Türkiye'deki intihar vakalarının mekânsal ve zamansal karakteristiklerinin sosyo-demografik ve ekonomik etmenlerle ilişkilerinin incelenmesi
Examining of the spatial and temporal characteristics of suicide cases in türkiye and their relationship with socio-demographic and economic factors
Yazar: DUYGU ALTINSU CANBAZ
Danışman: DOÇ. DR. AHMET ÖZGÜR DOĞRU
İstanbul Teknik Üniversitesi / Lisansüstü Eğitim Enstitüsü / Geomatik Mühendisliği Ana Bilim Dalı / Geomatik Mühendisliği Bilim Dalı
Derece: Yüksek Lisans, 2024
Konu: Bilim ve Teknoloji = Science and Technology ; Jeodezi ve Fotogrametri = Geodesy and Photogrammetry ; Mühendislik Bilimleri = Engineering Sciences
Dizin: Coğrafi bilgi sistemleri = Geographical information systems

Özet:
İntihar, bireyin yaşamını gönüllü olarak sona erdirmesidir. Dışarıdan bakıldığında bireysel bir olgu olarak görülse de nedenleri ve sonuçları irdelendiğinde toplumsal olduğu anlaşılmaktadır. Ciddi bir halk sağlığı problemi olan intihar, önlenebilir bir ölüm nedenidir. Bu nedenle intihar riski taşıyan grupları tespit etmek, intiharın önlenebilmesi için büyük önem taşımaktadır. 
Bu tez çalışması kapsamında 2002-2022 yılları arasında yaşanan intihar vakalarının mekânsal dağılımının iller ve bölgeler bazında incelenmesi, ekonomik ve sosyo-demografik etmenlerle ilişkilerinin istatistiksel olarak irdelenmesi amaçlanmıştır.
Türkiye'de 2002-2022 yılları arasında meydana gelen intihar vakalarının, iller ve istatistiki bölge birimleri bazında cinsiyete göre mekânsal dağılımları incelenmiştir. Buna ek olarak yoksulluk oranı ile mekânsal ilişkileri irdelenmiştir. Türkiye İstatistik Kurumu'ndan (TÜİK) elde edilen verileri mekânsal olarak analiz etmek için açık kaynak kodlu Coğrafi Bilgi Sistemleri (CBS) yazılımı olan QGIS kullanılmıştır. Analiz sonuçlarının görselleştirilmesi için koroplet haritalar ve orantılı işaretler kullanılarak tematik haritalar üretilmiştir. 
Epidemiyolojide kümelenmelerin tespiti, problemi önleme ve probleme müdahale aşamalarında büyük önem taşımaktadır. Bu nedenle bu çalışmada illere göre kaba intihar hızlarının kümelenmelerini incelemek adına sıcak nokta (hotspot) analizi yapılmıştır. 
Yapılan mekânsal analizler sonrasında 'İllere göre intihar sayısı ile cinsiyet arasında anlamlı bir fark var mıdır?' ve 'Bölgelere göre kaba intihar hızı ile yoksulluk oranı arasında anlamlı bir ilişki var mıdır?' soruları istatistiki olarak test edilmiştir. 
İntihar vakaları incelendiğinde çalışma kapsamındaki yıllarda erkek intihar sayısının kadın intihar sayısından daha fazla olduğu dikkat çekmektedir. 2002-2022 yılları arasında gerçekleşen intihar vakalarında erkekler tarafından gerçekleştirilen intiharların, meydana gelen intihar vakalarının %72'si olduğu görülmektedir. İntihar vakaları ve cinsiyet arasındaki ilişkiyi incelemek için yapılan Mann-Whitney U testi sonucunda intihar vakaları ile cinsiyet arasında anlamlı bir fark olduğu görülmüştür. 
TÜİK veritabanında intihar nedenleri; aile içi geçimsizlik, eğitim başarısızlığı, ticari başarısızlık, hastalık, duygusal ilişkiler ve maddi zorluklar olarak sınıflandırılmaktadır. Bireylerin psikolojisi ve davranışları, ekonomik koşullardaki düzensizlikler sonucunda etkilenmektedir. Bu nedenle yapılan çalışma kapsamında kaba intihar hızı ile yoksulluk oranı arasında anlamlı bir ilişkinin varlığı korelasyon testi ile irdelenmiştir. Yapılan analiz sonucunda kaba intihar hızı ile yoksulluk oranı arasında anlamlı bir ilişki bulunamamıştır.
Bireysel olduğu kadar toplumsal nedenlere de dayanan ve sonuçları açısından sosyal etki yaratan intihar gibi konuların sağlık alanında etkin bir şekilde kullanılan CBS yardımıyla ilişkilendirilerek ve görselleştirilerek incelenmesinin konuyu daha etkili hale getirebileceği öngörülmektedir. Çalışma sonucunda bireyin ait olduğu toplumun özellikleri göz önünde bulundurulduğunda toplumsal neden ve sonuçlara dayalı intiharlar ile ilgili çalışmaların daha yararlı olacağı düşünülmektedir.

