Silva Av. Nossa Sra. de Fátima, Bairro Nossa Sra. de Fátima, CEP: 64202-220. Parnaíba, PI, Brazil. E-mail: isaacgsilva@aluno.uespi. br EDITOR IN CHIEF: Ana Fatima Carvalho Fernandes ASSOCIATE EDITOR: Renan Alves Silva Isaac Gonçalves da Silva1 Thatiana Araujo Maranhão1 Taynara Lais Silva1 George Jó Bezerra Sousa2 José Claudio Garcia Lira Neto3 Maria Lúcia Duarte Pereira2 How to cite this article:: Silva IG, Maranhão TA, Silva TL, Sousa GJB, Lira Neto JCG, Pereira MLD. Gender differentials in suicide mortality. Rev Rene. 2021;22:e61520. DOI: https://doi.org/10.15253/2175-6783.20212261520 Silva IG, Maranhão TA, Silva TL, Sousa GJB, Lira Neto JCG, Pereira MLD Rev Rene. 2021;22:e61520. 2 Introduction According to the World Health Organization, about 800,000 people die every year from suicide, and for each adult who performs this act, at least 20 others attempt against their own lives without success. It is a complex and multifactorial phenomenon that is among the top twenty causes of death worldwide, surpassing the deaths resulting from wars and homicides. In light of this, self-provoked deaths represent a serious global public health problem that occurs most frequently in low and middle-income countries where, in turn, most of the world’s population is concentrated(1-2). Brazil is among the ten leading countries in absolute suicide numbers and, among the Brazilian regions, the Northeast region is highlighted, given the considerable increase of 72.4% in the rates of the bill of review observed in recent years(2-3). In the period from 2010 to 2014, 75.0% of the Northeastern municipalities had suicide mortality rates of up to 7.19 deaths per 100,000 inhabitants, and the states of Piauí and Ceará had the highest average mortality rates (7.77 and 6.92 deaths per 100,000 inhabitants, respectively)(4). Associated with the problem are general factors such as income inequality, low level of education, unemployment and the presence of mental disorders such as anxiety and depression(4-5). However, there are conditioning factors that are more common among individuals of a certain gender. Among them, we can mention the high consumption of alcohol and other substances, the presence of financial, criminal, and work-related problems among men, while among women suicide is more due to physical health problems, family issues, marital conflicts, and abusive relationships. In addition, the literature widely reports that women are more exposed to mistreatment and violence, especially sexual violence, which contribute to the highest rates of suicide attempts in this population(5-7). Although research has shown a steady increase in suicide mortality in Northeastern Brazil in recent decades(3,8-9), There are still few studies aimed at understanding the occurrence of this bill of review, according to the gender in the region(9). In this scenario, it is understood that the evaluation of individual factors that may lead to suicide among men and women contributes to a greater basis for health professionals in the formulation of intervention strategies aimed at reducing mortality in both populations. Therefore, this study aimed to identify gender differences in suicide mortality in Northeastern Brazil.