2016, Number 3
Epidemiology of suicide in Cuba, 1987–2014
Language: English
References: 35
Page: 15-20
PDF size: 142.56 Kb.
ABSTRACT
Introduction Suicide is a health problem influenced by biological, genetic, psychological, social and economic factors. It is responsible for 50% of violent deaths in the male population, worldwide, and 71% in the female. In the Americas, 65,000 deaths by suicide occur every year. It is the ninth most frequent cause of death in Cuba, and third among people aged 10–19.Objective Characterize the epidemiology of suicide in Cuba from 1987 to 2014.
Methods A retrospective descriptive study was conducted. The information comprised all records of death by suicide from January 1, 1987 to December 31, 2014, in the Cuban Ministry of Public Health’s National Statistics Division database. The variables were sex, age, skin color, employment status/occupation, marital status, and method of suicide. Crude and age-standardized mortality rates and age–sex specifi c mortality rates were calculated, all per 100,000 population, as well as the sex ratio. Relative change over the series was calculated as a percentage. Distribution of suicides by variable was calculated and proportions expressed as percentages.
Results A total of 51,113 deaths by suicide were reported (annual average 1825), of which 34,671 (67.8%) were among men. The sex ratio was 2.1:1 for the entire study period, and 3.9:1 for 2011–2014. Over the course of the period studied, age-standardized suicide rates decreased from 23.9 to 10.8 per 100,000 population (54.8% reduction). The group aged ≥ 60 years had the highest average agestandardized rate, 44.6 per 100,000 population. The highest suicide burden by age was in the group aged 20–59 years (60.5%). By skin color, the highest burden was in those recorded as white, 68.9%. By marital status, the highest burden was in persons with a stable partner (46.7%), and by employment status/occupation, in retired (25.9%). The most commonly used method was hanging (59.4%).
Conclusions Over the course of about three decades, suicide mortality rates have declined by almost half and they are still slightly higher than overall rates in the Americas. The most commonly used method is hanging. The sex ratio is greater than two and has increased over time. The highest rates occur in the group aged ≥60 years, but finer stratification is needed to identify an age-related risk trend. In view of Cuba’s aging population, these results are of interest for epidemiology and public health.
REFERENCES
Pan American Health Organization. Clasifi cación internacional de enfermedades CIE-10. Causas externas de morbilidad y mortalidad. Lesiones auto infl igidas intencionalmente. Capítulo 20 (X60-X84) [Internet]. Washington, D.C.: Pan American Health Organization; 2001 [cited 2015 Jun 2]. Available from: http://ais.paho.org/classi fi cations/Chapters/. Spanish.
The World Bank. La carga mundial de morbilidad: generar evidencia, orientar políticas. Conclusiones principales de la edición regional para América Latina y el Caribe [Internet]. Seattle: IHME; 2013 [cited 2016 Feb 1]. Available from: http://www.healthdata.org/sites/default/files/ files/policy_report/2013/WB_LatinAmericaCari bbean/IHME_GBD_WorldBank_LatinAmericaCari bbean_TwoPager_SPANISH.pdf. Spanish.
Pan American Health Organization. Informe Subregional del Suicidio. Centro América y República Dominicana. 1988–2008 [Internet]. Panamá: Pan American Health Organization; 2011 [cited 2015 Nov 14]. 55 p. Available from: http://new.paho.org/ hq/dmdocuments/OPS%20Suicidio%20en%20 CA%20y%20RD.pdf. Spanish.
Rátiva Osorio JS, Ruiz Vélez VA, Medina- Pérez OA. Análisis de las noticias sobre suicidio publicadas en un diario local del Quindío Colombia, entre 2004 y 2011. Rev Cubana Hig Epidemiol [Internet]. 2013 [cited 2016 Jun 9];51(2):184–91. Available from: http:// scielo.sld.cu/scielo.php?pid=S1561-3003201 3000200007&script=sci_abstract. Spanish.
World Health Organization. 53. Consejo directivo 66.a Sesión del Comité Regional de la OMS para las Américas. Plan de Acción sobre la Salud Mental [Internet]. Washington, D.C.: World Health Organization; 2014 [cited 2016 Jan 2]; [about 20 p.]. Available from: http://www .paho.org/HQ/index.php?option=com_content &view=article&id=9774%3A2014-53rd-directing -council&catid=7003%3A53rd-directing-council -29-sep-3-oct&Itemid=41062&lang=es. Spanish.
Ministry of Sanitation, Social Services and Equity (ES). Manual de la Clasifi cación Internacional de Enfermedades, Traumatismos, y Causas de Defunción CIE-9. Suicidio y lesiones auto infl igidas. Código E (950-E959) [Internet]. Madrid: Ministry of Sanitation, Social Services and Equity (ES); [cited 2016 Jun 8]. Available from: https://eciemaps. mspsi.es/ecieMaps/browser/index_9_mc.html# search=&flags=111100&flagsLT=11111111&sea rchId=1465569802138&indiceAlfabetico=&listaTab ular=id-1-class-Tab.D&expand=0&clasifi cation=cie 9mc&version=2014. Spanish.