Abstract:
Suicide is the voluntary end of one's life. Although it appears to be an individual phenomenon from the outside, when its causes and consequences are examined, it is understood that it is a social phenomenon. In order to reveal the social reasons for suicide, which is seen as a way out, it is necessary to examine the society to which the individual belongs. Although there are decreases in the crude suicide rate from time to time, it seems to be increasing throughout the country. Nearly 800,000 people die from suicide every year in the world. It is thought that this number is higher because the definitions of death are not precise. Considering the suicide rates in 2019, while this rate is 9.2 worldwide, it is 4.21 in Turkey. Although it is among the countries with low suicide rates in the world, suicide rates in Turkey are quite serious considering that a life is lost as a result of suicidal behavior. With its complex and multidimensional structure, suicidal behavior may vary from country to country and even regionally. For this reason, suicide prevention efforts should be approached at the national level as well as at the global level. Suicide, which has great effects on the individual and society, is affected by many psychological, genetic, socio-demographic, geographical and environmental parameters.
Suicide, a serious public health problem, is a preventable cause of death. Determining individual risk factors in suicide studies is of great importance in terms of preventing suicide, and identifying high-risk areas and investigating the spatial structure of suicide will provide a better understanding of the determinants of suicidal behavior compared to individual-level risk factors. Therefore, identifying high-risk areas using spatial analysis will help better use resources and suicide intervention efforts to prevent future suicides.
In this study, the spatial distribution of suicides that occurred in Turkey between 2002 and 2022 was examined by gender on the basis of provinces and statistical regional units. In addition, their relationship with Gross National Product and poverty rates were examined. The obtained data was stored in the PorgreSQL database management system. The raw data was finalized with the necessary arrangements. QGIS, an open source GIS (Geographic Information Systems) software, was used to spatially analyze the data obtained from TÜİK (Turkish Statistical Institute) on a provincial basis. The reason why QGIS software is preferred is that it is open source, open to development, has a user-friendly interface and does not have any license fees. Thematic maps and pie charts were used to visualize the analysis results. The graduated color distribution method was used to prepare the base maps.
The main purpose of spatial autocorrelation methods is to investigate the statistical closeness of phenomena observed in a certain place and time. Detection of clusters in epidemiology is of great importance in the prevention and intervention stages of the problem. For this reason, in this study, hotspot analysis was conducted with the Getis-Ord Gi* method to examine the clustering of crude suicide rates by province. In this method, by comparing the attribute values of each data with the attribute values of its neighboring data, it can be determined where high and low values are clustered. As a result of the study, it is recommended to conduct detailed analyzes in smaller areas in regions where clusters are dense. 
In this study covering the years 2002-2022, hot spot clusters were frequently encountered in the south of the Aegean Region, Tunceli and surrounding provinces, and Ardahan and surrounding provinces. It is important to conduct more comprehensive studies, especially in these regions, to identify risk factors that may cause suicide and to improve these conditions. In these regions, studies can be carried out on controlling access to various chemicals such as pesticides, narcotics and firearms used in suicide cases. Individuals who have attempted suicide before and have a family history of suicide have a higher tendency to commit suicide than other individuals. For this reason, it is thought that monitoring these individuals and providing psychological support will help reduce suicide cases.
After the spatial analysis, the question 'Is there a significant difference between the number of suicides and gender by province?' and 'Is there a significant relationship between the crude suicide rate and the poverty rate by region?' Questions such as these were tested statistically. The aim of the study was to determine high-risk areas and parameters that may be risk factors as a result of statistical and spatial examination of suicides. Thus, the study will be beneficial in making faster and more effective decisions during the prevention and intervention stages.
When the number of suicides is examined as a result of the study, it is noted that male suicides are more than female suicides every year. Looking at the overall 20 years, male suicides constitute 72% of the suicide cases. This may be because men attempt suicide using more lethal methods, are more impulsive, and seek help less than women. Although the number of suicide cases in men is higher than in women, the number of women attempting suicide is higher than men. As a result of the Mann Whitney-U test, it was seen that there was a significant difference between the number of suicides and gender.
In the TÜİK database, the reasons for suicide are classified as family discord, educational failure, commercial failure, illness, emotional relationships and financial difficulties. As a result of irregularities in economic conditions, individuals' psychology and behavior are affected. Many studies examining the effects of the economy on health show that suicide rates increase during periods of economic crisis. For this reason, this study examined the existence of a significant relationship between the crude suicide rate and the poverty rate by year. In the correlation analysis, no significant relationship was found between the crude suicide rate and the poverty rate.
In the study, some parameters that may be related to suicide cases were examined spatially and statistically. Due to the multi-layered nature of the phenomenon of suicide, it is recommended that future studies be conducted in multi-centres, in smaller areas, based on inter-institutional cooperation and with different parameters. Studying issues such as suicidal behavior, which are based on social as well as individual reasons and have a social impact in terms of their results, by associating and visualizing them with the help of GIS, which is effectively used in the field of health, will make the subject more effective. It is thought that studies on suicide based on social causes and consequences will be more useful when the characteristics of the society to which the individual belongs are taken into consideration.