Trigylidas TE, Reynolds EM, Teshome G, Dykstra HK, Lichenstein R. Paediatric suicide in the USA: analysis of the National Child Death Case Reporting System. Inj Prev [Internet]. 2016 Jan 18 [cited 2016 Jun 7]. DOI: 10.1136/injury prev-2015-041796. Available from: http://inju ryprevention.bmj.com/content/early/2016/01/18/ injuryprev-2015-041796.abstract
Hedeland RL, Teilmann G, Jorgensen MH, Thiesen LR; Study Associated Pediatric Departments, Andersen J. Risk factors and characteristics of suicide attempts among 381 suicidal adolescents. Acta Paediatr [Internet]. 2016 May 4 [cited 2016 Jun 12]:1–8. Available from: http://onlinelibrary.wiley.com/doi/10.1111/ apa.13458/pdf
Cortés Alfaro A, Aguilar Valdés J, Medina Suárez R, Peña García C, Redondo de la Fe G, Acosta Quintana L. Intento suicida y factores de riesgos asociados en adolescentes. Santiago de Cuba, julio-diciembre 2007. Rev Hosp Psiquiátrico de la Habana [Internet]. 2011 [cited 2016 Jan 10];8(1):[about 6 screens]. Available from: http:// www.revistahph.sld.cu/hph0111/hph06111.html. Spanish.
Tuisku V. Depressed adolescents grow up: Prevalence, course and clinical risk factors of non-suicidal self-injury, suicidal ideation and suicide attempts [Internet]. Tampere: Tampere University Press; 2015 [cited 2016 Jun 8]. 98 p. Available from: https://tampub.uta.fi /bitstream/ handle/10024/96626/978-951-44-9695-0.pdf ?sequence=1
Del Toro Kondeff M, Hernández González Y, David Huerta B. Caracterización de la conducta suicida en adolescentes del municipio Cerro, 2009–2010. Rev Hosp Psiquiátrico de La Habana [Internet]. 2012 [cited 2015 Dec 14];9(2):[about 7 p.]. Available from: http:// www.revistahph.sld.cu/Revista%202-2012/hph 03212.html. Spanish.
Sarracent Sarracent A, García Pérez T, Brown Miclin P, Sarracent Pupo Y, Saavedra de la Cruz LA. Caracterización psicológica de los pacientes con suicidio consumado en La Habana en el año 2010. Rev Hosp Psiquiátrico de La Habana [Internet]. 2013 [cited 2015 Dec 29];17(2):[about 8 p.]. Available from: http://www.revistahph.sld.cu /hph0113/hph12113.html. Spanish.
Chávez Negrín E. Población y crisis económica en Cuba: la familia y la dinámica demográfi ca del “Período Especial” [Internet]. Havana: Center for Psychological and Sociological Research (CU); 2000 Nov [cited 2016 Jun 10]. 22 p. Available from: http://biblioteca.clacso.edu.ar/Cuba/ cips/20120827123508/negrin3.pdf. Spanish.
Bethancourt Santana YC, Bethancourt Enríquez J, Moreno Rodríguez Y, Saavedra Díaz A. Determinación de los factores psicosociales potenciadores de conductas suicidas en los adultos mayores. MEDICIEGO [Internet]. 2015 [cited 2016 Mar 2];21(1). Available from: http:// www.revmediciego.sld.cu/index.php/mediciego/ article/view/85. Spanish.
García Otero A, Prades de la Rosa E, Fernández Quintana M, Legrá Legrá Y, Zayas Medina C. Evaluación de los estados funcional y afectivo en la población geriátrica del área de salud “28 de Septiembre”. MEDISAN [Internet]. 2013 Feb [cited 2015 Dec 29];17(2):206–12. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext& pid=S1029-30192013000200006. Spanish.
Sánchez García S, Juárez Cedillo T, Gallego Carrillo K, Gallo JJ, Wagner FA, García Peña C. Frecuencia de los síntomas depresivos entre adultos mayores de la Ciudad de México. Salud Ment [Internet]. 2012 Jan–Feb [cited 2-15 Dec 29];35(1):71–7. Available from: http://www .scielo.org.mx/scielo.php?script=sci_arttext&p id=S0185-33252012000100011. Spanish.
Oquendo MA, Ellis SP, Greenwald S, Weissman MM, Mann JJ. Psiquiatria.com [Internet]. Palma de Mallorca: Psiquiatria.com; c2016. I Congreso Virtual de Psiquiatría. Suicidio en depresión mayor y diferencias étnicas. Conferencia 36-CI-B; 2015 Feb [cited 2015 Dec]. Available from: https://www .psiquiatria.com/congreso_old/mesas/mesa36/ conferencias/36_ci_b.htmh. Spanish.